CORRESPONDING AUTHOR:
Name: Régine P.M. Steegers-Theunissen
Erasmus MC, University Medical Centre
Department of Obstetrics and Gynaecology
PO Box 2040, 3000 CA, Rotterdam, The Netherlands
Phone: +31 10 7038254 / Fax: +31 10 7036815
E-mail: r.steegers@erasmusmc.nl
RUNNING TITLE: Ultra-processed foods and utero-placental vascular
development
ABSTRACT
Objective: To investigate whether periconceptional maternal
intake of ultra-processed foods (UPF) impairs first-trimester
utero-placental vascular development, and whether macronutrients and
dietary patterns substantiate the associations.
Design: Prospective observational cohort.
Setting: Academic hospital.
Population or Sample: Ongoing pregnancies.
Methods: 93 women completed a food frequency questionnaire from
which we calculated percentage of energy intake from UPF, intake of
energy and macronutrients and adherence to dietary patterns. We
performed sequential three-dimensional power Doppler ultrasounds of the
first-trimester utero-placental vasculature. VOCAL software, Virtual
Reality segmentation and a skeletonization algorithm were applied to
measure placental volume (PV), utero-placental vascular volume (uPVV)
and generate the utero-placental vascular skeleton (uPVS). Absolute
vascular morphology was quantified by assigning a morphologic
characteristic to each voxel in the uPVS (end-, bifurcation-, crossing-
or vessel point) and used to calculate density of vascular branching.
Main Outcome Measures: PV, uPVV, uPVS characteristics and density
of vascular branching.
Results: Fully adjusted linear mixed models showed a 10%/day
higher UPF intake was associated with increased first-trimester density
of vascular branching (bifurcation points: β =0.465√n,
95%CI=0.148;0.782). Higher carbohydrate intake of 10g/day was
associated with increased trajectories of uPVV (β=0.017,
95%CI=0.001;0.032) and uPVS (end points (β=0.286, 95%CI=0.062;0.511),
bifurcation points (β=0.004, 95%CI=0.003;0.006), vessel points
(β=0.772, 95%CI=0.137;1.408). The associations were substantiated by
the adherence to the “Snack” dietary pattern.
Conclusions: Periconceptional maternal intake of UPF is
associated with impaired first-trimester utero-placental vascular
development, whereas the intake of carbohydrates and strong adherence to
a ‘Snack’ dietary pattern, is positively associated with first-trimester
utero-placental vascular development.
Funding: This research was funded by the Department of Obstetrics
and Gynaecology of the Erasmus MC, University Medical Centre Rotterdam,
Rotterdam, The Netherlands.
Keywords :
- Early pregnancy
- Periconceptional nutritional intake
- Ultra-processed foods
- Placental (vascular) development
- 3D power Doppler Ultrasound
FUNDING:
This research was funded by the Department of Obstetrics and Gynaecology
of the Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The
Netherlands.