Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial
Abstract Introduction The IMPACT BCN trial—a parallel‐group randomized clinical trial where 1221 pregnant women at high risk for small‐for‐gestational age (SGA) newborns were randomly allocated at 19‐ to 23‐week gestation into three groups: Mediterranean diet, Mindfulness‐based Stress reduction or n...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-10-01
|
| Series: | Acta Obstetricia et Gynecologica Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/aogs.14874 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850211284758298624 |
|---|---|
| author | Ayako Nakaki Eugenio Denaro Maddalena Crimella Roberta Castellani Kilian Vellvé Nora Izquierdo Annachiara Basso Cristina Paules Rosa Casas Leticia Benitez Irene Casas Marta Larroya Mariona Genero Sara Castro‐Barquero Alex Gomez‐Gomez Óscar J. Pozo Eduard Vieta Ramon Estruch Alfons Nadal Eduard Gratacós Francesca Crovetto Fàtima Crispi Lina Youssef |
| author_facet | Ayako Nakaki Eugenio Denaro Maddalena Crimella Roberta Castellani Kilian Vellvé Nora Izquierdo Annachiara Basso Cristina Paules Rosa Casas Leticia Benitez Irene Casas Marta Larroya Mariona Genero Sara Castro‐Barquero Alex Gomez‐Gomez Óscar J. Pozo Eduard Vieta Ramon Estruch Alfons Nadal Eduard Gratacós Francesca Crovetto Fàtima Crispi Lina Youssef |
| author_sort | Ayako Nakaki |
| collection | DOAJ |
| description | Abstract Introduction The IMPACT BCN trial—a parallel‐group randomized clinical trial where 1221 pregnant women at high risk for small‐for‐gestational age (SGA) newborns were randomly allocated at 19‐ to 23‐week gestation into three groups: Mediterranean diet, Mindfulness‐based Stress reduction or non‐intervention—has demonstrated a positive effect of Mediterranean diet and Stress reduction in the prevention of SGA. However, the mechanism of action of these interventions remains still unclear. The aim of this study is to investigate the effect of Mediterranean diet and Stress reduction on placental volume and perfusion. Material and Methods Participants in the Mediterranean diet group received monthly individual and group educational sessions, and free provision of extra‐virgin olive oil and walnuts. Women in the Stress reduction group underwent an 8‐week Stress reduction program adapted for pregnancy, consisting of weekly 2.5‐h and one full‐day sessions. Non‐intervention group was based on usual care. Placental volume and perfusion were assessed in a subgroup of randomly selected women (n = 165) using magnetic resonance (MR) at 36‐week gestation. Small placental volume was defined as MR estimated volume <10th centile. Perfusion was assessed by intravoxel incoherent motion. Results While mean MR placental volume was similar among the study groups, both interventions were associated with a lower prevalence of small placental volume (3.9% Mediterranean diet and 5% stress reduction vs. 17% non‐intervention; p = 0.03 and p = 0.04, respectively). Logistic regression showed that small placental volume was significantly associated with higher risk of SGA in both study groups (OR 7.48 [1.99–28.09] in Mediterranean diet and 20.44 [5.13–81.4] in Stress reduction). Mediation analysis showed that the effect of Mediterranean diet on SGA can be decomposed by a direct effect and an indirect effect (56.6%) mediated by a small placental volume. Similarly, the effect of Stress reduction on SGA is partially mediated (45.3%) by a small placental volume. Results on placental intravoxel incoherent motion perfusion fraction and diffusion coefficient were similar among the study groups. Conclusions Structured interventions during pregnancy based on Mediterranean diet or Stress reduction are associated with a lower proportion of small placentas, which is consistent with the previously observed beneficial effects of these interventions on fetal growth. |
| format | Article |
| id | doaj-art-81ddf4e028374da3b2bd567d344681c6 |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-81ddf4e028374da3b2bd567d344681c62025-08-20T02:09:35ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-10-01103102042205210.1111/aogs.14874Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trialAyako Nakaki0Eugenio Denaro1Maddalena Crimella2Roberta Castellani3Kilian Vellvé4Nora Izquierdo5Annachiara Basso6Cristina Paules7Rosa Casas8Leticia Benitez9Irene Casas10Marta Larroya11Mariona Genero12Sara Castro‐Barquero13Alex Gomez‐Gomez14Óscar J. Pozo15Eduard Vieta16Ramon Estruch17Alfons Nadal18Eduard Gratacós19Francesca Crovetto20Fàtima Crispi21Lina Youssef22BCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainDepartment of Internal Medicine Hospital Clinic, IDIBAPS University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainIntegrative Pharmacology and Systems Neuroscience Group IMIM (Hospital del Mar Medical Research Institute) Barcelona SpainIntegrative Pharmacology and Systems Neuroscience Group IMIM (Hospital del Mar Medical Research Institute) Barcelona SpainInstitut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS) Barcelona SpainInstitut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS) Barcelona SpainInstitut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS) Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainBCNatal – Barcelona Center for Maternal‐Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu) University of Barcelona Barcelona SpainAbstract Introduction The IMPACT BCN trial—a parallel‐group randomized clinical trial where 1221 pregnant women at high risk for small‐for‐gestational age (SGA) newborns were randomly allocated at 19‐ to 23‐week gestation into three groups: Mediterranean diet, Mindfulness‐based Stress reduction or non‐intervention—has demonstrated a positive effect of Mediterranean diet and Stress reduction in the prevention of SGA. However, the mechanism of action of these interventions remains still unclear. The aim of this study is to investigate the effect of Mediterranean diet and Stress reduction on placental volume and perfusion. Material and Methods Participants in the Mediterranean diet group received monthly individual and group educational sessions, and free provision of extra‐virgin olive oil and walnuts. Women in the Stress reduction group underwent an 8‐week Stress reduction program adapted for pregnancy, consisting of weekly 2.5‐h and one full‐day sessions. Non‐intervention group was based on usual care. Placental volume and perfusion were assessed in a subgroup of randomly selected women (n = 165) using magnetic resonance (MR) at 36‐week gestation. Small placental volume was defined as MR estimated volume <10th centile. Perfusion was assessed by intravoxel incoherent motion. Results While mean MR placental volume was similar among the study groups, both interventions were associated with a lower prevalence of small placental volume (3.9% Mediterranean diet and 5% stress reduction vs. 17% non‐intervention; p = 0.03 and p = 0.04, respectively). Logistic regression showed that small placental volume was significantly associated with higher risk of SGA in both study groups (OR 7.48 [1.99–28.09] in Mediterranean diet and 20.44 [5.13–81.4] in Stress reduction). Mediation analysis showed that the effect of Mediterranean diet on SGA can be decomposed by a direct effect and an indirect effect (56.6%) mediated by a small placental volume. Similarly, the effect of Stress reduction on SGA is partially mediated (45.3%) by a small placental volume. Results on placental intravoxel incoherent motion perfusion fraction and diffusion coefficient were similar among the study groups. Conclusions Structured interventions during pregnancy based on Mediterranean diet or Stress reduction are associated with a lower proportion of small placentas, which is consistent with the previously observed beneficial effects of these interventions on fetal growth.https://doi.org/10.1111/aogs.14874fetal growth restrictionintrauterine growth restrictionmagnetic resonanceMediterranean dietMindfulnessplacenta |
| spellingShingle | Ayako Nakaki Eugenio Denaro Maddalena Crimella Roberta Castellani Kilian Vellvé Nora Izquierdo Annachiara Basso Cristina Paules Rosa Casas Leticia Benitez Irene Casas Marta Larroya Mariona Genero Sara Castro‐Barquero Alex Gomez‐Gomez Óscar J. Pozo Eduard Vieta Ramon Estruch Alfons Nadal Eduard Gratacós Francesca Crovetto Fàtima Crispi Lina Youssef Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial Acta Obstetricia et Gynecologica Scandinavica fetal growth restriction intrauterine growth restriction magnetic resonance Mediterranean diet Mindfulness placenta |
| title | Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial |
| title_full | Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial |
| title_fullStr | Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial |
| title_full_unstemmed | Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial |
| title_short | Effect of Mediterranean diet or mindfulness‐based stress reduction during pregnancy on placental volume and perfusion: A subanalysis of the IMPACT BCN randomized clinical trial |
| title_sort | effect of mediterranean diet or mindfulness based stress reduction during pregnancy on placental volume and perfusion a subanalysis of the impact bcn randomized clinical trial |
| topic | fetal growth restriction intrauterine growth restriction magnetic resonance Mediterranean diet Mindfulness placenta |
| url | https://doi.org/10.1111/aogs.14874 |
| work_keys_str_mv | AT ayakonakaki effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT eugeniodenaro effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT maddalenacrimella effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT robertacastellani effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT kilianvellve effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT noraizquierdo effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT annachiarabasso effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT cristinapaules effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT rosacasas effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT leticiabenitez effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT irenecasas effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT martalarroya effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT marionagenero effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT saracastrobarquero effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT alexgomezgomez effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT oscarjpozo effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT eduardvieta effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT ramonestruch effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT alfonsnadal effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT eduardgratacos effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT francescacrovetto effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT fatimacrispi effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial AT linayoussef effectofmediterraneandietormindfulnessbasedstressreductionduringpregnancyonplacentalvolumeandperfusionasubanalysisoftheimpactbcnrandomizedclinicaltrial |