30% of pregnant women at high risk of having a low-weight neonate have in their hands to avoid it, following a Mediterranean diet and controlling stress, according to a study published today in Jama and coordinated by BCNatal researchers, from Hospital Clínic - IDIBAPS and the Sant Joan de Déu Hospital, from Barcelona, with the support of the "La Caixa" Foundation. Until now, no treatment or intervention was known that could prevent or improve low weight at birth.
This study, unique in international medical literature, is a change of paradigm in low birth weight prevention (caused by a delay in fetal growth due to lack of oxygen and nutrients) when empowering (or holding) by one third of pregnant women to try to avoid it with changes in your lifestyle; For the rest, with genetic and other factors not yet described / known, it will remain very difficult.
The study, which has demonstrated a reduction between 29 and 36% of babies born with low when intervenes in the mother's diet and reduces its stress level, has been coordinated by Eduard Gratacós, director of BCNatal Fetal and Perinatal Medicine Group of IDIBAPS and CIBERR, and by Francesca Crovetto (Hospital Sant Joan de Déu) and Fátima Crispi (Hospital Clínic), the Bacnatal Medicine Service of Binatal and researchers of those same groups. The teams of Ramon Estruch, from the Internal Medicine Service of the Clinic, Head of the Cardiovascular Risk, Nutrition and Aging of the Idibaps and Researcher of the Ciberon; Eduard Vieta, head of the Psychiatry and Psychology Service of the Clinic, the group of Bipolar and Depressive Disorders of the IDIBAPS and Scientific Director of the Cibersam, and professionals of the Esmindfulness Institute, led by Andrés Martín-Asuero. The project has also had the support of CERRA, CIBERR and AGAUR. Mutidisciplinary work is necessary because changes in diet and exercises for the reduction of stress must be validated previously and adapted to pregnancy.
According to the researchers in this study, in a meeting with the press held in Barcelona, babies that are born with low weight (weight lower than percentile 10) represent 10% of all births. Bass weight at birth reflects a delay of growth in fetal life and is recognized by WHO as one of the most important causes of perinatal mortality in the world. It is also associated with a worse neurodevelopment in childhood and more problems of metabolic and cardiovascular health in adulthood.
Gratacós has explained that, after studying the possible causes and consequences of low weight at birth for years, "we saw that mothers of newborns born with low weight, often had a suboptimal diet and high levels of stress." From there arose the idea of conducting a specific, something unusual clinical study when it comes to changes or improvements in lifestyle, and therefore with difficulties to obtain financing. In this case, the support of the "La Caixa" Foundation was achieved, which is already financing the draft artificial placenta for prematurers that leads Gratacós.
In the study, called Impact Barcelona, have participated for three years more than 1,200 pregnant women at high risk of having a small baby (with less than 10% of normal weight).
The pregnant women of the sample were randomly divided into three groups: a group (407 women) in which pregnant women had visits with a nutritionist to follow a Mediterranean diet; A group (407) in which a MINDFULNESS program was followed to reduce stress, and the control group (407 women), with the usual follow-up. Then he followed up to see how the baby was developed and if there were complications in pregnancy and childbirth.
The intervention on the diet was based on the methods used in the preded study (prevention with Mediterranean diet), which highlighted the benefits of the Mediterranean diet in the prevention of cardiovascular disease and that has been endorsed by the American Heart Association ( American Heart Association).
The pregnant women of this group went to monthly visits with a nutritionist to change the pattern of the diet and adapt it to the Mediterranean diet incorporating more fruit and vegetables, white meat, blue fish, dairy and whole grain cereals. In addition, high products in omega-3 were provided free of charge, that is, extra virgin olive oil and nuts. "To evaluate adherence to this intervention in an objective way, we measure biomarkers in blood and urine related to the intake of nuts and olive oil," said Crovetto.
The intervention to reduce stress was based on the MBSR program (Mindfulness Based Stress Reduction) program, developed by the University of Massachusetts and adapted to pregnancy by Barcelona researchers. Groups of 20-25 women were made that followed the program adapted to pregnancy for 8 weeks. "To know if there was a reduction in stress, some questionnaires were completed at the beginning and at the end of the program, and the levels of hormones related to stress, cortisol and cortisone, were measured," Crovetto said.
In this way, the study has demonstrated, for the first time, that, when a Mediterranean diet is used in a structured and guided manner or MINDFULNESS is done during pregnancy, the percentage of low fetal weight is reduced and also the complications of gestation, Like preeclampsia or perinatal death.
"The results were clear: the pregnant women of the control group had 21.9% of newborn newborns and the percentage was significantly reduced in the Mediterranean diet groups (14%) and Mindfulness (15.6%) , "Crispi said. The risk of very low weight drops up to 60%. In addition, benefits are recorded even in pregnant women who do not follow 100% recommendations.
"We are now designing a multicentre study to apply the results of this study to any pregnant woman without the need for the risk of having a low-weight baby," he adds.
Gratacós has announced that they will also study if with these prevention measures changes the brain configuration of the mother and the fetus, the microbiota, the epigenetics and, the DNA. "You have to do it in a forceful way," he emphasizes, after explaining that three different international teams reviewed this study published in Jama and did not have doubts about the results obtained, although of entrance they were surprising.
"These are measures of empowerment of women and society in general; they are tools to be able to say I am doing everything I can from the hand of scientific evidence," the expert has concluded.
Date Of Update: 07 December 2021, 13:01
