Periconceptional maternal dairy-rich dietary pattern is associated with prenatal cerebellar growth

<div><p>Background</p><p>Maternal nutrition during pregnancy has been related to intrauterine brain development and neurodevelopmental disabilities in adult life. We aim to investigate associations between periconceptional maternal dietary patterns and prenatal cerebellar growth from the first trimester onwards.</p><p>Materials and methods</p><p>126 women with singleton non-malformed pregnancies were enrolled before 8 weeks of gestation in the Rotterdam periconceptional cohort between 2013 and 2015. Periconceptional maternal dietary patterns were extracted from food frequency questionnaires and associated with blood biomarkers and micronutrient intakes. Serial two-dimensional and three-dimensional ultrasound scans were performed at 9, 11, 22, 26 and 32 weeks of gestation for transcerebellar diameter (TCD) measurement. Linear mixed models were estimated to investigate associations between periconceptional maternal dietary patterns and longitudinal TCD measurements as a function of gestational age.</p><p>Results</p><p>We performed a median of 4 scans per pregnancy, resulting in 570 total datasets. The success rate of TCD measurements was 87% (range 65–100%), depending on gestational age. The Mediterranean, Western, egg-rich and dairy-rich dietary patterns were extracted, explaining 37.2% of the overall variance of food intake in this population. The dairy-rich dietary pattern was positively associated with cerebellar growth trajectories (β = 0.02 (95% CI: 0.01; 0.03) √mm, p = 0.01). Maternal strong adherence to this dietary pattern increased TCD measurements by 0.8 standard deviation scores (SDs) compared to weak adherence, reflected in increased TCD estimates of 0.44 mm at 9 weeks (+6.8%), 0.88 mm at 22 weeks (+3.6%), and 1.17 mm at 32 weeks (+2.8%). No significant associations were detected for the Mediterranean, Western and egg-rich dietary patterns.</p><p>Conclusions</p><p>This study shows a positive association between periconceptional maternal adherence to a dairy-rich dietary pattern and human prenatal TCD measurements as a proxy of cerebellar growth. Next step is the investigation of the impact on neurodevelopmental outcomes in the offspring.</p></div

Associations between the adherence to the periconceptional maternal dairy-rich dietary pattern and longitudinal transcerebellar diameter (TCD) measurements after transformation to the original scale (mm) in the study population using model 2.

<p>The adherence to the dietary pattern is expressed as -2 standard deviation (SD) (weak) or +2SD (strong) in component score. Full adjustment, including energy intake, conception mode, alcohol, smoke, parity, age, BMI, folic acid supplement/multivitamin use and ethnicity, was performed. GA: gestational age; CI: confidence interval.</p

Maternal baseline characteristics of the study population and excluded pregnancies.

<p>Maternal baseline characteristics of the study population and excluded pregnancies.</p

Effect estimates from linear mixed models for the associations between periconceptional maternal dietary patterns and embryonic and fetal cerebellar growth trajectories, as a function of gestational age.

<p>Effect estimates from linear mixed models for the associations between periconceptional maternal dietary patterns and embryonic and fetal cerebellar growth trajectories, as a function of gestational age.</p

Correlations between nutrient intake and the four extracted dietary patterns expressed by correlation coefficients.

<p>Correlations between nutrient intake and the four extracted dietary patterns expressed by correlation coefficients.</p

Longitudinal transcerebellar diameter (TCD, mm) measurements in the study population.

<p>Mean values at 9, 11, 22, 26 and 32 weeks of gestation are reported. Dots and lines represent TCD measurements and trajectories of a single included pregnancy. n: number; GA: gestational age.</p