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

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• dc.contributor.author Nakaki, Ayako
• dc.contributor.author Gómez-Gómez, Àlex
• dc.contributor.author Pozo Mendoza, Óscar J., 1975-
• dc.contributor.author Youssef, Lina
• dc.date.accessioned 2025-02-13T07:49:22Z
• dc.date.available 2025-02-13T07:49:22Z
• dc.date.issued 2024
• dc.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.
• dc.description.sponsorship The project was partially funded by a grant from “La Caixa” Foundation (LCF/PR/GN18/10310003); Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); Departament d‘Innovació, Universitats i Empresa, Generalitat de Catalunya (2021-SGR-01422); Instituto de Salud Carlos III and co-funded by the European Union (INT21/00027, PI17/00675, PI18/00073, PI20/00246, CM19/00140, PI22/00684); Fundación Mutua Madrileña (AP180722022); MCIN/AEI/10.13039/501100011033 (CEX2021-001234-M). Francesca Crovetto has received support from Centro de Investigaciones Biomédicas en Red sobre Enfermedades Raras (CIBERER). Ayako Nakaki has received support from a fellowship from “La Caixa” Foundation, Doctoral INPhINIT Retaining fellowship (LCF/BQ/DR19/11740018). Ramon Estruch has received support from the Instituto de Salud Carlos III (AC19/00100), as part of the FoodPhyt project, under the umbrella of the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL) (2019–02201). Lina Youssef was supported from Ministerio de Ciencia e Innovación (FJC2021-048123-I), and by the European Union “NextGenerationEU”/PRT. Additionally, we would like to thank the Fundació Jesús Serra of the Grup Catalana Occident for the Fundació Jesús Serra Research Prize in the Clinical category awarded to the Researcher Fatima Crispi in its 4th edition for the project titled “Cardiovascular prevention from fetal life: benefits of Mediterranean diet during gestation.”
• dc.format.mimetype application/pdf
• dc.identifier.citation Nakaki A, Denaro E, Crimella M, Castellani R, Vellvé K, Izquierdo N, et al. 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 Obstet Gynecol Scand. 2024 Oct;103(10):2042-52. DOI: 10.1111/aogs.14874
• dc.identifier.doi http://dx.doi.org/10.1111/aogs.14874
• dc.identifier.issn 0001-6349
• dc.identifier.uri http://hdl.handle.net/10230/69591
• dc.language.iso eng
• dc.publisher Wiley
• dc.relation.ispartof Acta Obstet Gynecol Scand. 2024 Oct;103(10):2042-52
• dc.relation.projectID info:eu-repo/grantAgreement/ES/3PE/CEX2021-001234-M
• dc.rights © 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Mediterranean diet
• dc.subject.keyword Mindfulness
• dc.subject.keyword Fetal growth restriction
• dc.subject.keyword Intrauterine growth restriction
• dc.subject.keyword Magnetic resonance
• dc.subject.keyword Placenta
• dc.subject.keyword Placental MR
• dc.subject.keyword Placental insufficiency
• dc.subject.keyword Prenatal
• dc.subject.keyword Stress reduction
• dc.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
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion