Elsevier

The Journal of Pediatrics

Volume 152, Issue 1, January 2008, Pages 79-84.e2
The Journal of Pediatrics

Original article
Evidence of Infant Blood Pressure Programming by Maternal Nutrition during Pregnancy: A Prospective Randomized Controlled Intervention Study

https://doi.org/10.1016/j.jpeds.2007.05.048Get rights and content

Objectives

To evaluate the impact of maternal nutrition during pregnancy on infant blood pressure.

Study design

Pregnant women (n = 256) were randomized into 3 groups: modified dietary intake according to current recommendations and probiotics (diet/probiotics), placebo (diet/placebo), and a control/placebo group. In the infants born to these women, blood pressure was recorded at age 6 months using an automated oscillometric DINAMAP R.

Results

Despite significant differences in maternal dietary intakes between the study groups, the intervention focusing on maternal fat intake showed no direct impact on infants’ blood pressure. Instead, a complex U-shaped interrelationship was uncovered; the highest and lowest quartiles of intakes of specific nutrients, carbohydrate (P = .006 for systolic pressure and P = .015 for diastolic pressure), and monounsaturated fatty acids (P = .029 for diastolic pressure) compared with the middle quartiles resulted in higher blood pressure at age 6 months. The pattern between maternal carbohydrate intake during pregnancy and infants’ blood pressure remained significant even after adjustment for breastfeeding and body length. A reverse U-shaped trend again was observed between maternal intake of fruits and infants’ systolic blood pressure (P = .077).

Conclusion

With a view toward programming blood pressure to adulthood, our results suggest an opportunity for dietary counseling to promote child health.

Section snippets

Methods

The study population comprised pregnant women and their infants participating in an ongoing prospective, randomized mother-infant nutrition and probiotics study (http://www.clinicaltrials.gov/ct/gui/show/NCT00167700). A total of 256 pregnant women were recruited at visits to maternal welfare clinics in Turku, Finland early in pregnancy. The family history of cardiovascular diseases was assessed on the basis of hypertension, hypercholesterolemia, myocardial infarction, or stroke in parents or

Results

The clinical characteristics of the women (Table I) and infants (Table II) were similar in the 3 study groups. All participants were Caucasian and in good health. The majority had a high educational level and gave birth after a normal pregnancy (Table I).

Discussion

Dietary factors affect blood pressure directly through intake of nutrients, including sodium and fat, as well as indirectly by means of weight gain.15, 16 The results of the present study extend this notion into fetal life through maternal nutrition. We noted the relevance of specific nutrients during pregnancy in the programming of infants’ blood pressure. Considering the possibility of programming blood pressure from childhood to adulthood,17, 18, 19, 20 our findings may suggest a novel

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    Supported by grants from the Academy of Finland, the Social Insurance Institute of Finland, the Sigrid Juselius Foundation, and the Turku University Foundation (J.A.). The first draft of the manuscript was written by Jonna Aaltonen. Food products used in this study were provided by Raisio Group, Raisio, Finland; Bifidobacterium lactis was provided by C. Hansen, Hoersholm, Denmark; and Lactobacillus rhamnosus was provided by Valio Ltd, Helsinki, Finland.

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