Very low birthweight is associated with physical, psychological, and social difficulties during early childhood development. In studies previously reported in our September and November 2023 issues, newborns from a large cohort of women at high risk for very low-birthweight delivery benefited from both the Mediterranean Diet and from Mindfulness-Based Stress Reduction (MBSR). Both interventions resulted in fewer very low-birthweight deliveries, better early childhood developmental scores, and measurable differences in fetal brain development.
Very low birthweight is usually due to placental dysfunction, but those earlier analyses did not assess whether the treatments affected placental health. In a secondary analysis, Nakaki et al. [Acta Obstetricia et Gynecologica Scandinavica] used Magnetic Resonance Imaging (MRI) to assess placental volume and blood perfusion in a subset of the women from the original study.
The original study recruited 1,221 pregnant Spanish women who were at risk for delivering very low birthweight infants based on clinical guidelines. MBSR, the Mediterranean Diet, or treatment-as-usual conditions were randomly assigned to women. MBSR included 2.5-hour weekly group sessions, a full-day retreat, and home meditation practice.
The Mediterranean diet intervention involved monthly group assessment and education sessions along with the provision of extra virgin olive oil and walnuts for consumption. The usual care group received pregnancy care following current obstetrical protocols.
The authors invited a randomly selected subset of 350 of these women to undergo magnetic resonance imaging (MRI) of the placenta to assess placental volume and perfusion during the 36th week of pregnancy, and 165 women(average age = 38 years; 79% white) agreed to participate in this additional protocol.
The results show that while there was no significant between-group difference in average placental volume, there were significant differences in the likelihood of having a placental volume below the 10th percentile. Only 3.9% of the Mediterranean Diet group had volumes below the 10thpercentile, compared to 5% of the MBSR group and 17% of the treatment-as-usual group. Very small placental volumes were associated with significantly increased odds of giving birth to a very low birthweight infant.
No significant differences in blood perfusion were detected. Blood perfusion is a measure of the blood flow between the placenta and the fetus which is in turn related to the amount of nutrition and oxygen the fetus receives.
The study shows that the Mediterranean Diet and MBSR both lower the odds of having a very small placenta, which is in turn associated with the odds of giving birth to a very low weight infant. The authors discuss how the anti-inflammatory effects of the Mediterranean diet can beneficially affect placental development, and how lower levels of stress-related glucocorticoids can beneficially impact placental growth and nutrient transport.
The study’s method of measuring blood perfusion may not have been sensitive enough to detect meaningful differences. This relatively highly educated sample of pregnant women had low rates of obesity and gestational diabetes and may not be typical of the general obstetric population.
Reference:
Nakaki, A., Denaro, E., Crimella, M., Castellani, R., Vellvé, K., Izquierdo, N., Basso, A., Paules, C., Casas, R., Benitez, L., Casas, I., Larroya, M., Genero, M., Castro-Barquero, S., Gomez-Gomez, A., Pozo, Ó. J., Vieta, E., Estruch, R., Nadal, A., … Youssef, L. (2024). 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.
Link to study
