Effect of Mediterranean Diet or Mindfulness-Based Stress Reduction in Small-For-Gestational-Age (SGA) Birth Weights

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Highlights:

• High-risk pregnancy increases the possibility of small-for-gestational-age (SGA) birth weights in infants
• Currently, there are no standard interventions to prevent SGA among these populations
• A new study finds that risk for SGA might be reduced by the interventions like the Mediterranean diet or mindfulness-based stress reduction

The risk for small-for-gestational-age (SGA) birth weights in newborns might be curbed below the 10th percentile by the interventions like the Mediterranean diet or mindfulness-based stress reduction among at-risk pregnant women, as published by a study in JAMA.

What is Small-For-Gestational Age (SGA) Birth Weight?

SGA refers to lower birth weight of infants below the 10th percentile for gestational age (i.e., below the expected ideal birth weight).

The risk of SGA may be contributed by several factors like poor resources, maternal factors like height and weight, ethnicity, and the number of pregnancies, and genetic or metabolic diseases.

‘Interventions like the Mediterranean diet or mindfulness-based stress reduction may reduce the possibility of small-for-gestational-age (SGA) birth weights in infants at-risk.’

Although these infants have no amplified risk of perinatal morbidity or mortality, SGA may contribute to fetal growth-restriction (FGR) in the womb, which increases mortality rates in infants.

Mediterranean Diet and Mindfulness-Based Stress Reduction

"In pregnancy, small studies have reported that [mindfulness-based] stress reduction was feasible and associated with lower perceived stress and anxiety. However, no studies have evaluated the effect of [mindfulness-based] stress reduction on pregnancy outcomes," says Francesca Crovetto, MD, PhD, a post-doctoral fellow at the BCNatal Fetal Medicine Research Center in Barcelona, Spain, and colleagues.

The team randomly assigned 1,221 women with singleton pregnancies (19-23 weeks pregnancy at high risk for SGA) in a 1:1:1 ratio among the age groups 33.2 to 40.5 years.

Interventions Applied

The participants in the first group received one-on-one and group educational sessions at 2 hours per month along with a Mediterranean diet (free provision of extra-virgin olive oil and walnuts twice a month).

The second group was given an 8-week mindfulness stress reduction program (stress reduction cohort), while the third group was given the usual care. Most of the women had a pre-pregnancy BMI of about 24 kg/m2 and were white. Over 90% of each cohort completed the trial.

Effect on SGA

It was found that nearly 21.9% of newborns in the usual care cohort were born small for their gestational age. On the contrary, only 14% of infants in the Mediterranean diet cohort and 15.6% of those in the mindfulness stress reduction cohort were born small for their gestational age.

In addition, adverse perinatal outcomes were noted in 26.2% among the usual care cohort along with 18.6% in the Mediterranean diet cohort, and 19.5% in the stress reduction cohort.

Study Limitations

However, the study had multiple limitations such as smaller differences in the usual care cohort, imbalanced number of early births and healthcare-related visits, and "low participation" of other high-risk groups like obesity, gestational diabetes, and large-for-gestational-age newborns.

"Due to [these] important study limitations, these findings should be considered preliminary and require replication, as well as assessment in additional patient populations, before concluding that these treatments should be recommended to patients," noted the researchers.

Novel Findings

However, as there are no proven interventions to prevent SGA infants, the study findings nevertheless remain novel.

"Implementation of these interventions into clinical practice should await results of the neurodevelopmental assessment and other outcomes among the offspring at 2 years of age and replication of the study results in other populations," says Margaret Bublitz, PhD, an assistant professor of psychiatry and human behavior and assistant professor of medicine at Brown University, and Methodius G. Tuuli, MD, MPH, MBA, the executive chief of obstetrics and gynecology for Women & Infants Hospital in Rhode Island, and chair of the department of obstetrics and gynecology at the Warren Alpert Medical School at Brown University.

References:

1. Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction on Prevention of Small-for-Gestational Age Birth Weights in Newborns Born to At-Risk Pregnant Individuals - (https:jamanetwork.com/journals/jama/article-abstract/2786831)
2. Small for Gestational Age - (https:www.ncbi.nlm.nih.gov/books/NBK563247/)

Source: Medindia

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