Abstract
ObjectiveTo study the effect of an antiatherogenic diet on maternal and cord blood concentrations of systemic biomarkers of endothelial cell activation, haemostasis and inflammation.DesignSingle blinded randomised controlled clinical trial.SettingObstetric outpatient clinic and maternity unit of a university hospital in Norway.PopulationNonsmoking pregnant women aged 21–38 years carrying a single fetus and with no previous pregnancy-related complications.MethodsSubjects (n = 290) were randomised to continue their usual diet or to adopt a diet low in saturated fat and cholesterol from gestational week 17–20 to birth. Soluble forms of cellular adhesion molecules, high-sensitivity C-reactive protein (CRP) and haemostatic markers were measured at 17–20 weeks of gestation (baseline) and subsequently up to week 36. All the above, except CRP, were also measured in cord blood.Main outcome measuresConcentrations of maternal and fetal biomarkers and maternal CRP.ResultsAll biomarkers except CRP levels increased significantly during the study period in both the intervention and control groups. None of the maternal or fetal biomarkers were influenced by the intervention (P > 0.05) except for a tendency to lower concentrations of cord blood tissue plasminogen activator antigen in the intervention group compared with the control group, median (interquartile range) 5.4 ng/ml (3.1–7.7) versus 5.8 ng/ml (3.5–11.8), P = 0.05.ConclusionAn antiatherogenic diet in pregnancy did not significantly influence maternal or fetal blood concentrations of a range of biomarkers for inflammation. Thus, the previously reported effects of a cholesterol-lowering diet on maternal lipid profile and preterm delivery (<37 complete weeks of gestation) do not seem to involve changes in the systemic inflammatory responses of pregnancy.
Highlights
The Cardiovascular Risk Reduction Diet in Pregnancy (CARRDIP) trial was a randomised clinical trial designed to assess the effect of a low-cholesterol, low-saturated-fat antiatherogenic diet compared with the usual diet among nonsmoking white European healthy women on maternal, cord and neonatal lipid concentrations, and on pregnancy outcome
Several studies in nonpregnant subjects have indicated that diet influences concentrations of sCAMs and other novel cardiovascular risk markers[28,29,30] but have not been studied in relation to dietary intervention in pregnancy. In this analysis of the CARRDIP population, we investigated the effect of an antiatherogenic diet on maternal and fetal concentrations of sCAMs, markers of thrombosis and fibrinolysis and on maternal levels of high-sensitivity C-reactive protein (CRP)
Commercial methods were used for all analyses. sCAMs were analysed with kits provided by R&D Systems Europe, Abingdon, Oxon, UK, and the individual CAMs had the following coefficients of inter-assay variation (CV): VCAM-1, 5.2%; ICAM-1, 4.8%; and E-selectin, 5.3%
Summary
Complications of pregnancy, including pre-eclampsia, spontaneous loss of early pregnancy, low birthweight and preterm delivery, have been linked to the maternal risk of coronary heart disease in later life.[1,2] Pathological changes in the uteroplacental circulation in pre-eclampsia and preterm delivery share common features with atherosclerosis.[3,4] Adverse. The Cardiovascular Risk Reduction Diet in Pregnancy (CARRDIP) trial was a randomised clinical trial designed to assess the effect of a low-cholesterol, low-saturated-fat antiatherogenic diet compared with the usual diet among nonsmoking white European healthy women on maternal, cord and neonatal lipid concentrations, and on pregnancy outcome. Maternal lipid concentrations were reduced in the intervention arm of the trial, while cord blood and neonatal lipids did not differ between the groups. There were no differences between the intervention and control groups with respect to other pregnancy complications.[9]
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