Cholesterol Lowering Diet for Pregnant Women May Help Prevent Preterm Birth
Cholesterol Lowering Diet for Pregnant Women May Help Prevent Preterm Birth
Abstract & Commentary
By John C. Hobbins, MD, Professor and Chief of Obstetrics, University of Colorado Health Sciences Center, Denver, is Associate Editor for OB/GYN Clinical Alert.
Dr. Hobbins reports no financial relationship to this field of study.
Synopsis: A cholesterol-lowering diet may modify maternal lipid levels but not cord and neonatal lipids.
Source: Khoury J, et al. Effect of a cholesterol-lowering diet on maternal, cord, and neonatal lipids, and pregnancy outcome: a randomized clinical trial. Am J Obstet Gynecol. 2005;193:1292-1301.
There was a relatively recent article in the American Journal of Obstetrics and Gynecology that I passed over the first time, but have decided to cover now since it was highlighted in the British Medical Journal.
The concept was to see if eating a healthy diet of low saturated fats and cholesterol would have an effect on maternal, umbilical cord, and 4-day infant blood lipid profiles. In addition, Khoury and associates evaluated various pregnancy outcomes.
In this study, 290 pregnant Norwegian women were randomized to have a normal diet (149 patients) or a modified diet (141 patients). This latter regimen was heavy on whole grains, fish, fruits and vegetables—yielding a saturated fat intake of less than 8% of total energy and daily cholesterol intake of less than 150 mg/day.
Maternal serum lipid profiles were obtained 4 times during pregnancy. The same lipid analysis was done on cord bloods and neonatal samples at 4 days. The diet regimen had a modest effect on the maternal lipid profile and only late in pregnancy (average total cholesterol of 6.65 mmoL/L vs 6.70 mmoL/L and average LDL of 3.83 mmoL/L vs 3.93 mmoL/L). There was no effect on infant lipid profiles. However, one result should definitely get our attention. The preterm birth rate (< 37 wks) in the modified diet group was 1/141 (0.7%) vs 11/149 (7.4%), which gave a relative risk of 0.10 (95% CI, 0.01-0.77).
Commentary
There is not enough space here to go into the numbers of articles dealing with various diets, antioxidants, minerals, egg supplements, and herbs that have been postulated to have a beneficial effect on pregnancy outcome. Here is a study to suggest that eating a healthy diet of low saturated fat can possibly decrease the rate of preterm birth, which has risen in the United States from 7.9% in 2003 to 8.1% in 2004 (CDC data), despite current thrusts to decrease it. The knock on the study is that the patient numbers were small. However, the effect on preterm delivery was significant. One wonders whether the results would be even more dramatic if the numbers were increased and the control groups consisted of subjects eating the standard fast food-spiked American diet responsible for our soaring rate of obesity, rather than the "normal" Norwegian diet.
There was a relatively recent article in the American Journal of Obstetrics and Gynecology that I passed over the first time, but have decided to cover now since it was highlighted in the British Medical Journal.Subscribe Now for Access
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