Maternal restriction of polyphenols and fetal ductal dynamics in normal pregnancy: an open clinical trial.
BACKGROUND
We have recently demonstrated reversal of fetal ductal constriction after dietary maternal restriction of polyphenol-rich foods (PRF), due to its inhibitory action on prostaglandin synthesis.


OBJECTIVE
To test the hyphotesis that normal third trimester fetuses also improve ductus arteriosus dynamics after maternal restriction of polyphenols.


METHODS
Open clinical trial with 46 fetuses with gestational age (GA) > 28 weeks submitted to 2 Doppler echocardiographic studies with an interval of at least 2 weeks, being the examiners blinded to maternal dietary habits. A validated food frequency questionnaire was applied and a diet based on polyphenol-poor foods (<30 mg/100 mg) was recommended. A control group of 26 third trimester fetuses was submitted to the same protocol. Statistics used t test for independent samples.


RESULTS
Mean GA was 33 ± 2 weeks. Mean daily maternal estimated polyphenol intake (DMPI) was 1277 mg, decreasing to 126 mg after dietary orientation (p=0.0001). Significant decreases in systolic (SDV) and diastolic (DDV) ductal velocities, and RV/LV diameters ratio, as well as increase in ductal PI were observed [DSV = 1.2 ± 0.4 m/s (0.7-1.6) to 0.9 ± 0.3 m/s (0.6-1.3) (p = 0.018); DDV = 0.21 ± 0.09 m/s (0.15-0.32) to 0.18 ± 0.06 m/s (0.11-0.25) (p = 0.016); RV/LV ratio = 1.3 ± 0.2 (0.9-1.4) to 1.1 ± 0.2 (0.8-1.3) (p=0.004); ductal PI = 2.2 ± 0.03 (2.0-2.7) to 2.4 ± 0.4(2.2-2.9) (p = 0.04)]. In the control group, with GA of 32 ± 4 weeks, there were no significant differences in DMPI, mean SDV, DDV, PI and RV/LV ratio.


CONCLUSIONS
The oriented restriction of third trimester maternal ingestion of polyphenol-rich foods for a period of 2 weeks or more improve fetal ductus arteriosus flow dynamics and right ventricular dimensions.
Paulo
P
Zielinsky
Antônio Luiz
AL
Piccoli
Izabele
I
Vian
Ana Maria
AM
Zílio
Alexandre Antônio
AA
Naujorks
Luiz Henrique
LH
Nicoloso
Carolina Weiss
CW
Barbisan
Stefano
S
Busato
Mauro
M
Lopes
Caroline
C
Klein
D004373:Ductus Arteriosus / Q000000981:diagnostic imaging / Q000502:physiology*; D015150:Echocardiography, Doppler; D005247:Feeding Behavior; D005260:Female; D005333:Fetus; D005502:Food; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D059808:Polyphenols / Q000008:administration & dosage*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011453:Prostaglandins / Q000096:biosynthesis; D013997:Time Factors
D059808:Polyphenols; D011453:Prostaglandins