title: Dietary interventions for fetal growth restriction - therapeutic potential of dietary nitrate supplementation in pregnancy.
abstract: Fetal growth restriction (FGR) affects around 5% of pregnancies and is associated with significant short- and long-term adverse outcomes. A number of factors can increase the risk of FGR, one of which is poor maternal diet. In terms of pathology, both clinically and in many experimental models of FGR, impaired uteroplacental vascular function is implicated, leading to a reduction in the delivery of oxygen and nutrients to the developing fetus. Whilst mechanisms underpinning impaired uteroplacental vascular function are not fully understood, interventions aimed at enhancing nitric oxide (NO) bioavailability remain a key area of interest in obstetric research. In addition to endogenous NO production from the amino acid l-arginine, via nitric oxide synthase (NOS) enzymes, research in recent years has established that significant NO can be derived from dietary nitrate, via the 'alternative NO pathway'. Dietary nitrate, abundant in green leafy vegetables and beetroot, can increase NO bioactivity, conferring beneficial effects on cardiovascular function and blood flow. Given the beneficial effects of dietary nitrate supplementation to date in non-pregnant humans and animals, current investigations aim to assess the therapeutic potential of this approach in pregnancy to enhance NO bioactivity, improve uteroplacental vascular function and increase fetal growth.
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Elizabeth
authors.identifier: 0000-0002-0888-4707
authors.initials: E
authors.lastname: Cottrell
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Teresa
authors.identifier: 0000-0003-3972-3313
authors.initials: T
authors.lastname: Tropea
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Ormesher
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Greenwood
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Wareing
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Johnstone
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Myers
authors.affiliation: School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, M13 9WL, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Sibley
mesh_terms: D000818:Animals; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005317:Fetal Growth Retardation / Q000178:diet therapy*; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D009566:Nitrates / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000378:metabolism; D010920:Placenta / Q000502:physiology; D011247:Pregnancy; D014599:Uterus / Q000502:physiology
chemical_list: D009566:Nitrates; D009569:Nitric Oxide
keywords: fetal growth restriction; nitrate supplementation; pregnancy