Research project
36 | monthsASTRA_MATER

Association between first trimester maternal nutritional score and birth outcomes, and maternal sample biobank collection

Related toSpoke 05

Principal investigators
Irene Cetin

Other partecipantsGaia Maria Anelli, Chiara Mandò, Francesca Parisi
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Project partners

Task involved

Task 5.1.3

Development of an ONFOODS cohort (including relevant target groups along the lifecycle) within the geographical area covered by the participant institutions with the aim to systematically assess nutritional status, eating behaviour, physical activity and lifestyle in target populations through the application of shared procedures and questionnaire able to add information lacking from the available datasets and to provide a setting for the validation of possible biomarker (see WP 5.4.) new intervention (in connection with Spoke 4) or educational strategies (in connection with spoke 7).

Task 5.2.5.

Definition of new protocols/surveys for the evaluation of the nutritional status across life stages, with attention to maternal-infant dyad in the "first 1000 days"; b) adult population (including physically active people and athletes); and free-living older adults.

Task 5.4.3.

Organisation of a multicentre infrastructure for the collection of samples and data dedicated to the identification and validation of food biomarkers (organisation of a multicentre infrastructure for collection of biological samples and identification standards, organisation of a multicentre and multisectoral infrastructure for data analysis, organisation of a clinical multicentre infrastructure for population recruitment and relationships with ethics committees).

Project deliverables

D5.1.3.1.

Protocols for the definition of nutritional status, eating behaviour, physical activity, and lifestyle (M12)

D5.1.3.2

Report on nutritional status, eating behaviour, physical activity and lifestyle linked to quality of diet, nutrition and adherence to sustainable food patterns (M36)

D5.2.5.1.

Recommendations for the adoption of adequate healthy dietary patterns a) during the first 1000 days window, b) physically active people, athletes (M36)

D5.4.3.1.

Agreements among different national recruitment centres to be involved in a dedicated infrastructure for biobank, data storage and recruitment of healthy subjects for screening of population (M12)

D5.4.3.2.

Guidelines to prepare dossiers for ethical committees’ applications (M12)

State of the art

Maternal nutrition is the main determinant of fetal nutrition, representing a critical and modifiable risk factor for adverse pregnancy and long-term outcomes in both mother and offspring. Nutritional deficiencies have been associated with maternal pro-inflammatory status and maladaptation to pregnancy, resulting in deranged embryogenesis, placental dysfunction, and poor pregnancy outcomes. Our preliminary data showed that a first trimester nutritional score as a measure of adherence to a healthy diet is significantly associated with early markers of placental development, with further association with gestational age at birth.
Therefore, the definition of new protocols/surveys for the evaluation of the maternal nutritional status is crucial in pregnancy care, and the assessment of recommendations for the adoption of adequate healthy dietary patterns during the first 1000 days window is mandatory to prevent both short- and long-term adverse outcomes in mother and offspring.

Operation plan

The research will involve the following activities:

  • Enrollment of a large cohort (about 2000 individuals) of I trimester pregnant healthy women (aged >18, single spontaneous pregnancies) at the ASST Fatebenefratelli Sacco, Milan. 
  • Women compilation of a general questionnaire (family, obstetric, medical history; anthropometric measurements; details on age, ethnicity, education, periconceptional lifestyle, supplementation) as well as an adapted version of the nutritional questionnaire developed and based on the International Federation of Gynecology and Obstetrics recommendation with adaptations based on the Italian guidelines on maternal nutrition during pregnancy. The questionnaire will provide a final calculation of a 0 to 10 score, measuring the adherence to a healthy diet and lifestyle in pregnancy.
  • Recording of data on birth outcomes (gestational age, mode of delivery, blood loss, birth weight, newborn sex, pregnancy outcome).
  • Collection of maternal I trimester blood.

Expected results

  • Evaluation of the associations between a maternal nutritional score and birth outcomes, which are known to be strongly correlated with long-term non communicable diseases.
  • Definition of a new protocol, using a fast and easy-to-get nutritional score that measures the adherence to a healthy diet, for the evaluation of the maternal nutritional status, eating behavior and lifestyle since the beginning of pregnancy.
  • Planning of a dedicated nutritional counseling even among low-risk pregnancies, with the consequent reduction of nutrition/lifestyle-related pregnancy and long-term adverse outcomes for the mother and the offspring.
  • Creation of a biobank of I trimester blood samples for the future identification and validation of food biomarkers for pregnancy outcomes.