Abstract
Purpose
Pre-eclampsia is a multi-system disorder caused by inadequate placentation in early pregnancy; however, little is known about the influence of nutrient intake on placental development during the crucial 1st trimester. The objective of this study was to examine the relationships between nutrient intake and the raw values and ratios of angiogenic [placental growth factor (PlGF)] and antiangiogenic [soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng)] placental biomarkers in the 1st trimester.
Methods
A cross-sectional study of low-income, pregnant women (n = 118). Average nutrient intake was calculated from three 24-h dietary recalls. Biomarker values were adjusted for gestational age and nutrients were adjusted for energy.
Results
The angiogenic to antiangiogenic ratio [PlGF/(sFlt-1 × sEng)] was positively related to intake of vitamin D (r = 0.24), vitamin B2 (r = 0.25), B12 (r = 0.20), dietary folate equivalents (r = 0.19), iron (r = 0.19), and zinc (r = 0.19) and negatively related to transfats (r = −0.24). Principal component analysis revealed that a vitamin/mineral factor [t (112) = 2.58, p = 0.011] and transfats factor [t (112) = −2.03, p = 0.045] were significant predictors of the PlGF/(sFlt-1 × sEng) ratio. The vitamin and mineral factor was a significant predictor of sFlt-1 [t (122) = 2.29, p = 0.024].
Conclusions
Expression of placental biomarkers in the early weeks of pregnancy may be influenced by intake of nutrients. Understanding the influence of maternal nutrient intake and placental development in the 1st trimester may provide the opportunity to avert the development or blunt the severity of preeclampsia.
Similar content being viewed by others
References
Funai E, Friedlander Y, Paltiel O, Tiram E, Xue X, Dutsch L, Harlap S (2005) Long-term mortality after preeclampsia. Epidemiology 16:206–215
Magnussen E, Vatten L, Smithy G, Romundstad P (2009) Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet Gynecol 114:961–970
Rajakumar A, Michael H, Rajakumar P, Shibata E, Hubel C, Karumanchi S, Thadhani R, Wolf M, Harger G, Markovic N (2005) Extra-plancetal expression of vascular endothelial growth factor receptor-1 (sflt-1), and soluble Flt-1 (sFlt-1), by peripheral blood mononuclear cell (PBMCs) in normotensive and preeclamptic pregnant women. Placenta 26:563–573
Ziche M, Maglione D, Ribatti S, Morbidelli L, Lago C, Battisti M, Paoletti I, Barra A, Tucci M, Parise G, Vincenti V, Granger HJ, Viglietto G, Persico MG (1997) Placental growth factor-1 is chemotactic, mitogenic, and angiogenic. Lab Invest 76:517–531
Levine R, Maynard W, Qian C, Lim K, England L, Yu K, Schisterman b, Epstein F, Sibai B, Sukhatme V, Karumanchi SA (2004) Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 350:672–683
Tjoa M, Levine R, Karumanchi A (2007) Angiogenic factors and preeclampsia. Front Biosci 12:2395–2402
Myatt L, Webster R (2008) Vascular biology of preeclampsia. J Thromb Haemost 7:375–384
Ferrera N, Gerber H-P, LeCouter J (2003) The biology of VEGF and its receptors. Nat Med 9:669–676
Ahmad S, Ahmed A (2004) Elevated placental soluble vascular endothelial growth factor receptor-1 inhibits angiogenesis in preeclampsia. Circ Res 95:884–891
Levine R, Lam C, Qian C, Yu L, Maynard S, Sachs B, Sibai B, Epstein F, Romero R, Thadhani R, Karumanchi S (2006) Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med 355:992–1005
DeVivo A, Baviera G, Giordano D, Todarello G, Corrado F, D’Anna R (2008) Endoglin, PlGF, and sFlt-1 as markers for predicting preeclampsia. Acta Obstetricia et Gynecologica 87:837–842
Tripathi R, Rath G, Ralhan R, Sazena S, Salhan S (2009) Soluble and membranous vascular endothelial growth factor receptor-2 in pregnancies complicated by pre-eclampsia. Yonsei Med J 50:656–666
Chaiworaponga T, Romero R, Cotsch F, Espinoza J, Nien J, Gonclaves L, Edwin S, Kim Y, Erez O, Kusanovic J, Pineles B, Papp Z, Hassan S (2008) Low maternal concentrations of soluble vascular endothelial growth factor receptor-2 in preeclampsia and small for gestational age. J Matern Fetal Neonatal Med 21:41–52
Erez O, Romero R, Espinoza J, Fu W, Todem D, Kusanovic J, Cotsch F, Edwin S, Nien J, Chaiworapongsa T, Mittal P, Masaki-Tovi S, Than N, Gomez R, Hassan S (2008) The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small for gestational age. J Matern Fetal Neonatal Med 21:279–287
Romero R, Nien J, Espinoza J, TOdem D, Fu W, Chung H, Kusanovic J, GOtsch F, Erez O, Mazaki-tovi S, Gomes R, Edwin S, Chaiworapongsa T, Levine R, Karumanchi A (2008) A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble VEGR receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small-for-gestational-age neonate. J Matern Fetal Neonatal Med 21:9–23
Rana S, Karumanchi S, Levine R, Venkatesha S, Rauh-Hain J, Tamez H, Thadhani R (2007) Sequential changes in antiangiogenic factors in early pregnancy and risk of developing preeclampsia. Hypertension 50:137–142
Vatten L, Eskild A, Nilsen T, Jeansson S, Jenum P, Staff A (2007) Changes in circulating level of angiogenic factors from the first to the second trimester as predictors of preeclampsia. Am J Obstet Gynecol 196(239):e1–e6
Kusanovic J, Romero R, Chaiworapongsa T, Erez O, Mittal P, Vaisbuch E, Mazaki-Tovi S, Cotsch F, Edwin S, Gomez R, Yeo L, Conde-Agudelo A, Hassan S (2009) A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia. J Matern Fetal Neonatal Med 22:1021–1038
Lim J, Kim S, Park S, Yang H, Kim M, Ruy H (2008) Effective prediction of preeclampsia by a combined ratio of angiogenesis-related factors. Obstet Gynecol 111:1403–1409
Fowles E, Murphey C, Ruiz RJ (2011) Exploring relationships among psychosocial status, dietary quality and measures of placental development during the 1st trimester in low-income women. Biol Res Nurs 13:70–79
Roberts J, Balk J, Bodnar L, Belizan J, Bergel E, Martinez A (2003) Nutrient involvement in preeclampsia. J Nutr 133:1684A–1692S
Scholl T, Leskiw M, Chen X, Sims M, Stein T (2005) Oxidative stress, diet and the etiology of preeclampsia. Am J Clin Nutr 81:1390–1396
Fiore G, Capasso A (2008) Effects of vitamin E and C on placental oxidative stress: an in vitro evidence for the potential therapeutic or prophylactic treatment of preeclampsia. Med Chem 4:526–530
Haugen M, Brantsaeter A, Trogstad L, Alexander J, Roth C, Magnus P, Meltzer H (2009) Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology 20:720–726
Bhargava A (2004) Socio-economic and behavioral factors are predictors of food use in the National Food Stamp Program Survey. Br J Nutr 92:497–506
Fowles E (2002) Comparing pregnant women’s nutritional knowledge to their actual dietary intake. MCN Am J Matern Child Nurs 27:171–177
Matthews F, Neil H (1998) Nutrient intakes during pregnancy in a cohort of nulliparous women. J Hum Nutr Diet 11:151–161
Suitor C, Gardner J, Feldstien M (1990) Characteristics of diet among a culturally diverse group of low-income pregnant women. J Hum Nutr Diet 90:543–550
Swenson A, Harnack L, Ross J (2001) Nutritional assessment of pregnant women enrolled in the Special Supplemental Program for Women, Infants, and Children (WIC). J Am Diet Assoc 101:903–908
Turner R, Langkamp-Henken B, Littell R, Lukowksi M, Suarez M (2003) Comparing nutrient intake from food to the estimated average requirements shows middle- to upper-income pregnant women lack iron and possible magnesium. J Am Diet Assoc 103:461–466
Wunderlich S, Hongu N, Courter A, Bendixen C (1996) Nutrient intake and nutritional status of low-income pregnant women. Top Clin Nutr 12:66–73
Brodsky D, Christou H (2004) Current concepts in intrauterine growth restriction. J Intensive Care Med 19:307–319
Kind K, Moore V, Davies M (2006) Diet around conception and during pregnancy: effects on fetal and neonatal outcomes. Reprod Biomed Online 12:532–541
Baschat A, Hecher K (2004) Fetal growth restriction due to placental disease. Semin Perinatol 28:67–80
Cross J, Mickelson L (2006) Nutritional influences on implantation and placental development. Nutr Rev 64(5, Part 2):S12–S18
Brown J, Murtaugh M, Jacobs D, Margellos H (2002) Variation in newborn size according to pregnancy weight change by trimester. Am J Clin Nutr 76:205–209
Susser M, Stein Z (1994) Timing of prenatal nutrition: a reprise of the Dutch Famine Study. Nutr Rev 52:84–94
Relton C, Pearce M, Parker L (2005) The influence of erythrocyte folate and serum vitamin B12 status on birth weight. Br J Nutr 93:593–599
Barker D (1995) Fetal origins of coronary heart disease. Br Med J 311(6998):171–174
Barker D (1999) Fetal origins of type 2 diabetes mellitus. Ann Intern Med 130:322–325
Godfrey K, Barker D (2000) Fetal nutrition and adult disease. Am J Clin Nutr 71(Suppl. 1):1344S–1352S
Eriksson J, Forsen T, Tuomilehto J, Osmond C, Barker D (2000) Fetal and childhood growth and hypertension in adult life. Hypertension 36:790–794
McMillen I, Muhlhausler B, Duffield J, Yuen B (2004) Prenatal programming of postnatal obesity: Fetal nutrition and the regulation of leptin synthesis and secretion before birth. Proc Nutr Soc 63:405–412
Wild S, Byrne C (2004) Evidence for fetal programming of obesity with a focus on putative mechanisms. Nutr Res Rev 17:153–162
Stevens J (2002) Applied multivariate statistics for the social sciences, 4th edn. Psychology Press, New York
Fox J (2008) Applied regression analysis and generalized linear models, 2nd edn. Sage, Newbury Park
Schlaeppi JM, Gutzwiller S, Finkenzeller G, Fournier B (1997) 1,25-dihydroxyvitamin D3 induces the expression of vascular endothelial growth factor in osteoblastic cells. Endocr Res 23:213–229
Wang DS, Miura M, Demura H, Sato K (1997) Anabolic effects of 1,25-dihydroxyvitamin D3 on osteoblasts are enhanced by vascular endothelial growth factor produced by osteoblasts and by growth factors produced by endothelial cells.Endocrinology 138:2953–2962
Cardus A, Panizo S, Encinas M, Dolcet X, Gallego C, Aldea M, Fernandez E, Valdivielso JM (2009) 1,25-dihydroxyvitamin D3 regulates VEGF production through a vitamin D response element in the VEGF promoter. Atherosclerosis 204:85–89
Cardús A, Parisi E, Gallego C, Aldea M, Fernández E, Valdivielso JM (2006) 1,25-Dihydroxyvitamin D3 stimulates vascular smooth muscle cell proliferation through a VEGF-mediated pathway. Kidney Int 69:1377–1384
Gruber HE, Hoelscher G, Ingram JA, Chow Y, Loeffler B, Hanley EN Jr (2008) 1,25(OH)2-vitamin D3 inhibits proliferation and decreases production of monocyte chemoattractant protein-1, thrombopoietin, VEGF, and angiogenin by human annulus cells in vitro. Spine 33:755–765
Ben-Shoshan M, Amir S, Dang DT, Dang LH, Weisman Y, Mabjeesh NJ (2007) 1alpha,25-dihydroxyvitamin D3 (Calcitriol) inhibits hypoxia-inducible factor-1/vascular endothelial growth factor pathway in human cancer cells. Mol Cancer Ther 6:1433–1439
Levine MJ, Teegarden D (2004) 1alpha,25-dihydroxycholecalciferol increases the expression of vascular endothelial growth factor in C3H10T1/2 mouse embryo fibroblasts. J Nutr 134:2244–2250
Kulkarni AV, Mehendale SS, Yadav HR, Joshi SR (2011) Reduced placental docosahexaenoic acid levels associated with increased levels of sFlt-1 in preeclampsia. Prostaglandins Leukot Essent Fatty Acids 84(1–2):51–55
Kulkarni AV, Mehendale SS, Yadav HR, Kilari AS, Taralekar VS, Joshi SR (2010) Circulating angiogenic factors and their association with birth outcomes in preeclampsia. Hypertens Res 33:561–567
Bhatia J (2005) Perinatal nutrition: optimizing infant health and development. Marcel Dekker, New York
Rasmussen K (2001) Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? J Nutr 131:590S–603S
Patil S, Kodiwadmath M, Kodiwadmath S (2008) Lipid peroxidation and antioxidant status in hypertensive pregnancies. Clin Exper Obstet Gynecol 35:272–274
Williams M, Woelk G, King I, Jenkins L, Mahomed K (2003) Plasma carotenoids, retinol, tocopherols, and lipoproteins in preeclamptic and normotensive pregnant Zimbabwean women. Am J Hypertens 16:665–672
Finch B (2003) Socioeconomic gradients and low birth-weight: empirical and policy considerations. Health Serv Res 38:1819–1842
Watts V, Rockett H, Baer H, Colditz G (2007) Assessing dietary quality in a population of low-income pregnant women: a comparison between Native American and Whites. Matern Child Health J 11:127–136
Rumbold A, Crowther C (2005) Vitamin E supplementation in pregnancy. Cochrane Datatabase Syst Rev 18(2):CD004069
Rumbold A, Crowther C (2005) Vitamin C supplementation in pregnancy. Cochrane Datatabase Syst Rev 18(2):CD004072
Acknowledgments
Funding for this project was received from the National Institute of Nursing Research/National Institutes of Health, USA, [1R21NR010592-01A1: Predictors of Dietary Quality in Low-Income Pregnant Women].
Conflict of interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fowles, E.R., Walker, L.O., Marti, C.N. et al. Relationships among maternal nutrient intake and placental biomarkers during the 1st trimester in low-income women. Arch Gynecol Obstet 285, 891–899 (2012). https://doi.org/10.1007/s00404-011-2213-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-011-2213-2