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Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial

IMPORTANCE: Maternal suboptimal nutrition and high stress levels are associated with adverse fetal and childhood neurodevelopment. OBJECTIVE: To test the hypothesis that structured interventions based on a Mediterranean diet or mindfulness-based stress reduction (MBSR) during pregnancy improve child...

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Autores principales: Crovetto, Francesca, Nakaki, Ayako, Arranz, Angela, Borras, Roger, Vellvé, Kilian, Paules, Cristina, Boutet, Maria Laura, Castro-Barquero, Sara, Freitas, Tania, Casas, Rosa, Martín-Asuero, Andrés, Oller Guzmán, Teresa, Morilla, Ivette, Martínez-Àran, Anabel, Camacho, Alba, Pasqual, Mireia, Izquierdo Renau, Montserrat, Pozo, Óscar J., Gomez-Gomez, Alex, Estruch, Ramon, Vieta, Eduard, Crispi, Fàtima, Gratacós, Eduard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445211/
https://www.ncbi.nlm.nih.gov/pubmed/37606923
http://dx.doi.org/10.1001/jamanetworkopen.2023.30255
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author Crovetto, Francesca
Nakaki, Ayako
Arranz, Angela
Borras, Roger
Vellvé, Kilian
Paules, Cristina
Boutet, Maria Laura
Castro-Barquero, Sara
Freitas, Tania
Casas, Rosa
Martín-Asuero, Andrés
Oller Guzmán, Teresa
Morilla, Ivette
Martínez-Àran, Anabel
Camacho, Alba
Pasqual, Mireia
Izquierdo Renau, Montserrat
Pozo, Óscar J.
Gomez-Gomez, Alex
Estruch, Ramon
Vieta, Eduard
Crispi, Fàtima
Gratacós, Eduard
author_facet Crovetto, Francesca
Nakaki, Ayako
Arranz, Angela
Borras, Roger
Vellvé, Kilian
Paules, Cristina
Boutet, Maria Laura
Castro-Barquero, Sara
Freitas, Tania
Casas, Rosa
Martín-Asuero, Andrés
Oller Guzmán, Teresa
Morilla, Ivette
Martínez-Àran, Anabel
Camacho, Alba
Pasqual, Mireia
Izquierdo Renau, Montserrat
Pozo, Óscar J.
Gomez-Gomez, Alex
Estruch, Ramon
Vieta, Eduard
Crispi, Fàtima
Gratacós, Eduard
author_sort Crovetto, Francesca
collection PubMed
description IMPORTANCE: Maternal suboptimal nutrition and high stress levels are associated with adverse fetal and childhood neurodevelopment. OBJECTIVE: To test the hypothesis that structured interventions based on a Mediterranean diet or mindfulness-based stress reduction (MBSR) during pregnancy improve child neurodevelopment at age 2 years. DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified analysis of the parallel-group Improving Mothers for a Better Prenatal Care Trial Barcelona (IMPACT BCN) randomized clinical trial, which was conducted at a university hospital in Barcelona, Spain, from February 2017 to March 2020. A total of 1221 singleton pregnancies (19 to 23 weeks’ gestation) with high risk of delivering newborns who were small for gestational age were randomly allocated into 3 groups: a Mediterranean diet intervention, an MBSR program, or usual care. A postnatal evaluation with the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III), was performed. Data were analyzed from July to November 2022. INTERVENTIONS: Participants in the Mediterranean diet group received monthly individual and group educational sessions and free provision of extra virgin olive oil and walnuts. Those in the stress reduction group underwent an 8-week MBSR program adapted for pregnancy. Individuals in the usual care group received pregnancy care per institutional protocols. MAIN OUTCOMES AND MEASURES: Neurodevelopment in children was assessed by Bayley-III at 24 months of corrected postnatal age. RESULTS: A total of 626 children (293 [46.8%] female and 333 [53.2%] male) participated at a mean (SD) age of 24.8 (2.9) months. No differences were observed in the baseline characteristics between intervention groups. Compared with children from the usual care group, children in the Mediterranean diet group had higher scores in the cognitive domain (β, 5.02; 95% CI, 1.52-8.53; P = .005) and social-emotional domain (β, 5.15; 95% CI, 1.18-9.12; P = .01), whereas children from the stress reduction group had higher scores in the social-emotional domain (β, 4.75; 95% CI, 0.54-8.85; P = .02). CONCLUSIONS AND RELEVANCE: In this prespecified analysis of a randomized clinical trial, maternal structured lifestyle interventions during pregnancy based on a Mediterranean diet or MBSR significantly improved child neurodevelopmental outcomes at age 2 years. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03166332
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spelling pubmed-104452112023-08-24 Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial Crovetto, Francesca Nakaki, Ayako Arranz, Angela Borras, Roger Vellvé, Kilian Paules, Cristina Boutet, Maria Laura Castro-Barquero, Sara Freitas, Tania Casas, Rosa Martín-Asuero, Andrés Oller Guzmán, Teresa Morilla, Ivette Martínez-Àran, Anabel Camacho, Alba Pasqual, Mireia Izquierdo Renau, Montserrat Pozo, Óscar J. Gomez-Gomez, Alex Estruch, Ramon Vieta, Eduard Crispi, Fàtima Gratacós, Eduard JAMA Netw Open Original Investigation IMPORTANCE: Maternal suboptimal nutrition and high stress levels are associated with adverse fetal and childhood neurodevelopment. OBJECTIVE: To test the hypothesis that structured interventions based on a Mediterranean diet or mindfulness-based stress reduction (MBSR) during pregnancy improve child neurodevelopment at age 2 years. DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified analysis of the parallel-group Improving Mothers for a Better Prenatal Care Trial Barcelona (IMPACT BCN) randomized clinical trial, which was conducted at a university hospital in Barcelona, Spain, from February 2017 to March 2020. A total of 1221 singleton pregnancies (19 to 23 weeks’ gestation) with high risk of delivering newborns who were small for gestational age were randomly allocated into 3 groups: a Mediterranean diet intervention, an MBSR program, or usual care. A postnatal evaluation with the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III), was performed. Data were analyzed from July to November 2022. INTERVENTIONS: Participants in the Mediterranean diet group received monthly individual and group educational sessions and free provision of extra virgin olive oil and walnuts. Those in the stress reduction group underwent an 8-week MBSR program adapted for pregnancy. Individuals in the usual care group received pregnancy care per institutional protocols. MAIN OUTCOMES AND MEASURES: Neurodevelopment in children was assessed by Bayley-III at 24 months of corrected postnatal age. RESULTS: A total of 626 children (293 [46.8%] female and 333 [53.2%] male) participated at a mean (SD) age of 24.8 (2.9) months. No differences were observed in the baseline characteristics between intervention groups. Compared with children from the usual care group, children in the Mediterranean diet group had higher scores in the cognitive domain (β, 5.02; 95% CI, 1.52-8.53; P = .005) and social-emotional domain (β, 5.15; 95% CI, 1.18-9.12; P = .01), whereas children from the stress reduction group had higher scores in the social-emotional domain (β, 4.75; 95% CI, 0.54-8.85; P = .02). CONCLUSIONS AND RELEVANCE: In this prespecified analysis of a randomized clinical trial, maternal structured lifestyle interventions during pregnancy based on a Mediterranean diet or MBSR significantly improved child neurodevelopmental outcomes at age 2 years. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03166332 American Medical Association 2023-08-22 /pmc/articles/PMC10445211/ /pubmed/37606923 http://dx.doi.org/10.1001/jamanetworkopen.2023.30255 Text en Copyright 2023 Crovetto F et al. JAMA Network Open. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the CC-BY-NC-ND License.
spellingShingle Original Investigation
Crovetto, Francesca
Nakaki, Ayako
Arranz, Angela
Borras, Roger
Vellvé, Kilian
Paules, Cristina
Boutet, Maria Laura
Castro-Barquero, Sara
Freitas, Tania
Casas, Rosa
Martín-Asuero, Andrés
Oller Guzmán, Teresa
Morilla, Ivette
Martínez-Àran, Anabel
Camacho, Alba
Pasqual, Mireia
Izquierdo Renau, Montserrat
Pozo, Óscar J.
Gomez-Gomez, Alex
Estruch, Ramon
Vieta, Eduard
Crispi, Fàtima
Gratacós, Eduard
Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial
title Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial
title_full Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial
title_fullStr Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial
title_full_unstemmed Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial
title_short Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial
title_sort effect of a mediterranean diet or mindfulness-based stress reduction during pregnancy on child neurodevelopment: a prespecified analysis of the impact bcn randomized clinical trial
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445211/
https://www.ncbi.nlm.nih.gov/pubmed/37606923
http://dx.doi.org/10.1001/jamanetworkopen.2023.30255
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