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The effect of a maternal meal on fetal liver blood flow

INTRODUCTION: During the third trimester of development, the human fetus accumulates fat, an important energy reservoir during the early postnatal period. The fetal liver, perfused by the nutrient-rich and well-oxygenated blood coming directly from the placenta, is assumed to play a central role in...

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Autores principales: Opheim, Gun Lisbet, Henriksen, Tore, Haugen, Guttorm
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561550/
https://www.ncbi.nlm.nih.gov/pubmed/31188835
http://dx.doi.org/10.1371/journal.pone.0216176
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author Opheim, Gun Lisbet
Henriksen, Tore
Haugen, Guttorm
author_facet Opheim, Gun Lisbet
Henriksen, Tore
Haugen, Guttorm
author_sort Opheim, Gun Lisbet
collection PubMed
description INTRODUCTION: During the third trimester of development, the human fetus accumulates fat, an important energy reservoir during the early postnatal period. The fetal liver, perfused by the nutrient-rich and well-oxygenated blood coming directly from the placenta, is assumed to play a central role in these processes. Earlier studies have linked fetal liver blood flow with maternal nutritional status and response to the maternal oral glucose tolerance test. Our aim was to explore the effect of a regular maternal meal on fetal liver blood flow at two timepoints during the third trimester, representing the start and towards the end of the fetal fat accretion period. We also sought to explore the influence of prepregancy body mass index on how the maternal meal affects fetal liver blood flow. METHODS: Using ultrasound Doppler, we examined 108 healthy women with singleton pregnancies in gestational weeks 30 and 36. At each visit, the first examination was performed with the participant in a fasting state at 08.30 a.m., followed by a standard breakfast meal of approximately 400 kcal. The examination was repeated after 105 minutes. Umbilical vein and ductus venosus blood flow was estimated from diameter and blood flow velocity measurements. Fetal liver flow was calculated as umbilical vein flow minus ductus venosus flow, and change in liver blood flow as flow after minus before the meal. The total group was divided into a normal-weight group (prepregancy body mass index 18.5–25.0 kg/m(2); n = 83) and an overweight group (prepregancy body mass index >25.0 kg/m(2); n = 21). Four women with prepregancy body mass index <18.5 kg/m(2) were excluded from these analyses. Non-parametric statistical hypothesis tests were used for group comparisons. RESULTS: For the total group, we observed a significant increase in median (10(th) - 90(th) percentile) liver flow 28.9 (‒67.9–111.6) ml/min (p = 0.002) following the meal in week 36, but not in week 30, ‒2.63 (‒53.2–65.0) ml/min (p = 0.91). This result in turn yielded a statistically significant increase in delta liver flow from weeks 30 to 36 of 26.0 (‒107.1–146.6) ml/min (p = 0.008). The increase in postprandial liver flow was observed only in the normal-weight group in week 36. Accordingly, the delta liver flow values between the two weight groups were significantly different in week 36 (p = 0.006) but not in week 30 (p = 0.155). Among the normal-weight women, the increase in delta liver blood flow from weeks 30 to 36 was 39.3 (‒83.0–156.1) ml/min (p<0.001); in contrast, we observed no statistically significant change in the overweight group (‒44.5 (‒229.0–123.2) ml/min; p = 0.073). As a substitute for liver size, we divided the delta liver flow values by abdominal circumference and found no changes in the statistical significance results within or between the two weight groups. CONCLUSION: In our healthy study population, we observed a statistically significant difference in liver blood flow after maternal intake of a regular meal. This effect depended on gestational age and maternal prepregancy body mass index, but apparently was independent of liver size, based on abdominal circumference as a proxy measure.
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spelling pubmed-65615502019-06-20 The effect of a maternal meal on fetal liver blood flow Opheim, Gun Lisbet Henriksen, Tore Haugen, Guttorm PLoS One Research Article INTRODUCTION: During the third trimester of development, the human fetus accumulates fat, an important energy reservoir during the early postnatal period. The fetal liver, perfused by the nutrient-rich and well-oxygenated blood coming directly from the placenta, is assumed to play a central role in these processes. Earlier studies have linked fetal liver blood flow with maternal nutritional status and response to the maternal oral glucose tolerance test. Our aim was to explore the effect of a regular maternal meal on fetal liver blood flow at two timepoints during the third trimester, representing the start and towards the end of the fetal fat accretion period. We also sought to explore the influence of prepregancy body mass index on how the maternal meal affects fetal liver blood flow. METHODS: Using ultrasound Doppler, we examined 108 healthy women with singleton pregnancies in gestational weeks 30 and 36. At each visit, the first examination was performed with the participant in a fasting state at 08.30 a.m., followed by a standard breakfast meal of approximately 400 kcal. The examination was repeated after 105 minutes. Umbilical vein and ductus venosus blood flow was estimated from diameter and blood flow velocity measurements. Fetal liver flow was calculated as umbilical vein flow minus ductus venosus flow, and change in liver blood flow as flow after minus before the meal. The total group was divided into a normal-weight group (prepregancy body mass index 18.5–25.0 kg/m(2); n = 83) and an overweight group (prepregancy body mass index >25.0 kg/m(2); n = 21). Four women with prepregancy body mass index <18.5 kg/m(2) were excluded from these analyses. Non-parametric statistical hypothesis tests were used for group comparisons. RESULTS: For the total group, we observed a significant increase in median (10(th) - 90(th) percentile) liver flow 28.9 (‒67.9–111.6) ml/min (p = 0.002) following the meal in week 36, but not in week 30, ‒2.63 (‒53.2–65.0) ml/min (p = 0.91). This result in turn yielded a statistically significant increase in delta liver flow from weeks 30 to 36 of 26.0 (‒107.1–146.6) ml/min (p = 0.008). The increase in postprandial liver flow was observed only in the normal-weight group in week 36. Accordingly, the delta liver flow values between the two weight groups were significantly different in week 36 (p = 0.006) but not in week 30 (p = 0.155). Among the normal-weight women, the increase in delta liver blood flow from weeks 30 to 36 was 39.3 (‒83.0–156.1) ml/min (p<0.001); in contrast, we observed no statistically significant change in the overweight group (‒44.5 (‒229.0–123.2) ml/min; p = 0.073). As a substitute for liver size, we divided the delta liver flow values by abdominal circumference and found no changes in the statistical significance results within or between the two weight groups. CONCLUSION: In our healthy study population, we observed a statistically significant difference in liver blood flow after maternal intake of a regular meal. This effect depended on gestational age and maternal prepregancy body mass index, but apparently was independent of liver size, based on abdominal circumference as a proxy measure. Public Library of Science 2019-06-12 /pmc/articles/PMC6561550/ /pubmed/31188835 http://dx.doi.org/10.1371/journal.pone.0216176 Text en © 2019 Opheim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Opheim, Gun Lisbet
Henriksen, Tore
Haugen, Guttorm
The effect of a maternal meal on fetal liver blood flow
title The effect of a maternal meal on fetal liver blood flow
title_full The effect of a maternal meal on fetal liver blood flow
title_fullStr The effect of a maternal meal on fetal liver blood flow
title_full_unstemmed The effect of a maternal meal on fetal liver blood flow
title_short The effect of a maternal meal on fetal liver blood flow
title_sort effect of a maternal meal on fetal liver blood flow
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561550/
https://www.ncbi.nlm.nih.gov/pubmed/31188835
http://dx.doi.org/10.1371/journal.pone.0216176
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