Although these infants have no amplified risk of perinatal morbidity or mortality, SGA may contribute to fetal growth-restriction (FGR) in the womb, which increases mortality rates in infants.
says Francesca Crovetto, MD, PhD, a post-doctoral fellow at the BCNatal Fetal Medicine Research Center in Barcelona, Spain, and colleagues.
The team randomly assigned 1,221 women with singleton pregnancies (19-23 weeks pregnancy at high risk for SGA) in a 1:1:1 ratio among the age groups 33.2 to 40.5 years.
Interventions Applied
The participants in the first group received one-on-one and group educational sessions at 2 hours per month along with a Mediterranean diet (free provision of extra-virgin olive oil and walnuts twice a month).
The second group was given an 8-week mindfulness stress reduction program (stress reduction cohort), while the third group was given the usual care. Most of the women had a pre-pregnancy BMI of about 24 kg/m2 and were white. Over 90% of each cohort completed the trial.
Effect on SGA
It was found that nearly 21.9% of newborns in the usual care cohort were born small for their gestational age. On the contrary, only 14% of infants in the Mediterranean diet cohort and 15.6% of those in the mindfulness stress reduction cohort were born small for their gestational age.
In addition, adverse perinatal outcomes were noted in 26.2% among the usual care cohort along with 18.6% in the Mediterranean diet cohort, and 19.5% in the stress reduction cohort.
Study Limitations
However, the study had multiple limitations such as smaller differences in the usual care cohort, imbalanced number of early births and healthcare-related visits, and “low participation” of other high-risk groups like obesity, gestational diabetes, and large-for-gestational-age newborns.
“Due to [these] important study limitations, these findings should be considered preliminary and require replication, as well as assessment in additional patient populations, before concluding that these treatments should be recommended to patients,” noted the researchers.
Novel Findings
However, as there are no proven interventions to prevent SGA infants, the study findings nevertheless remain novel.
“Implementation of these interventions into clinical practice should await results of the neurodevelopmental assessment and other outcomes among the offspring at 2 years of age and replication of the study results in other populations,” says Margaret Bublitz, PhD, an assistant professor of psychiatry and human behavior and assistant professor of medicine at Brown University, and Methodius G. Tuuli, MD, MPH, MBA, the executive chief of obstetrics and gynecology for Women & Infants Hospital in Rhode Island, and chair of the department of obstetrics and gynecology at the Warren Alpert Medical School at Brown University.
References:
- Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction on Prevention of Small-for-Gestational Age Birth Weights in Newborns Born to At-Risk Pregnant Individuals
– (https://jamanetwork.com/journals/jama/article-abstract/2786831) - Small for Gestational Age
– (https://www.ncbi.nlm.nih.gov/books/NBK563247/)
Source: Medindia
