Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-23T15:41:53.989Z Has data issue: false hasContentIssue false

Diet during pregnancy and the risk of cerebral palsy

Published online by Cambridge University Press:  09 March 2007

Eleni Petridou*
Affiliation:
Department of Hygiene and Epidemiology, Athens University Medical School, 75 M. Asias Str. T.K. 115 27 Athens, Greece Department of Epidemiology, Harvard School of Public Health, 677 Huntingdon Avenue, Boston, MA 02115, USA Foundation for Research in Childhood ‘S. Doxiadis’, 42 Amalias Avenue, Athens, Greece
Mary Koussouri
Affiliation:
Department of Hygiene and Epidemiology, Athens University Medical School, 75 M. Asias Str. T.K. 115 27 Athens, Greece
Nektaria Toupadaki
Affiliation:
Department of Hygiene and Epidemiology, Athens University Medical School, 75 M. Asias Str. T.K. 115 27 Athens, Greece
Sotiris Youroukos
Affiliation:
Department of Pediatrics, Athens University Medical School, Agia Sophia Children's Hospital, 9 Thiron Str. T.K. 115 27 Athens, Greece
Antigoni Papavassiliou
Affiliation:
Department of Neurology, Penteli Children's Hospital, Palaia Penteli, Athens, Greece
Stephanos Pantelakis
Affiliation:
Foundation for Research in Childhood ‘S. Doxiadis’, 42 Amalias Avenue, Athens, Greece
Jorn Olsen
Affiliation:
Department of Epidemiology, Harvard School of Public Health, 677 Huntingdon Avenue, Boston, MA 02115, USA The Danish Epidemiology Science Centre, University of Aarhus, Norrebrogade 44 Building 2c, DK-8000 Aarhus, Denmark
Dimitrios Trichopoulos
Affiliation:
Department of Epidemiology, Harvard School of Public Health, 677 Huntingdon Avenue, Boston, MA 02115, USA
*
*Corresponding author: Dr Eleni Petridou, fax +301 777 3840, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The role of maternal diet in the development of the fetal brain has not been adequately explored. Marine n-3 fatty acids have, however, been proposed to be important for brain development. The present case–control study aimed to investigate the relationship between dietary intake during pregnancy and the occurrence of cerebral palsy (CP) in the offspring. Children with CP (n 109), born between 1984 and 1988 to mothers residing in the Greater Athens area, were identified at any time in 1991 or 1992 through institutions delivering care and rehabilitation. Successful nutritional interviews were conducted with ninety-one of these children. Controls were chosen among the neighbours of the CP cases or were healthy siblings of children with neurological diseases other than CP, seen by the same neurologists as the children with CP. A total of 278 control children were chosen, and 246 of them were included in the nutritional study. Guardians of all children were interviewed in person on the basis of a questionnaire covering obstetric, perinatal socioeconomic and environmental variables. A validated semiquantitative food-frequency questionnaire of 111 food items was used to estimate maternal dietary intake during pregnancy. Statistical analysis was done by modelling the data through logistic regression. Food groups controlling for energy intake were alternatively and simultaneously introduced in a core model containing non-nutritional confounding variables. Consumption of cereals (mostly bread) and fish intake were inversely associated with CP (P < 0·05 and P < 0·09 respectively) whereas consumption of meat was associated with increased risk (P < 0·02). A protective effect of fish consumption and a detrimental effect of meat intake have been suggested on the basis of earlier work and appear to be biologically plausible. If corroborated by other studies, these results could contribute to our understanding of the nutritional influences on fetal brain development.

Type
Human and Clinical Nutrition
Copyright
Copyright © The Nutrition Society 1998

References

Allan, WC, Dransfield, DA & Kessler, DL (1994) Cerebral palsy in preterm infants. Lancet 343, 1048.Google Scholar
Blair, E & Stanley, F (1993) When can cerebral palsy be prevented? The generation of causal hypotheses by multivariate analysis of a case–control study. Pediatric Epidemiology 7, 272301.Google Scholar
Breslow, NE & Day, NE (1980) Statistical Methods in Cancer Research, Vol 1. The Analysis of Case–control Studies. IARC Scientific Publication no 32. Lyon, France: International Agency for Research on Cancer.Google Scholar
Crawford, MA (1993) The role of essential fatty acids in neural development: implications for perinatal nutrition. American Journal of Clinical Nutrition 57, 703S710S.Google Scholar
Crawford, MA & Sinclair, AJ (1972) Nutritional influences in the evolution of the mammalian brain. In Lipids, Malnutrition and the Developing Brain, pp. 267292 [Eliot, K and Knight, J, editors]. Amsterdam: Elsevier.Google Scholar
Cummins, SK, Nelson, KB, Grether, JK & Velie, EM (1993) Cerebral palsy in four northern California counties, births 1983 through 1985. Journal of Pediatrics 123, 230237.CrossRefGoogle ScholarPubMed
Davidson, S & Passmore, R (1979) Human Nutrition and Dietetics. Edinburgh: Churchill Livingstone.Google Scholar
Fujimoto, S, Yamaguchi, N, Togari, H, Wada, Y & Yokochi, K (1994) Cerebral palsy of cystic periventricular leucomalacia in low-birthweight infants. Acta Pediatrica 83, 397401.CrossRefGoogle Scholar
Gnardellis, C, Trichopoulou, A, Katsouyanni, K, Polychronopoulos, E, Rimm, EB & Trichopoulos, D (1995) Reproducibility and validity of an extensive semiquantitative food frequency questionnaire among Greek school teachers. Epidemiology 6, 7477.CrossRefGoogle ScholarPubMed
Graham, S, Dayal, H, Swanson, M, Mittelman, A & Wilkinson, G (1978) Diet in the epidemiology of cancer of the colon and rectum. Journal of the National Cancer Institute 61, 709714.Google Scholar
Katsouyanni, K, Skalkidis, Y, Petridou, E, Polychronopoulou-Trichopoulou, A, Willett, W & Trichopoulos, D (1991) Diet and peripheral arterial occlusive disease: the role of poly-, mono-, and saturated fatty acids. American Journal of Epidemiology 133,2431.Google Scholar
Leaf, AA, Leighfield, MJ, Costeloe, KL & Crawford, MA (1992) Factors affecting long-chain polyunsaturated fatty acid composition of plasma choline phosphoglycerides in preterm infants. Journal of Pediatric Gastroenterology and Nutrition 14, 300308.Google Scholar
MacMahon, B & Trichopoulos, D (1996) Epidemiology: Principles and Methods, 2nd ed. Boston, MA: Little Brown and Co.Google Scholar
Miettinen, OS (1985) Theoretical Epidemiology. New York, NY: J. Wiley and Sons.Google Scholar
Olsen, SF (1993) Consumption of marine n-fatty acids during pregnancy as a possible determinant of birth weight: a review of the current epidemiologic evidence. Epidemiologic Reviews 15, 399413.Google Scholar
Olsen, SF, Grandjean, P, Weihe, P & Videroe, T (1993) Frequency of seafood intake in pregnancy as a determinant of birthweight: evidence for a dose dependent relationship Journal of Epidemiology and Community Health 47, 436440.CrossRefGoogle ScholarPubMed
Olsen, SF, Hansen, HS, Sommer, S, Jensen, B, Sorensen, TI, Secher, NJ & Zachariassen, P (1991) Gestational age in relation to marine n-fatty acids in maternal erythrocytes: a study of women in the Faroe Islands and Denmark. American Journal of Obstetrics and Gynecology 164, 12031209.Google Scholar
Oslen, SF, Hansen, H, Sorensen, TIA, Jensen, B, Secher, NJ, Sommer, S & Knudsen, IB (1986) Intake of marine fat, rich in (n-3)-polyunsaturated fatty acids may increase birthweight by prolonging gestation. Lancet 2, 367369.Google Scholar
Olsen, SF, Olsen, J & Frische, G (1990) Does fish consumption during pregnancy increase fetal growth? A study of the size of the newborn, placenta weight and gestational age in relation to fish consumption during pregnancy. International Journal of Epidemiology 19, 971977.Google Scholar
Olsen, SF, Sorensen, JD, Secher, NJ, Hedegaard, M, Henriksen, TB, Hansen, HS & Grant, A (1992) Randomized controlled trial of effect of fish oil supplementation on pregnancy duration. Lancet 339, 10031007.Google Scholar
Petridou, E, Koussouri, M, Toupadaki, N, Papavassiliou, A, Youroukos, S, Katsarou, E & Trichopoulos, D (1996) Risk factors for cerebral palsy: a case control study in Greece. Scandinavian Journal of Social Medicine 24, 1426.Google Scholar
Pharoah, POD, Cooke, T, Cooke, RWI & Rosenbloom, L (1990) Birthweight specific trends in cerebral palsy. Archives of Disease in Childhood 65, 602606.Google Scholar
Stanley, F & Alberman, E (editors) (1984) The Epidemiology of the Cerebral Palsies. Spastics International Medical Publications. Oxford: Blackwell Scientific Publications Ltd, Philadelphia, PA: J.B. Lippincott Co.Google Scholar
Trichopoulou, A (1992) Composition of Greek Foods and Dishes. Athens, Greece: Athens School of Public Health.Google Scholar
Trichopoulou, A, Katsouyanni, K, Stuver, S, Tzala, L, Gnardellis, C, Rimm, E & Trichopoulos, D (1995) Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece. Journal of the National Cancer Institute 87, 110116.Google Scholar
Uvebrant, P & Hagberg, G (1992) Intrauterine growth in children with cerebral palsy. Acta Pediatrica 81, 407412.Google Scholar
Willett, W & Stampfer, MJ (1986) Total energy intake: implications for epidemiologic analyses. American Journal of Epidemiology 124, 1727.Google Scholar
Williams, MA, Zingheim, RW, King, IB & Zebelman, AM (1995) Omega-3 fatty acids in maternal erythrocytes and risk of preeclampsia. Epidemiology 6, 232237.Google Scholar