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Indonesian Journal of Obstetrics and Gynecology

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Nutrition versus Great Obstetric Syndrome: A Bridge too Far?Hermanto T. JoewonoEditorialThe term ‘the great obstetrical syndromes’ (not discrete entities, with more than one cause)1 refers to preterm labor, preterm premature rupture of membranes, preeclampsia, small for gestational age (SGA), large for gestational age (LGA), stillbirth etc. The “Great Obstetrical Syndromes” are associated with defective deep placentation,2 The same opinions mentioned (biomarkers) and as well 3,4 (added gestational diabetes on the list and biomarkers). More specifically explained that trigger for abnormal placental development and the subsequent cascade of events remains unknown.5 Various dietary and lifestyle factors have been associated with an increased risk of preeclampsia; however, causality has been difficult to prove. Maternal interventions in dietary advice and modifications have lacked significant success in preventing FGR.6There are at least two papers on nutrition in pregnancy, on behalf of FIGO released paper think nutrition first.7 Women’s nutrition and health can play a role in the intergenerational transmission of human health capital, ensuring future health, happiness, longevity, and economic progress. Epigenetic modifications, a modifiable risk factor, undernutrition and overnutrition may be associated with GOS8,9. Different findings found no significant associations were observed between dietary and infant’s outcomes.10 And that several nutrients and dietary factors previously believed to be implicated in the risk of pre-eclampsia have now been shown to have no effect on risk such as vitamins C and E, magnesium, salt, ω-3 long-chain polyunsaturated fatty acids (fish oils) and zinc.11 Findings in other specific nutrition related group; Undernutrition group12 confirmed relationship with fetal growth restriction, low birth weight (LBW) and preterm birth. Obese group13 increased risk for several GOS, increasing risk of developing preeclampsia with OR 6.04 in women whose BMI was ≥40 kg/m2. Vegan group8,9 : Only potential concerns on neonatal adverse outocmes . Fasting group; Ramadan fasting: no adverse effects on birth weight or preterm birth rate. In Surabaya, some animal studies showed no effect of maternal fasting to the neuronal number and apoptotic index of newborn Rattus norvegicus cerebrum and cerebellum14,15.Important on nutrition in pregnancy;8,9 limitations of available evidence, many questions remain unanswered due to the many challenges of performing high-quality research in pregnancy. Thus, many recommendations for intake are based on observational studies and expert consensus, and lack randomized trials to support them. Other unanswered questions on nutrition are; absorption, distribution, metabolism, excretrion or pharmacokinetics – dynamics of nutrition the same between potato dominant eaters(Western) versus rice dominant eaters(Asia)? Is it wise to treat fe deficiency anemia without measuring the blood albumin level? Of note also, finding in mechanism of autophagy that is essential for the cellular response to starvation and other types of stress that can be an answer to what happen during fasting state.16 The most of the GOS result from non nutritional causes.17 Markers for this GOS without nutritional related items. In conclusion: correlation between nutritional modification and great obstetrics syndrome is positive but large multi centre multi ethnicity, multi trimester with various group of nutrition studies are needed to further elaborate what have been found to specifically conclude causal relationship.GOS: Great Obstetrical Syndrome LGA: Large for Gestational Age SGA: Small for Gestational Age DOHaD: Developmental Origins of Health and Disease FIGO: International Federation of Gynecologist & Obstetricians NIH: National Institute of Health LBW: Low Birth Weight FGR: Fetal Growth Restriction GDM: Gestational Diabetes Mellitus MDI: Mental Development Index

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

618.2 Joe i

Penerbit

: ., 2022

Deskripsi Fisik

246 hal., il., ind., 28 cm

Bahasa

Inggris

ISBN/ISSN

P-ISSN : 23387335 E-

Klasifikasi

618

Tipe Isi

text

Tipe Media

other

Tipe Pembawa

-

Edisi

Volume 10 No. 4 Oktober 2022

Subjek

Kebidanan
Ginekologi dan Obstetri
health

Info Detail Spesifik

The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynecology. INAJOG is published quarterly. submit the manuscript by logging in first.

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