Studio della nutrizione in gravidanza nell'ambito del progetto "HUMAN-BB": impatto dell'alimentazione sulla salute mterno/neonatale in un campione di 800 gravide fisiologiche

Scientific evidences support the importance of an appropriate nutrition during pregnancy in promoting maternal and neonatal positive outcomes as well as in preventing gestational complications, such as hypertension, diabetes and fetal growth defects. According to “DOHaD hypothesis” (Developmental Origin of Health and Disease), the quantity and quality of nutrients assumed by the fetus during intra-uterine develoment could contribute in modulating the fetal metabolism, with long-term consequences on adult health. The "HuMAN-BB" project was conceived to investigate the impact of maternal nutrition on neonatal outcomes, in particular on newborn epigenome setting, through the “EPIC-FFQ” questionnaire on one side and the analysis of maternal/placental biological samples and related clinical data, on the other side. As part of “HuMAN-BB” project, this thesis evaluates the adequacy of maternal nutrition, compared to current guidelines (SIGO 2018). In addition, maternal and neonatal clinical parameters, related to nutrition, will be investigated, such as maternal BMI, birth weight and placenta weight. The investigated population includes 826 women, recruited between September 2016 and January 2019 at the "L. Mangiagalli" Clinic (Ca' Granda Foundation, Maggiore Policlinico Hospital). Inclusion criteria were European women; singleton spontaneous pregnancies, absence of neonatal malformations and/or fetal genetic anomalies. At the time of delivery, biological samples were taken, and clinical data were collected by consulting maternal medical records. The EPIC questionnaires were collected before hospital discharge and subsequently analyzed through a dedicated software. The main findings of this thesis are: 1) a slight excess in daily caloric intake has been observed (found in 64% of women), especially in fats consumption; 2) we confirmed the importance of dietary supplementation of folic acid, since the amount of this micronutrient introduced by the diet is not enough to support fetal requirements; 3) the amount of water and dietary fiber resulted significantly lower than those recommended. Finally, the evaluation of maternal clinical parameters highlighted the relationship between an increased pregestational BMI and an excessive weight gain during pregnancy, likely related to unhealthy dietary habits. So far as pregestational BMI, data suggest possible correlation with birth weight percentile, especially in newborns with growth defects. In this contest, the role of midwife is essential to support women during the pregnancy and to educate them about the importance of a healthy diet.