Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Dietary Patterns and Diet Quality before and/or during Pregnancy and How These Affect Birth Outcomes: A Systematic Review and Meta-analysis(Elsevier Inc. on behalf of American Society for Nutrition, 2025-10) Salatas C; Bronnert A; Lawrence R; Alexander T; Wall C; Bloomfield FH; Lin LLimited consistent evidence exists on how diet quality before and during pregnancy influences preterm birth and low birthweight risk. This study aims to assess whether diet quality based on dietary patterns before and during pregnancy affects preterm birth and low birthweight risk. We systematically searched 3 electronic databases and 4 registries for randomized controlled trials (RCTs) and quasi-RCTs without restrictions on publication date or language until 22 November, 2024. Included RCTs evaluated dietary patterns to enhance diet quality before/during pregnancy compared with a usual diet or placebo. Results were synthesized using random-effects meta-analyses with risk ratios (RRs) and 95% confidence intervals. Study quality was assessed using the Cochrane Risk of Bias 1 tool, and certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Twenty-nine RCTs (7367 participants) were included. Improved diet quality through dietary patterns providing the recommended macronutrient intake or high unsaturated fats before and during pregnancy reduced the incidence of low birthweight (<2500 g) (7 RCTs, 2178 participants, RR 0.53 [0.37, 0.77], low certainty of evidence) and have potential benefit for reducing preterm birth (15 RCTs, 4949 participants, RR 0.79 [0.62, 1.02], low certainty of evidence) compared with usual diet. The data available support interventions starting in the first trimester (RR 0.30 [0.11, 0.80]), lasting 4–7 mo (RR 0.52 [0.37, 0.73]), with similar effects in both high-/upper-middle-income [RR 0.44 (0.19, 10.04)] and lower-middle-income (RR 0.44 [0.31, 0.63]) populations, especially in low-risk women (RR 0.52 [0.37, 0.73]). Diets providing the recommended macronutrient intake or high in unsaturated fats significantly reduced risk of low birthweight when initiated in the first trimester and maintained for 4–7 mo, regardless of country-level socioeconomic context. Healthcare providers should consider recommending dietary patterns emphasizing whole foods and high-quality fats as part of early prenatal care.Item Adherence to Dietary Guidelines among Women with and without Gestational Diabetes: Evidence from the Growing Up in New Zealand Study(MDPI (Basel, Switzerland), 2022-05-21) Lawrence RL; Wall CR; Bloomfield FH; Brunetti ADiet is thought to play a role in the development and management of gestational diabetes mellitus (GDM). Dietary guidelines provide practical recommendations for achieving nutrient requirements and mitigating the risk of chronic disease. The aim of this study was to describe the adherence to dietary guidelines by women with and without GDM and determine whether adherence is associated with the development of GDM. Adherence to Ministry of Health food group recommendations was assessed in 5391 pregnant women participating in the Growing Up in New Zealand study. A food frequency questionnaire (FFQ) administered during pregnancy provided dietary data. The presence of GDM was determined using diagnostic coding in clinical data and blood glucose results. A quarter of women did not meet any food group recommendations. There were no significant differences in the number of food group targets met by women with or those without GDM. Meeting food group recommendations was not associated with odds of having GDM in adjusted analyses. This study found adherence to dietary recommendations is poor in both women with and without GDM and no association between adherence to food group recommendations and the development of GDM. Greater support is required to assist women to achieve food and nutrition recommendations.Item Dietary patterns and dietary adaptations in women with and without gestational diabetes: Evidence from the growing up in New Zealand study(MDPI (Basel, Switzerland), 2020-01-15) Lawrence RL; Wall CR; Bloomfield FHDiet is a cornerstone of the management of gestational diabetes (GDM). We investigated differences in dietary patterns and dietary adaptations among pregnant women with and without GDM participating in the Growing Up in New Zealand study. Presence of GDM was determined using coded clinical data and plasma glucose results meeting the New Zealand Society for the Study of Diabetes diagnostic criteria. Women answered a food frequency questionnaire and questions regarding dietary changes and information received during pregnancy. Women with GDM had lower adherence scores than those without GDM for ‘Junk’ (mean (SD) score −0.28 (0.95) versus 0.02 (1.01) p < 0.0005) and ‘Traditional/White bread’ dietary patterns (−0.18 (0.93) versus 0.01 (1.01) p = 0.002). More women with GDM reported avoiding foods high in fat or sugar (25.3% versus 5.7%, p < 0.05) compared to women without GDM. A greater proportion of women with GDM compared with those without GDM received information from dietitians or nutritionists (27.0% versus 1.7%, p < 0.05) or obstetricians (12.6% versus 7.5%, p < 0.05). More women diagnosed before the antenatal interview received advice from dietitians or nutritionists compared with those diagnosed after (46.9% versus 6.0%, p < 0.05). Women with GDM appear to make positive changes to their diet in response to advice received from health care professionals.Item Supplement Use during Pregnancy in Aotearoa, New Zealand(MDPI (Basel, Switzerland), 2023-03-06) Funnell C; Coad J; Brough L; Smith C; Mackay S; Jalili-Moghaddam S; Gibbs MIodine is an essential micronutrient required for thyroid function, and is essential during pregnancy for growth and development. Manatū Hauora (MoH) recommends an iodine supplement of 150 µg/day during pregnancy and breastfeeding. To reduce the risk of brain and spinal cord birth defects, the MoH also recommends a folic acid (FA) supplement of 800 µg/day preconception (four weeks) and during the first trimester of pregnancy. A self-administered Qualtrics XM survey was designed for pregnant women between 20–23 weeks of gestation and advertised on Facebook between March 2021–June 2021 throughout Aotearoa. The aim of the survey was to ascertain supplement usage during pregnancy, with a particular focus on iodine and FA. In total, one hundred and sixty pregnant women completed the online survey. A total of 50% were of New Zealand/European ethnicity, 11% were Māori, and 3.2% of a Pacific Island ethnicity. Furthermore, 43% were educated to university level, and 80% were in either voluntary and/or paid employment. In addition, 66% consumed iodine-only supplements (Neurotab; 150 µg/day), 44% consumed FA-only supplements (800 µg/day), and 34% consumed multiple-micronutrient (MN) supplements containing iodine and FA, predominately Elevit or Blackmore pregnancy supplements. Concerningly, 11% of participants took no supplements, and only 45% of the FA supplement users reported taking the FA prior to conception. Furthermore, 13% took both folic and an MN supplement, putting them at risk of an intake over the upper level of intake (1000 mg/day). Additionally, 18% of the participants consumed both an iodine-only and an MN supplement. Only 37% of those using an iodine supplement planned to stop taking it when breastfeeding ceased, suggesting that many were not aware of the recommendation for continuation of use. Despite the high educational status, many did not adhere to the supplement use recommendations. Public health strategies are required to ensure that women of childbearing age are aware of these recommendations for supplement use pre-, during, and post-pregnancy.Item Effect of Iodine Nutrition During Pregnancy and Lactation on Child Cognitive Outcomes: A Review(MDPI (Basel, Switzerland), 2025-06-16) Ma ZF; Brough L; Marconi AMIodine deficiency remains one of the most serious global public health challenges, recognised as the leading cause of preventable brain damage worldwide. It is widely accepted as the primary aetiological factor underlying iodine deficiency disorders (IDD). Inadequate maternal iodine intake reduces thyroxine synthesis, impairing foetal brain development and leading to long-term deficits in cognitive function across childhood and adulthood. However, emerging evidence also suggests that excessive iodine intake may disrupt thyroid function, particularly in individuals with underlying thyroid autoimmunity, potentially leading to adverse neurodevelopmental outcomes. In this state-of-the-art review, we examine the effects of iodine nutrition during pregnancy and lactation on child cognitive outcomes. We provide an overview of the recent global iodine status, critically appraise the current evidence linking both iodine deficiency and excess to neurodevelopmental outcomes, and offer expert interpretation of the key findings. We further highlight areas of uncertainty, introduce emerging evidence from contemporary studies, and propose directions for future research to inform and optimise public health policies and clinical practice. Our findings highlight a U-shaped association, whereby both insufficient and excessive iodine exposure during pregnancy and lactation may impair optimal brain development in the offspring.Item Access to reticulated water in late-pregnancy: impacts on ewe productivity, drinking behaviour and some physiological indicators of dehydration(Taylor and Francis Group on behalf of the Royal Society of New Zealand, 2025-03-02) Corner-Thomas R; Stafford K; Winchester N; Kenyon P; Sneddon NThere has been industry debate regarding sheep access to waterways, although there is little information available on the impact of access to water on sheep productivity. It is theoretically possible for actively growing pasture to provide sufficient moisture to meet the daily water intake requirements of sheep. A study was conducted in the Manawatu region during winter across two years with single- (n = 40) and twin-bearing ewes (n = 40) in late-pregnancy. Ewes were restricted from accessing a reticulated water source (no water) or given access (water). Herbage moisture was 81.5 ± 0.7% and 84.8 ± 0.4% in 2017 and 2018, respectively. Of the 40 water treatment ewes, 45% and 55% in 2017 and 2018, respectively, were never observed to drink water. Packed cell volume and total protein concentrations remained within the normal range throughout each study. Ewe liveweight and BCS increased (P < 0.05) throughout the study period but did not differ between treatments except among single-bearing ewes in 2018. The litter weight of single- and twin-bearing ewes in the water and no water treatments did not differ (P > 0.05). These results suggest that under the conditions of the current study, ewes in late pregnancy did not require access to reticulated water.Item Time in Bed, Sleeping Difficulties, and Nutrition in Pregnant New Zealand Women.(MDPI (Basel, Switzerland), 2023-02-23) McDonald BW; Watson PE; Trakada GWe consider the relationship between time in bed (TIB) and sleeping difficulties with demographic variables and nutrient intakes in the second (T2) and third (T3) trimester of pregnancy. Data were acquired from a volunteer sample of New Zealand pregnant women. In T2 and T3, questionnaires were administered, diets were obtained from one 24 h recall and three weighed food records, and physical activity was measured with the use of three 24 h diaries. In total, 370 women had complete information in T2 and 310 in T3. In both trimesters, TIB was associated with welfare or disability status, marital status and age. In T2, TIB was associated with work, childcare, education and pre-pregnancy alcohol consumption. There were fewer significant lifestyle covariates in T3. In both trimesters, TIB declined with increasing dietary intake, especially water, protein, biotin, potassium, magnesium, calcium, phosphorus and manganese. Adjusted for weight of dietary intake and welfare/disability, TIB declined with increasing nutrient density of B vitamins, saturated fats, potassium, fructose and lactose; and TIB increased with carbohydrate, sucrose and vitamin E. Subjective sleeping difficulties increased with the week of gestation, morning sickness severity, anxiety, dairy and saturated fat intake, and they decreased with fruit, vegetable and monounsaturated fat intake. The study highlights the changing influence of covariates throughout the pregnancy and corroborates several published findings on the relationship of diet and sleep.Item Maternal depressive symptoms in and beyond the perinatal period: Associations with infant and preschooler sleep(Oxford University Press on behalf of Sleep Research Society, 2024-10-29) Carter ML; Paine S-J; Sweeney BM; Taylor J; Signal TLStudy Objectives (1) To describe sleep in infancy and early childhood among children born to mothers with and without clinically significant depressive symptoms, and (2) to explore the relationships between maternal depressive symptoms and sleep patterns and problems during infancy and early childhood. Methods Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study. Data were collected in pregnancy (T1), 12 weeks postpartum (T2), and 3 years post-birth (T3). Participants were 262 Māori and 594 non-Māori mother–child dyads. Chi-square and independent t-tests measured bivariate associations between maternal mood (T1, T2, and T3) and child sleep characteristics (T2 and T3). Binary logistic regression models examined longitudinal and concurrent associations between maternal depressive symptoms and infant and preschooler sleep. Adjusted models accounted for key socio-demographic variables, as well as infant sleep variables in preschooler models. Results Bivariate associations were found between prior and concurrent depressive symptomology and many of the infant and preschooler sleep outcomes. In adjusted models, prenatal depressive symptoms remained independently associated with shorter-than-recommended sleep durations in preschoolers. In these models, concurrent depression was also associated with night waking, night LSRSP, and perceived sleep problems at 12 weeks postpartum, and CSHQ-determined and perceived sleep problems at 3 years post-birth. Conclusions Longitudinal and cross-sectional associations were found between maternal depressive symptoms and child sleep. Sleep appears to be one pathway by which maternal depression confers risk for suboptimal child health outcomes. Findings support the need for earlier and better maternal mental health services.Item Heifers with positive genetic merit for fertility traits reach puberty earlier and have a greater pregnancy rate than heifers with negative genetic merit for fertility traits(Elsevier Inc on behalf of the American Dairy Science Association, 2021-03) Meier S; McNaughton LR; Handcock R; Amer PR; Beatson PR; Bryant JR; Dodds KG; Spelman R; Roche JR; Burke CRThis study investigated the hypothesis that dairy heifers divergent in genetic merit for fertility traits differ in the age of puberty and reproductive performance. New Zealand's fertility breeding value (FertBV) is the proportion of a sire's daughters expected to calve in the first 42 d of the seasonal calving period. We used the New Zealand national dairy database to identify and select Holstein-Friesian dams with either positive (POS, +5 FertBV, n = 1,334) or negative FertBV (NEG, -5% FertBV, n = 1,662) for insemination with semen from POS or NEG FertBV sires, respectively. The resulting POS and NEG heifers were predicted to have a difference in average FertBV of 10 percentage points. We enrolled 640 heifer calves (POS, n = 324; NEG, n = 316) at 9 d ± 5.4 d (± standard deviation; SD) for the POS calves and 8 d ± 4.4 d old for the NEG calves. Of these, 275 POS and 248 NEG heifers were DNA parent verified and retained for further study. The average FertBV was +5.0% (SD = 0.74) and -5.1% (SD = 1.36) for POS and NEG groups, respectively. Heifers were reared at 2 successive facilities as follows: (1) calf rearing (enrollment to ∼13 wk of age) and (2) grazier, after 13 wk until 22 mo of age. All heifers wore a collar with an activity sensor to monitor estrus events starting at 8 mo of age, and we collected weekly blood samples when individual heifers reached 190 kg of body weight (BW) to measure plasma progesterone concentrations. Puberty was characterized by plasma progesterone concentrations >1 ng/mL in at least 2 of 3 successive weeks. Date of puberty was defined when the first of these samples was >1 ng/mL. Heifers were seasonally bred for 98 d starting at ∼14 mo of age. Transrectal ultrasound was used to confirm pregnancy and combined with activity data to estimate breeding and pregnancy dates. We measured BW every 2 wk, and body condition and stature at 6, 9, 12, and 15 mo of age. The significant FertBV by day interaction for BW was such that the NEG heifers had increasingly greater BW with age. This difference was mirrored with the significant FertBV by month interaction for average daily gain, with the NEG heifers having a greater average daily gain between 9 and 18 mo of age. There was no difference in heifer stature between the POS and NEG heifers. The POS heifers were younger and lighter at puberty, and were at a lesser mature BW, compared with the NEG heifers. As a result, 94 ± 1.6% of the POS and 82 ± 3.2% of the NEG heifers had reached puberty at the start of breeding. The POS heifers were 20% and 11% more likely to be pregnant after 21 d and 42 d of breeding than NEG heifers (relative risk = 1.20, 95% confidence interval of 1.03-1.34; relative risk = 1.11, 95% confidence interval of 1.01-1.16). Results from this experiment support an association between extremes in genetic merit for fertility base on cow traits and heifer reproduction. Our results indicate that heifer puberty and pregnancy rates are affected by genetic merit for fertility traits, and these may be useful phenotypes for genetic selection.Item Do Micronutrient and Omega-3 Fatty Acid Supplements Affect Human Maternal Immunity during Pregnancy? A Scoping Review(MDPI (Basel, Switzerland), 2022-01-15) Rees G; Brough L; Orsatti GM; Lodge A; Walker S; Pérez-Cano FJMaternal dietary micronutrients and omega-3 fatty acids support development of the fetal and neonatal immune system. Whether supplementation is similarly beneficial for the mother during gestation has received limited attention. A scoping review of human trials was conducted looking for evidence of biochemical, genomic, and clinical effects of supplementation on the maternal immune system. The authors explored the literature on PubMed, Cochrane Library, and Web of Science databases from 2010 to the present day using PRISMA-ScR methodology. Full-length human trials in English were searched for using general terms and vitamin A, B12, C, D, and E; choline; iodine; iron; selenium; zinc; and docosahexaenoic/eicosapentaenoic acid. Of 1391 unique articles, 36 were eligible for inclusion. Diverse biochemical and epigenomic effects of supplementation were identified that may influence innate and adaptive immunity. Possible clinical benefits were encountered in malaria, HIV infections, anemia, Type 1 diabetes mellitus, and preventing preterm delivery. Only limited publications were identified that directly explored maternal immunity in pregnancy and the effects of micronutrients. None provided a holistic perspective. It is concluded that supplementation may influence biochemical aspects of the maternal immune response and some clinical outcomes, but the evidence from this review is not sufficient to justify changes to current guidelines.