Increase of Prostaglandin E2 in Reversal of Ductal Constriction After Dietary Restriction of Polyphenols
Condition: Pregnancy Complications
MeSH terms: Pregnancy Complications; Constriction, Pathologic
Study type: Interventional

Summary: 
      INCREASE OF PROSTAGLANDIN E2 IN REVERSAL OF DUCTAL CONSTRICTION AFTER DIETARY RESTRICTION OF
      POLYPHENOLS.

      Clinical trial with a healthy group as comparator. The interventional group was made up of
      third-trimester mothers whose single fetuses had ductal constriction, excluding those exposed
      to NSAID, and the control group only by third-trimester normal fetuses. The interventional
      group was submitted to dietary orientation to restrict polyphenol-rich foods and both groups
      answered a food frequency questionnaire after fetal Doppler-echocardiographic examination and
      blood draw for PGE2 levels analysis. After two weeks, the women were again submitted to fetal
      echocardiogram, dietary assessment and blood draw.
    

Detailed description: 
      INCREASE OF PROSTAGLANDIN E2 IN REVERSAL OF DUCTAL CONSTRICTION AFTER DIETARY RESTRICTION OF
      POLYPHENOLS.

      Fetal ductal constriction is a clinical situation with high morbidity and potential
      mortality. Patency the fetal ductus arteriosus (DA) depends on circulating prostaglandin
      (PG), which is produced by the cyclooxygenase (COX) pathway during inflammatory response(1)
      and from the third trimester of pregnancy on, is physiologically released. COX-inhibiting
      substances, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can interfere with PG
      metabolism and induce constriction of the DA. To treat or prevent DA constriction, it is
      therefore important to reduce fetal exposure to drugs that may interfere with prostaglandin
      biosynthesis, such as natural anti-inflammatory drugs and polyphenol-rich foods.

      Polyphenols, the most abundant antioxidants present in the diet, are widely distributed in
      vegetable foods. One of the possible mechanisms to explain their activity is inhibition of
      synthesis and release of inflammatory mediators. However, clinical studies investigating the
      effect of polyphenols on inflammatory responses are inconclusive and, in most cases, only
      evaluate clinical outcomes. The role of polyphenols on the inflammatory response, and
      associated modifications of the plasma concentration of PGE2 in pregnant women, has not yet
      been studied.

      Despite the potential benefits of a diet rich in polyphenols, a high consumption of these
      substances in the third trimester of pregnancy may reduce plasma levels of PGE2 and result in
      DA constriction,so that a restriction in their ingestion during this period is already
      recommended.This functional problem has high prevalence and may result in severe fetal and
      neonatal complications. These considerations raised the hypothesis that reversal of fetal
      ductal constriction after maternal restriction of polyphenol-rich foods is accompanied by
      increased in prostaglandin E2 levels. Demonstration of this effect would represent an
      advancement in knowledge and might result in changes in dietary guidance during pregnancy and
      prevention of perinatal complications, with potential impact in terms of public health.

      The aim of this study was to test the hypothesis that reversal of fetal ductal constriction
      in the third trimester of pregnancy, after maternal restriction of polyphenol-rich foods, is
      accompanied by increased plasma levels of prostaglandin E2.
    

Intervention name(s): restrict polyphenol-rich foods
Intervention type(s): Other
Intervention description(s): dietary orientation to restrict polyphenol-rich foods
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: Clinical trial with a healthy group as comparator.
Masking: Double (Care Provider, Investigator)
Primary purpose: Treatment
Keywords: polyphenols; pregnant; fetal ductal constriction; prostaglandin E2