RESULTS
3.1 Study
population
The flowchart of participant selection is depicted in Figure S2. A total
of 93 women were included in the analyses. Table S2 shows participant
characteristics at baseline and periconceptional maternal dietary intake
of total energy, PEI-UPF, macronutrients and its compounds.
3.2 Ultra-processed foods and total
energy
First, we investigated associations between periconceptional maternal
intake of UPF and first-trimester imaging markers of utero-placental
vascular development. All models showed higher PEI-UPF is associated
with increased density of vascular branching for bifurcation points and
crossing points in the uPVS but not with absolute morphologic
development, see Table 2. Model 3 shows a statistically significant
association between PEI-UPF and density of bifurcation points
[β=0.465, 95%CI=0.148;0.782, p-value=0.006].
Next, we investigated associations between the periconceptional maternal
intake of total energy (kcal/day) and first-trimester imaging markers of
utero-placental vascular development. Total energy intake was negatively
associated with density of bifurcation points in the uPVS [β=-0.053,
95%CI=-0.101;-0.004, p-value=0.039], see Table S3. We found no
associations with the imaging markers of absolute morphologic
utero-placental vascular development.
3.3
Macronutrients
We investigated the intake of separate macronutrients and observed
positive associations between the intake of carbohydrates (g/day) and
first-trimester development of uPVV [β=0.017, 95%CI=0.001;0.032]
and imaging markers of absolute morphologic development: uPVS end points
[β=0.286, 95%CI=0.062;0.511], bifurcation points [β=0.004,
95%CI=0.003;0.006], vessel points [β=0.772, 95%CI=0.137;1.408]
and total length [β=0.700, 95%CI=0.106;1.295], all
p-values<0.05, see Table 3 (only model 3 is shown). No
associations were found between carbohydrate intake and imaging markers
representing density of vascular branching. Further, we observed
positive associations between the periconceptional maternal intake of
mono-/disaccharides and first-trimester development of uPVV [β=0.021,
95%CI=0.003;0.039] and imaging markers of absolute morphologic
development: uPVS end points [β=0.336, 95%CI=0.072;0.603],
bifurcation points [β=0.380, 95%CI=0.057;0.703], crossing points
[β=0.257, 95%CI=0.011;0.502], vessel points [β=0.916,
95%CI=0.170;1.662] and total length [β=0.856,
95%CI=0.158;1.554], all p-values<0.05, but not for the
intake of polysaccharides, see Table 3. We found no associations between
carbohydrate intake and imaging markers representing density of vascular
branching.
These analyses were repeated for the total intake of fats and proteins
and their respective compounds, see Table S4 (only model 3 shown). We
observed no associations between the periconceptional maternal intake of
fats, proteins and their compounds and first-trimester imaging markers
of utero-placental vascular development in any of our models.
3.4 Dietary
patterns
Using the PCA analysis we identified three distinct dietary patterns.
The first dietary pattern is associated with higher intake of fresh and
processed meats, cereal products, potatoes, eggs, cakes and sauces, and
is therefore referred to as a Western dietary pattern, which explains
16.2% of the variance. The second dietary pattern is associated with
higher intake of vegetables, fruits, fish and shellfish, nuts and seeds,
vegetable oils and soy- and other plant-based meat-/dairy substitutes.
Accordingly, this dietary pattern is referred to as a Mediterranean
dietary pattern, which explains 11.7% of the variance. The third
dietary pattern is associated with higher intake of sugar and
confectionary, savoury snacks, milk and dairy products, soft drinks,
fruit/vegetable juices and butter. We refer to this last dietary pattern
as a Snack dietary pattern, which explains 8.4% of the variance. A
nutritional overview of the dietary patterns is depicted in Table S5.
We investigated associations between periconceptional maternal adherence
to the three dietary patterns and imaging markers of utero-placental
vascular development. There are no associations between adherence to the
Western or Mediterranean dietary patterns and imaging markers of
utero-placental vascular development in all three models, see Table 4.
Model 2 shows (borderline-) statistically significant positive
associations between adherence to the Snack dietary pattern and
first-trimester development of uPVV and imaging markers of absolute
morphologic development: uPVS end points, bifurcation points, crossing
points, vessel points and total length. Model 3 shows similar effect
estimates with wide confidence intervals and no statistically
significant associations, see Table 4.