الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Maternal diet during pregnancy is an important factor for a healthy growing newborn. Therefore, a big concern was raised about the effect of certain chemical such as acrylamide that is formed in certain foods which might be taken on a regular basis during the pregnancy and how does it affect the newborn.
The placenta gives a negligible protection of the fetus from the exposure to the acrylamide and glycidamide compounds found in the maternal food eaten during pregnancy. Therefore, fetal exposure to acrylamide through the diet starts in utero as acrylamide can cross the placenta barrier as proved by a cohort study that included 1,101 pregnant women from five different European countries.
Both acrylamide and glycidamide are electrophiles that form adducts with hemoglobin, DNA and phospholipids and that raises a particular concern about the health risks to the unborn child and so the effect of acrylamide intake during pregnancy should be studied and assessed to prevent any adverse effects on the fetal growth during pregnancy that might affect the newborn’s life later on and for this reason the study was carried out.
A pilot study on 15 cases of pregnant women was conducted earlier in this study to calculate the sample size. The study was conducted on the pregnant woman attending El-Shatby Obstetrics and Gynecology Hospital for delivery and their newborns as well. A total of 201 subjects were randomly selected. Each pregnant woman was individually interviewed and asked about the frequency of consumption of the food items containing high levels of acrylamide during her pregnancy which were written in the food frequency questionnaire, in addition to other questions as obstetric history, socio-demographic characteristics, dietary habits, life style and antenatal care during pregnancy.
All of the mentioned above was done after checking the hospital reports for any of the exclusion criteria about the selected sample of pregnant women. And these criteria included any pregnant women with chronic diseases, gestational diabetes, anemia during pregnancy or pre-eclampsia or having a newborn with known congenital anomaly or with low birth weight.
The newborns were also assessed individually by taking their anthropometric measurements which included both their birth weight and head circumference and this was done immediately after delivery using the procedures of Gibson. The cord blood sampling was applied on a subsample of about twenty newborns at the time of delivery after fulfilling the questionnaire from their mothers, then the samples were collected in heparinized tubes and stored overnight at -80 oc, then analyzed using the Gas chromatography electron capture detector device.
In the questionnaire the mother was asked about the amount and frequency of intake of foods expected to contain high levels of acrylamide that are commonly consumed during pregnancy such as fried potatoes (chips and french fries), falafel, fried chicken, fried egg, fried cereals (crisps, popcorn and breakfast cereals), bread, toast, fine bakery (cookies, bateau, etc.), roasted nuts, confectionary and coffee.
The dietary intake of acrylamide of the studied sample was calculated by multiplying both the amount of food consumed by the pregnant women in gm /day which were obtained from the food frequency questionnaire during the interview and the data about the level of acrylamide resulted from the analysis of food items which was asked about in the questionnaire. The detection of acrylamide in food was carried out using HPLC. A total of 42 food item were analyzed, 10 samples were analyzed in the Central Laboratory of the Public Institute of Public Health 2014 and the remaining from the results of the central administration of laboratories in the Ministry of health and the study of Agamy NF 2013.
After finishing the data collection, the data was revised, coded and fed to the computer using SPSS version ”16.0” software for tabulation and analysis. The data was presented mathematically in the form of arithmetic mean, standard deviation, median and range. All statistical analysis were performed using 5% level of significance. The following tests of significance were used in this study: Chi square test, One Way ANOVA, Kruskal-Wallis & Mann-Whitney tests, the spearman correlation and multiple stepwise linear regression.
Results of this study can be summarized as follows:
• The overall estimated median daily dietary intake of acrylamide among the whole studied sample of 201 pregnant women was 41.8 µg/day.
• An increase in the dietary acrylamide was noticed with the prime gravida, women with five or more children, women with birth spacing of four or more years and women who had previous abortions or previous fetal death.
• The dietary acrylamide intake increases with the decrease in the antenatal visits during pregnancy and with those who gained weight 10 or more kilograms during pregnancy.
• A statistical significance regarding the intake of the dietary supplements during pregnancy was found as the median acrylamide intake during pregnancy was the lowest among women consumed no supplements followed by those who consumed folic acid then those who took calcium & vitamin D then iron then vitamin B12 and vitamin C.
• The birth weight of the newborns decrease with the increase of the dietary intake of acrylamide by the mother during pregnancy with a reduction of 70 gm in the birth weight between the highest and lowest intake of acrylamide. Also the birth weight of the newborns decrease as the level of acrylamide in the cord blood sample increases with a reduction of 250 gm between the highest and the lowest levels of acrylamide level in the cord blood samples.
• While as regards to the changes in the head circumference of the newborns, it was found that it decreases as the birth weight decreases and have a negative relationship with both the dietary intake of acrylamide and the acrylamide level in the cord blood by which a decrease of about 0.5cm in the head circumference was found between the highest and lowest acrylamide level in the cord blood.
• The study reveals that the acrylamide containing foods that contribute to the highest consumption among the pregnant women in the study were the bakery products and fried potato followed by white bread, falafel, fried egg and potato chips.
from the results of this study, the following can be recommended:
• The intake of acrylamide during pregnancy should be monitored along with checking any changes in the fetal weight during the antenatal visits.
• Pregnant women should eat a balanced and varied diet and should moderate their consumption of fried and fatty foods.
• Raising the awareness of the pregnant women about the acrylamide containing foods such as potato chips, French fries, fried chicken, fried egg bread, biscuits, breakfast cereals or crackers, popcorn, coffee, roasted nuts, chocolate and confectionary that should be avoided during pregnancy and its effect on both of the weight and head circumference of the newborns.
• Nutritional education about methods of cooking that should be encouraged when using foods which can form acrylamide such as boiling and avoid other methods such as frying, roasting, grilling, toasting and baking.
• Raising the public awareness about certain points:
Food that may form acrylamide should not be fried or grilled or baked or roasted for too long or at too high temperature.
Cooking potato cuts to a golden yellow color rather than a brown color. Brown areas tend to contain more acrylamide.
Keeping potatoes somewhere cool and dry but not in the fridge. This is because putting potatoes in the fridge can increase the amount of sugar they contain and this could lead to higher acrylamide levels when the potatoes are roasted, baked or fried at high temperatures.
Measures for reducing the levels of acrylamide in food should be encouraged such as immersing of the potato chips in citric acid of 10-20g/l for half an hour or blanching it at 50oc for 70 min or soaking it in a distilled water for 90 min before frying avoid frying these food at high temperature which is more than 150 up to 190oc.
Adding garlic powder to the diet containing acrylamide is recommended.
• Further researches are needed to assess sources of acrylamide exposure during pregnancy other than diet, smoking and occupation as well as the effect of the intake of dietary supplement on the level of acrylamide.