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Am J Perinatol 2023; 40(12): 1286-1291
DOI: 10.1055/s-0041-1735555
Original Article

Non-Nutritive Sweeteners in Human Amniotic Fluid and Cord Blood: Evidence of Transplacental Fetal Exposure

Brianna C. Halasa
1   National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
,
Allison C. Sylvetsky
2   Department of Exercise and Nutrition Sciences, George Washington University, Washington, District of Columbia
,
Ellen M. Conway
3   National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, Maryland
,
Eileen L. Shouppe
3   National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, Maryland
,
Mary F. Walter
3   National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, Maryland
,
Peter J. Walter
3   National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, Maryland
,
Hongyi Cai
3   National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, Maryland
,
Lisa Hui
4   Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Victoria, Australia
,
Kristina I. Rother
1   National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
› Author Affiliations Funding None.
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Abstract

Objective This study aimed to investigate human fetal exposure to non-nutritive sweeteners (NNS) by analyzing amniotic fluid and umbilical cord blood.

Study Design Concentrations of four NNS (acesulfame-potassium [ace-K], saccharin, steviol glucuronide, and sucralose) were measured in amniotic fluid (n = 13) and cord blood samples (n = 15) using liquid chromatography-mass spectrometry. Amniotic fluid samples were obtained for research purposes at the time of term elective cesarean birth or clinically indicated third trimester amnioreduction at Mercy Hospital for Women (Melbourne, Australia). All except four women were in the fasting state. Cord blood samples were obtained from an independent cohort of newborns whose mothers were enrolled in a separate clinical trial at the National Institutes of Health.

Results Ten of 13 amniotic fluid samples contained at least one NNS (ace-K, saccharin, steviol glucuronide, and/or sucralose). Maximum amniotic fluid NNS concentrations of ace-K, saccharin, steviol glucuronide, and sucralose were 78.9, 55.9, 93.5, and 30.6 ng/mL, respectively. Ace-K and saccharin were present in 100% and 80% of the cord blood samples, with maximal concentrations of 6.5 and 2.7 ng/mL, respectively. Sucralose was not detected and steviol glucuronide was not measurable in any of the cord blood samples.

Conclusion Our results provide evidence of human transplacental transmission of NNS. Based on results predominantly obtained from rodent models, we speculate that NNS exposure may adversely influence the offsprings' metabolic health. Well-designed, prospective clinical trials are necessary to understand the impact of NNS intake during pregnancy on human development and long-term health.

Key Points

  • NNS consumption during pregnancy has increased in recent years.

  • Maternal NNS intake during pregnancy is associated with preterm birth and higher infant weight gain in epidemiologic studies.

  • In rodents, in utero NNS exposure induces metabolic abnormalities in mothers and their offspring, alters offspring gut microbiota composition, and promotes sweet taste preference in adulthood.

  • It is presently unknown whether and to what degree maternal NNS ingestion in humans leads to direct in utero exposure.

  • This study provides the first evidence of in utero NNS exposure in humans and highlights the urgent need to investigate clinical consequences of early life NNS exposure on metabolism, weight, taste preference, and general health.

Keywords

diet soda - pregnancy - artificial sweetener - sucralose - acesulfame-potassium - saccharin - stevia


Publication History

Received: 09 December 2020

Accepted: 22 July 2021

Article published online:
09 September 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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