A maternal “mixed, high sugar” dietary pattern is associated with fetal growth

Abstract

This study examined associations between a maternal “mixed, high sugar” dietary pattern during pregnancy and ultrasound‐determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m2), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m2; p = .011) and femur length (0.01 cm/+1 kg/m2; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer‐term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.

Pilot implementation of Bukhali: A preconception health trial in South Africa

“… 7 Findings from the Soweto First 1000 Days cohort reported that 67% of women presenting at their first antenatal clinic visit were either overweight or obese. 8 Concerns about obesity also extend to childhood in SA whereby one in four girls age 2 to 14 years, and one in six boys in the same age group, were either overweight or obese. 9…”

“…7 Findings from the Soweto First 1000 Days cohort reported that 67% of women presenting at their first antenatal clinic visit were either overweight or obese. 8 Concerns about obesity also extend to childhood in SA whereby one in four girls age 2 to 14 years, and one in six boys in the same age group, were either overweight or obese. 9 Given the public health distress around childhood obesity, the SA Medical Research Council, partnering with World Health Organization and the Canadian Institutes of Health Research, launched the Healthy Life Trajectories Initiative (HeLTI) in SA.…”

The association between fetal growth and neonatal adiposity in urban South African infants

“…8 Data from our longitudinal birth cohort study (Soweto First 1000-Days Study; S1000) has shown that multiple maternal exposures during pregnancy are associated with fetal growth across the prenatal period. [9][10][11] Of all maternal exposures examined in S1000, being at the higher end of the BMI spectrum when entering pregnancy has been most consistently associated with infant outcomes; specifically related to elevated growth across fetal parameters and delivery of larger infants. 11,12 In addition, women who were affected by overweight or obesity at recruitment were more likely to gain excessive weight during pregnancy; with higher GWG also being positively associated with fetal growth and neonatal size.…”

Double-duty solutions for optimising maternal and child nutrition in urban South Africa: a qualitative study

“…Participants included men and women aged ≥18 years. Women's FGD were held in three age groups to cover the different stages of the reproductive life course and to potentially avoid older women inhibiting younger women's (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) and >40 years) expressions.…”