Financial difficulties, smoking habits, composition of the diet and birthweight in a population of pregnant women in the South West of England

Abstract

Objective: To investigate the relationships between self-assessed ®nancial dif®culties, diet in pregnancy and birthweight. Design: Information on diet composition, dif®culty in affording food, smoking habits and parity was collected by self-completion questionnaires at 32 weeks of pregnancy. Information on birthweights was obtained from hospital records. Subjects: A geographically de®ned population 11 833 pregnant women resident in the South-West of England. Main outcome measures: Nutrient intakes, food choices and birthweight. Results: Women with greater dif®culty in affording food had lower intakes of protein, ®bre, vitamin C, niacin, pyridoxine, iron, zinc, magnesium and potassium than did women with little or no dif®culty. They were more likely to use cooking and spreading fats with a high saturates content, and less likely to eat ®sh, fruit, vegetables and salad. In a multivariate analysis including parity and smoking status, ®nancial dif®culty was found to have no signi®cant relationship with birthweight. Conclusion: The quality of diet in pregnancy falls with increasing dif®culty in affording food. However, this does not appear to affect mean birthweight of infants born after 32 weeks gestation. Sponsor: The nutritional aspects of the study have been supported by Northern and Yorkshire regionÐNHS executive, Cow and Gate Ltd, the Meat & Livestock Commission and Coca-Cola UK. Descriptors: pregnancy; diet; nutrient intake; food choices; ®nancial dif®culties; smoking; birthweight IntroductionIn a 1995 report published by the National Children's Home and the Maternity Alliance (Dallison & Lobstein, 1995) the average weekly cost of an adequate diet for a pregnant woman was estimated at £18.12, almost half the income of a woman under 25 receiving bene®ts. However, in their survey of low-income pregnant women attending National Children's Home family centres 41% managed to spend less than £10 a week on food per family member, with many women regularly missing meals to save money. It has been suggested that the high incidence of lower than average birthweight among infants of these women might be partly attributable to a poor quality of diet during pregnancy.A number of studies have suggested that both the quantity and the quality of the diet in pregnancy may have an effect on birthweight (Rush, 1982;Olsen et al, 1986;Simmer et al, 1987;Doyle et al, 1990;Olsen et al, 1990). Low birthweight has a number of consequences, including an increased incidence of neonatal morbidity (Walther & Ramaekers, 1982) and mortality (Bakketeig et al, 1984). Furthermore, recent work from Professor Barker and his group has suggested that poor diet in pregnancy, as a result of poverty, may cause both low birthweight and metabolic programming in the fetus which is associated with an increased risk of a number of disorders such as cardiovascular disease (Barker & Fall, 1993;Barker et al, 1993b) and diabetes (Barker et al, 1993a) in adult life. Thus, if poor diets in pregnancy are adversely affecting birthweight at present this could repr...

Session 7: Early nutrition and later health Early developmental pathways of obesity and diabetes risk

“…In countries such as India, where nutrition has recently improved, particularly with population migration from rural to urban environments or emigration, babies born small are at high risk for developing T2D (McKeigue et al 1991;World Health Organization Expert Consultation, 2004). In contemporary Western countries the risks associated with low birth weight as a result of poor maternal nutrition during pregnancy are much lower (Godfrey et al 1997;Rogers et al 1998;Mathews et al 1999); however, the risks related to increasing rates of maternal obesity and gestational diabetes are of greater concern (Reilly et al 1999;Dabelea et al 2000;Bundred et al 2001). A recent study of women in Eastern Europe (Hesse et al 2003) has shown that an increase in maternal pregnancy weight gain is one of the first responses to socio-economic improvement.…”

Dietary assessment in the Avon Longitudinal Study of Parents and Children

“…We were able to estimate nutrient intake in pregnancy in this large group, fairly, quickly and relatively cheaply; thus we were able to investigate whether dietary differences between groups of varying socioeconomic position were likely to impact on birth weight. We showed that although diet varied with a measure of socioeconomic position, birth weight did not, once account had been taken of parity and smoking status in pregnancy (Rogers et al, 1998b). A further strength of the FFQ data was evident when we investigated the dietary contribution of foods that were usually eaten less than twice a week.…”

The effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children

“…It is well established from studies in adults that smoking status is associated with dietary quality (Fulton et al, 1988;Margetts & Jackson, 1993;Oshaug et al, 1996;Marangon et al, 1998;Rogers et al, 1998;Jeffrey et al, 2000). Smokers have been reported to have diets that are lower in fibre and antioxidants and higher in fat, and to consume less fruit and vegetables and wholemeal bread and more meat products and chips and soft drinks, but also less biscuits and cakes and pastries.…”