Maternal Dietary Patterns and Birth Outcomes: A Systematic Review and Meta-Analysis

Abstract

Findings on the relations of maternal dietary patterns during pregnancy and risk of preterm birth and offspring birth size remain inconclusive. We aimed to systematically review and quantify these associations. We searched MEDLINE, Embase, CENTRAL, and CINAHL up to December 2017. Three authors independently conducted a literature search, study selection, data extraction, and quality assessment. Summary effect sizes were calculated with random effects models and studies were summarized narratively if results could not be pooled. We included 36 studies and pooled results from 25 observational studies (167,507 participants). Two common dietary patterns—“healthy” and “unhealthy”—were identified. Healthy dietary patterns—characterized by high intakes of vegetables, fruits, wholegrains, low-fat dairy, and lean protein foods—were associated with lower risk of preterm birth (OR for top compared with bottom tertile: 0.79; 95% CI: 0.68, 0.91; I2 = 32%) and a weak trend towards a lower risk of small-for-gestational-age (OR: 0.86; 95% CI: 0.73, 1.01; I2 = 34%). Only statistically data-driven healthy dietary patterns, and not dietary index-based patterns, were associated with higher birth weight (mean difference: 67 g; 95% CI: 37, 96 g; I2 = 75%). Unhealthy dietary patterns—characterized by high intakes of refined grains, processed meat, and foods high in saturated fat or sugar—were associated with lower birth weight (mean difference: −40 g; 95% CI: −61, −20 g; I2 = 0%) and a trend towards a higher risk of preterm birth (OR: 1.17; 95% CI: 0.99, 1.39; I2 = 76%). Data from observational studies indicate that greater adherence to healthy dietary patterns during pregnancy is significantly related to lower risk of preterm birth. No consistent associations with birth weight and small- or large-for-gestational-age were observed.

Maternal sucralose intake alters gut microbiota of offspring and exacerbates hepatic steatosis in adulthood

“…It is widely believed that maternal diet is associated with progeny's body weight gain and obesity. 33,34 However, the effects of sucralose on the weight gain were not fully consistent in previous studies. Abou-Donia reported that administration of sucralose approximately 1.1 to 11 mg/kg BW/day from the 4th week after birth for 12 weeks significantly increased body weight in rats.…”

Maternal Nutrition and Inadequate Gestational Weight Gain in Relation to Birth Weight: Results from a Prospective Cohort Study in India

“…As suggested by National Institute of Nutrition (NIN), India, the energy demand in pregnancy increases by 350 kcal along with increased demand of macronutrients and micronutrients [15]. However, studies pertaining to dietary intake throughout gestation in Indian women are insufficient and those available were mostly cross-sectional in nature [16]. Owing to the fact that dietary behaviour has many implications on mother and child's weight, this prospective cohort study was conducted to evaluate GWG and nutrient intake in all trimesters of pregnancy and investigate the relationship between themselves along with that of BW.…”

Which modifiable prenatal factors mediate the relation between socio‐economic position and a child's weight and length at birth?

“…Moreover, other prenatal factors remain to be studied. Indeed, healthy dietary patterns during pregnancy have been shown to be positively associated with birth weight (Chia et al, 2019;Emmett, Jones, & Northstone, 2015), whereas negative associations were observed between both unhealthy dietary patterns and maternal depression and birth weight (Chia et al, 2019;Field, 2011). One review also reported a birth length decrease in offspring of mothers with depression during pregnancy (Field, 2011).…”