Maternal dietary patterns in pregnancy and the association with small-for-gestational-age infants

Abstract

Maternal nutritional status before and during pregnancy is important for the growth and development of the fetus. The effects of pre-pregnancy nutrition (estimated by maternal size) are well documented. There is little information in today's Western society on the effect of maternal nutrition during pregnancy on the fetus. The aim of the study was to describe dietary patterns of a cohort of mothers during pregnancy (using principal components analysis with a varimax rotation) and assess the effect of these dietary patterns on the risk of delivering a small-for-gestationalage (SGA) baby. The study was a case -control study investigating factors related to SGA. The population was 1714 subjects in Auckland, New Zealand, born between October 1995 and November 1997, about half of whom were born SGA (#10th percentile for sex and gestation). Maternal dietary information was collected using FFQ after delivery for the first and last months of pregnancy. Three dietary patterns (traditional, junk and fusion) were defined. Factors associated with these dietary patterns when examined in multivariable analyses included marital status, maternal weight, maternal age and ethnicity. In multivariable analysis, mothers who had higher 'traditional' diet scores in early pregnancy were less likely to deliver a SGA infant (OR ¼ 0·86; 95 % CI 0·75, 0·99). Maternal diet, particularly in early pregnancy, is important for the development of the fetus. Socio-demographic factors tend to be significantly related to dietary patterns, suggesting that extra resources may be necessary for disadvantaged mothers to ensure good nutrition in pregnancy.

Maternal dietary patterns in pregnancy and fetal growth in Japan: the Osaka Maternal and Child Health Study

“…In a Mexican-American survey using factor analysis, nutrient-dense (fruits, vegetables and low-fat dairy) and protein-rich (low-fat meats, processed meats and dairy desserts) eating patterns were associated with increased birth weight, while a transitional (fats and oils, bread and cereals, high-fat meats and sugar) eating pattern was associated with decreased birth weight (20) . Similar studies have also been conducted in Denmark (21) , the UK (22) and New Zealand (23) . All these four studies were conducted in Western countries.…”

“…A UK study has found a positive association between a 'Health conscious' pattern and birth weight (22) , while a very recent case -control study in New Zealand (23) has shown that the 'traditional' diet in early pregnancy, characterised by a high intake of meat, potatoes, carrots, peas, fruits and several kinds of vegetables, was associated with a decreased risk of having a SGA infant. In the present study, the women in the 'rice, fish and vegetables' pattern had infants with significantly higher average birth weight (P¼0·013) and a lower risk of having a SGA infant compared with those in the 'wheat products' pattern (OR 0·19, 95 % CI 0·04, 0·89).…”

A periconceptional energy‐rich dietary pattern is associated with early fetal growth: the Generation R study

“…Maternal use of a Traditional dietary pattern in early pregnancy (high intakes of potatoes, meat, vegetables) reduced the risk of having a small-for-gestational-age (SGA) child by 14% (95% CI 0.75-0.99). 27 In contrast, Knudsen et al 28 showed that maternal adherence to a Western dietary pattern, based on red and processed meat and high-fat dairy, was associated with an increased risk of SGA (odds ratio 0.74, 95% CI 0.64-0.86 for women in the Health Conscious class compared with women in the Western Diet class). The Dutch Famine study demonstrated that exposure to famine during early pregnancy resulted in a risk for cardiovascular disease in later life, but independent of birthweight.…”

Harmonization of Food-Frequency Questionnaires and Dietary Pattern Analysis in 4 Ethnically Diverse Birth Cohorts

“…However, it is often desirable to isolate the effect of a specific food item or 329 nutrient from its unspecific contribution to total energy intake when assessing diet-disease 330 associations (e.g., the unique contribution of trans fat from other energy-containing nutrients of 331 the foods in which it is contained). analyses within diverse cohorts often requires adjustment for ethnicity (16,57), which is most 345 often accomplished by including ethnicity as a covariate in multivariable models. An alternative 346 approach is to include ÒethnicityÓ in the PCA when deriving dietary patterns, which would help 347 account for the tight conceptual linking of diet and ÒcultureÓ.…”