Meal patterning and the onset of spontaneous labor

Abstract

Background There is a lack of consensus in the literature about the association between meal patterning during pregnancy and birth outcomes. This study examined whether maternal meal patterning in the week before birth was associated with an increased likelihood of imminent spontaneous labor. Methods Data came from 607 participants in the third phase of the Pregnancy, Infection, and Nutrition Study (PIN3). Data were collected through an interviewer‐administered questionnaire after birth, before hospital discharge. Questions included the typical number of meals and snacks consumed daily, during both the week before labor onset and the 24‐hour period before labor onset. A self‐matched, case‐crossover study design examined the association between skipping one or more meals and the likelihood of spontaneous labor onset within the subsequent 24 hours. Results Among women who experienced spontaneous labor, 87.0% reported routinely eating three daily meals (breakfast, lunch, and dinner) during the week before their labor began, but only 71.2% reported eating three meals during the 24‐hour period before their labor began. Compared with the week before their labor, the odds of imminent spontaneous labor were 5.43 times as high (95% CI: 3.41‐8.65) within 24 hours of skipping 1 or more meals. The association between skipping 1 or more meals and the onset of spontaneous labor remained elevated for both pregnant individuals who birthed early (37‐<39 weeks) and full‐term (≥39 weeks). Conclusions Skipping meals later in pregnancy was associated with an increased likelihood of imminent spontaneous labor, though we are unable to rule out reverse causality.

Chrononutrition during Pregnancy and Its Association with Maternal and Offspring Outcomes: A Systematic Review and Meta-Analysis of Ramadan and Non-Ramadan Studies

“…In two self-matched case-crossover studies (used to assess health event triggers) from the United States, compared with a week [ 20 ] or three days [ 21 ] before labor (control period), the odds of imminent spontaneous labor were 5.4 (95% CI: 3.41, 8.65) [ 20 ] and 4.3 (95% CI: 1.2, 15.2) [ 21 ] times as high within 24 h (hazard period) of skipping one or more meals [ 20 , 21 ]. However, these results may be affected by reverse causality since irregular meal intake can be a sign rather than a cause of the approaching labor due to a lack of appetite [ 20 ].…”

“… Associations of meal skipping with maternal and birth outcomes. Regression coefficient: beta estimates ( β ); docosahexaenoic acid (DHA); eicosapentaenoic acid (EPA); gestational diabetes mellitus (GDM); odds ratio (OR); relative risk (RR); postpartum weight retention (PPWR) [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. …”

“…In this systematic review, the chrononutrition factors investigated in the original studies could be broadly classified into four categories: meal skipping, night eating, meal frequency, and (Ramadan) fasting. We found that meal skipping and night eating have a potential adverse influence on maternal and birth outcomes, including increased PPWR [ 26 ], GWG [ 30 ], risk of spontaneous preterm delivery [ 20 , 21 ], insomnia [ 28 ], impaired maternal nutritional status [ 22 , 23 ], and impaired glucose metabolism [ 25 , 32 , 33 ]. However, in the meal skipping literature, it is unclear whether these associations were causal, as most studies were cross-sectional in nature.…”

“…However, irregular eating patterns caused by loss of appetite may be a potential sign that labor is approaching rather than meal skipping leading to labor. Therefore, the causal relationship between meal skipping and spontaneous birth requires further investigation [ 20 , 21 ].…”