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Pre-pregnancy dietary pattern is associated with newborn size: results from ProcriAr study
Juliana A Teixeira1, Daniel J Hoffman2, Teresa G Castro3,4
1Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo-SP01246-904, Brazil.
Insights
Maternal pre-pregnancy consumption of snacks, sweets, and soft drinks significantly increases the risk of delivering small-for-gestational age (SGA) babies. Improving pre-pregnancy nutrition education and access to healthy foods is crucial for better child health outcomes.
Area of Science:
- Maternal and Child Health
- Nutritional Epidemiology
- Public Health Nutrition
Background:
- Small-for-gestational age (SGA) newborns face increased risks of mortality and long-term health issues.
- Maternal pre-pregnancy diet is a potential modifiable factor influencing fetal growth and birth size.
- Understanding dietary patterns' impact on SGA is critical for developing targeted public health interventions.
Purpose of the Study:
- To investigate the association between maternal pre-pregnancy dietary patterns (DP) and the incidence of delivering SGA newborns.
- To identify specific dietary behaviors that may increase the risk of SGA births within the ProcriAr Cohort Study in Sao Paulo, Brazil.
Main Methods:
- A cohort of 299 pregnant women had their pre-pregnancy dietary patterns assessed using a 110-item food frequency questionnaire and factor analysis.
- Newborns were classified as SGA based on INTERGROWTH-21st standards for weight and length, adjusted for gestational age and sex.
- Multivariate Poisson regression analysis was employed to determine the relative risk of SGA births associated with different dietary patterns.
Main Results:
- Women with the highest intake of "Snacks, sandwiches, sweets and soft drinks" showed a significantly higher likelihood of delivering SGA babies (RR 1.92; 95% CI 1.08–3.39).
- An energy-dense, nutrient-poor dietary pattern during pre-pregnancy was identified as a risk factor for SGA newborns.
- Associations were adjusted for maternal sociodemographic factors and health behaviors.
Conclusions:
- Pre-pregnancy dietary patterns characterized by high consumption of energy-dense, nutrient-poor foods are associated with an increased risk of delivering SGA newborns.
- Public health initiatives focusing on pre-pregnancy nutrition education and access to healthy food are recommended to improve infant health.
- Further research is needed to elucidate the specific metabolic pathways linking maternal diet to SGA outcomes.
Abstract:
Babies born small-for-gestational age (SGA) have an increased risk of mortality, morbidity and adverse functional consequences. Studies suggest that pre-pregnancy maternal diet may influence newborns' size. This study aimed to determine whether maternal pre-pregnancy dietary patterns (DP) are associated with delivering SGA newborns in the ProcriAr Cohort Study, Sao Paulo-Brazil. Pre-pregnancy DP of 299 women were investigated using factor analysis with principal component's estimation, based on intake reported on a validated 110-item FFQ. Newborns were classified as SGA if their weight and/or length, adjusted by gestational age and sex, were below the 10th percentile of the INTERGROWTH-21st standards. Multivariate Poisson regression modelling with robust error variance was performed to examine associations between the different DP (in quintiles) and SGA. In a model adjusted by maternal sociodemographic and health behaviours, women who scored in the highest quintile of the DP 'Snacks, sandwiches, sweets and soft drinks' (in relation to the women who scored in the lowest quintile) were significantly more likely to deliver SGA babies (relative risk 1·92; 95 % CI 1·08, 3·39). This study verified that women's pre-pregnancy dietary behaviour characterised by an energy-dense nutrient-poor food intake was a risk factor for delivering SGA newborns. Investments in education and improved access to healthful food and nutritional information before pregnancy should be prioritised due to their potential positive impact on child health. However, further studies are warranted to identify specific metabolic pathways that may be underlying these associations.
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