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Updated: Jul 7, 2025
Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Periconceptional Dietary Patterns and Adverse Pregnancy and Birth Outcomes
Lisa M Bodnar1, Sharon I Kirkpatrick2, Sara M Parisi3
1Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
Insights
Healthy periconceptional diets rich in fruits, vegetables, and whole grains are linked to better pregnancy outcomes. Diets high in fat, sugar, and sodium are associated with increased adverse pregnancy and birth complications.
Area of Science:
- Reproductive health
- Nutritional science
- Perinatal epidemiology
Background:
- The periconceptional period is crucial for pregnancy and birth outcomes.
- Limited understanding exists regarding dietary patterns that support perinatal health.
Purpose of the Study:
- To investigate the impact of periconceptional dietary patterns on risks of preeclampsia, gestational diabetes, preterm birth, and small-for-gestational-age (SGA) birth.
- To utilize machine learning for identifying dietary patterns and their associations with adverse perinatal outcomes.
Main Methods:
- Analysis of data from 8259 participants in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be.
- Identification of dietary patterns using k-means clustering based on 82 food groups from a food frequency questionnaire.
- Estimation of the effects of dietary patterns on perinatal outcomes using targeted maximum likelihood estimation and ensemble machine learning algorithms, adjusting for confounders.
Main Results:
- Four distinct periconceptional dietary patterns were identified: 'Sandwiches and snacks,' 'High fat, sugar, and sodium,' 'Beverages, refined grains, and mixed dishes,' and 'High fruits, vegetables, whole grains, and plant proteins.'
- Compared to the 'High fat, sugar, and sodium' pattern, the other three patterns were associated with a reduced risk of a composite adverse perinatal outcome.
- Specifically, the 'Beverages, refined grains, and mixed dishes,' 'High fruits, vegetables, whole grains, and plant proteins,' and 'Sandwiches and snacks' patterns showed a risk difference of -0.043, -0.041, and -0.033, respectively, per 100 pregnancies.
Conclusions:
- Periconceptional dietary patterns significantly influence perinatal health outcomes.
- Diets characterized by high intake of fat, sugars, and sodium are linked to adverse pregnancy and birth complications.
- Promoting dietary patterns rich in fruits, vegetables, whole grains, and plant proteins may be beneficial for improving perinatal health.
Background:
The periconceptional period is a critical window for the origins of adverse pregnancy and birth outcomes, yet little is known about the dietary patterns that promote perinatal health.
Objective:
We used machine learning methods to determine the effect of periconceptional dietary patterns on risk of preeclampsia, gestational diabetes, preterm birth, small-for-gestational-age (SGA) birth, and a composite of these outcomes.
Methods:
We used data from 8259 participants in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (8 US medical centers, 2010‒2013). Usual daily periconceptional intake of 82 food groups was estimated from a food frequency questionnaire. We used k-means clustering with a Euclidean distance metric to identify dietary patterns. We estimated the effect of dietary patterns on each perinatal outcome using targeted maximum likelihood estimation and an ensemble of machine learning algorithms, adjusting for confounders including health behaviors and psychological, neighborhood, and sociodemographic factors.
Results:
The 4 dietary patterns that emerged from our data were identified as "Sandwiches and snacks" (34% of the sample); "High fat, sugar, and sodium" (29%); "Beverages, refined grains, and mixed dishes" (21%); and "High fruits, vegetables, whole grains, and plant proteins" (16%). One-quarter of pregnancies had preeclampsia (8% incidence), gestational diabetes (5%), preterm birth (8%), or SGA birth (8%). Compared with the "High fat, sugar, and sodium" pattern, there were 3.3 to 4.3 fewer cases of the composite adverse outcome per 100 pregnancies among participants following the "Beverages, refined grains and mixed dishes" pattern (risk difference -0.043; 95% confidence interval -0.078, -0.009), "High fruits, vegetables, whole grains and plant proteins" pattern (-0.041; 95% confidence interval -0.078, -0.004), and "Sandwiches and snacks" pattern (-0.033; 95% confidence interval -0.065, -0.002).
Conclusions:
Our results highlight that there are a variety of periconceptional dietary patterns that are associated with perinatal health and reinforce the negative health implications of diets high in fat, sugars, and sodium.
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