Association Between Carbohydrate Quality Index During Pregnancy and Risk for Large-for-Gestational-Age Neonates:...

Area of Science:

• Obstetrics and Gynecology
• Nutritional Science
• Perinatal Epidemiology

Background:

• Dietary patterns during early pregnancy influence fetal growth.
• The Carbohydrate Quality Index (CQI) is a composite measure of carbohydrate intake quality.
• Large-for-gestational-age (LGA) infants are associated with increased perinatal risks.

Purpose of the Study:

• To investigate the association between early pregnancy carbohydrate quality (CQI) and LGA infant risk.
• To explore this association in a Mediterranean cohort, including women with gestational diabetes mellitus (GDM).

Main Methods:

• Prospective cohort study (BORN 2020) in Greece.
• Dietary intake assessed using a validated food frequency questionnaire.
• CQI calculated based on glycemic index, fiber density, whole-to-refined grain ratio, and solid-to-liquid carbohydrate ratio.
• Multivariable logistic regression models used to analyze LGA risk.

Main Results:

• Higher intake of low-quality carbohydrates was significantly associated with increased LGA risk (aOR: 4.25).
• Moderate CQI showed a consistent association with increased LGA odds (aOR ≈ 1.60) in the general population.
• In GDM subgroup, high CQI was initially linked to LGA but lost significance after full adjustment.
• Maternal pre-pregnancy BMI and height were associated with LGA in the total population and GDM subgroup, respectively.

Conclusions:

• Early pregnancy intake of low-quality carbohydrates is linked to elevated LGA risk.
• The relationship between CQI and LGA is non-linear and inconsistent, with moderate CQI showing a notable association.
• Comprehensive dietary assessment, considering both carbohydrate quality and quantity, is crucial for pregnancy nutritional guidance, especially for high-risk groups.