Rural-urban differences in dietary intake across pregnancy trimesters: A multisite prospective cohort study

Area of Science:

• Maternal Health
• Nutritional Epidemiology
• Rural Health Disparities

Background:

• Poor maternal diet impacts pregnancy outcomes and reflects societal inequities.
• Understanding geographic and socioeconomic influences on nutrition is crucial for maternal-fetal health.

Purpose of the Study:

• To examine dietary intake differences between rural and urban pregnant women in the U.S.
• To assess if socioeconomic status (SES) modifies these rural-urban dietary disparities.

Main Methods:

• Prospective study of 495 pregnant women across three U.S. sites.
• Dietary intake assessed via the Dietary Screener Questionnaire (DSQ) each trimester.
• SES score derived from education, income, and insurance; analyzed using mixed-effects models with SES interaction.

Main Results:

• Rural women had higher sugar-sweetened beverage (SSB) intake and lower fiber intake compared to urban women.
• High-SES urban women consumed more fiber and calcium, and fewer SSBs than low-SES counterparts.
• Differences in diet between rural and urban settings were modest.

Conclusions:

• Rurality is associated with increased SSB consumption and decreased fiber intake during pregnancy.
• Low SES is a significant predictor of poorer dietary quality, irrespective of geographic location.
• Interventions should target low-SES pregnant women in both rural and urban areas.