Socioeconomic Factors Associated With Diet Quality in Pregnancy: A Cross-Sectional Australian Study

Prenatal diet affects maternal and child health; however, adherence to dietary guidelines in pregnancy is low. This cross-sectional study aimed to describe overall diet quality and to examine relationships between socioeconomic factors and diet quality in a sample of Australian pregnant women. Participants (n = 1580) completed an online survey and self-reported usual dietary intake (via a food frequency questionnaire [FFQ]) and socioeconomic factors, including highest educational attainment, income, perception of overall financial situation, residential postcode for area-level socioeconomic status (SES), stressful life events, and perceived social support. FFQ responses were converted to an overall diet quality score using the Dietary Guidelines Index 2013 (DGI-13) criteria. Latent class analysis was used to identify groups of stressful life events, and multiple linear regression models examined associations between the socioeconomic factors and DGI-13 score. Overall, adherence to dietary guidelines and prenatal diet quality were low. The mean DGI-13 score was 76.1 (SD 13.7) out of a maximum possible score of 130. All socioeconomic factors were significantly associated with DGI-13 score. For all socioeconomic factors except the perceived social support score, the lowest/most disadvantaged categories and middle/medium categories were associated with clinically important reductions of 5-9 points and 3-6 points, respectively, indicating a social gradient in diet quality. There is a need to improve prenatal diet quality among all women. However, there is an urgent need for systems-level interventions and policy change that target those with lower SES backgrounds to reduce dietary and health inequities.