Dietary patterns and birth outcomes in the ELSPAC pregnancy cohort

Abstract

ObjectivesThe aim of this study was to identify dietary patterns in a Czech pregnancy cohort established in the early postcommunist era and investigate associations between dietary patterns, maternal characteristics and birth outcomes.MethodsPregnant women were recruited for the Czech part of the European Longitudinal Study of Pregnancy and Childhood. A self-reported questionnaire answered in late pregnancy was used to assess information about the weekly intake of 43 food items. Information about birth outcomes (birth weight, height, ponderal index, head circumference, cephalisation index, gestational length and Apgar score) was obtained from the National Registry of Newborns. Complete details on diet and birth outcomes were available for 4320 mother–infant pairs.Results and conclusionThe food items were aggregated into 28 variables and used for extraction of two dietary patterns by principal component factor analysis. The patterns were denoted ‘unhealthy’ and ‘healthy/traditional’ based on the food items with the highest factor loadings on each pattern. The ‘unhealthy’ pattern had high positive loadings on meat, processed food and confectionaries. In contrast, the ‘healthy/traditional’ pattern had high positive loadings on vegetables, dairy, fruits and wholemeal bread. Following adjustment for covariates, we found that high adherence to the unhealthy pattern (expressed as beta for 1 unit increase in pattern score), that is, the higher consumption of less healthy foods, was associated with lower birth weight: −23.8 g (95% CI −44.4 to −3.2) and length: −0.10 cm (95% CI −0.19 to −0.01) and increased cephalisation index: 0.91 μm/g (95% CI 0.23 to 1.60). The ‘healthy/traditional’ pattern was not associated with any birth outcomes. This study supports the recommendation to eat a healthy and balanced diet during pregnancy.

Maternal Consumption of Ultra-Processed Foods-Rich Diet and Perinatal Outcomes: A Systematic Review and Meta-Analysis

“…Two articles explored depressive symptoms during pregnancy [ 46 , 88 ]. Neonatal outcomes included LBW, investigated in eleven articles [ 21 , 40 , 43 , 44 , 47 , 48 , 53 , 65 , 73 , 80 , 86 ]; LGA, investigated in eight articles [ 47 , 50 , 54 , 66 , 68 , 73 , 82 , 87 ]; birth length, explored in four articles [ 48 , 54 , 60 , 86 ]; one publication reporting body mass index (BMI)/age at birth [ 59 ]; five reporting preterm birth [ 22 , 48 , 55 , 83 , 85 ]; and offspring congenital heart defects, examined in two publications [ 70 , 79 ].…”

“…Teixeira et al [ 60 ] observed that women who consumed more “snacks, sandwiches, sweets and soft drinks” were significantly more likely to deliver SGA (birth weight and birth length <10th percentile) babies (RR: 1.92; 95% CI: 1.08, 3.39). Mikes et al [ 86 ] showed that higher consumption of unhealthy foods (confectionary, fried, and processed meats) was associated with lower birth length: (β = −0.10 cm; 95% CI: −0.19, −0.01). One study explored BMI-for-age z score at birth and reported a decrease of 20.41 standard deviations (SD) (95% CI: 20.79, 20.03) associated with a diet characterized by a high intake of white bread, red and processed meat, French fries, fried chicken, and vitamin C–rich drinks [ 59 ].…”

“…Two indicators were accomplished in all studies: “confounding factors identified” and “strategies to deal with confounding factors stated”. Most studies were at high risk of bias due to not presenting the strategies to address incomplete follow-up, which is considered a potential source of bias [ 4 , 42 , 52 , 53 , 56 , 59 , 63 , 68 , 76 , 78 , 85 , 86 , 87 ]. Most of cross-sectional studies (77.7%) were at low risk of bias [ 22 , 43 , 45 , 61 , 64 , 65 , 80 ].…”

Adequate Dietary Intake and Vitamin D Supplementation: A Study of Their Relative Importance in Determining Serum Vitamin D and Ferritin Concentrations during Pregnancy

“…Overall findings suggest that pregnant women, regardless of geographical locations, tend to make consistent food choices (either sufficient or insufficient intake). Considering the adverse health consequences of inadequate dietary intake for mothers and their offspring [ 19 , 20 ], antenatal nutrition counseling together with dietary monitoring and education services should be provided to pregnant women, particularly for those who show signs of inadequate dietary intake.…”

Dietary acrylamide and incident osteoporotic fractures: an 8-year prospective cohort study

“…The World Health Organization (WHO) attempted to evaluate the average exposure to acrylamide in foods, however, this is difficult to measure with traditional instruments available in nutritional research [ 5 ]. At the same time, increasing research is reporting that higher dietary acrylamide intake could be associated with a higher risk of cancer, in particular genito-urinary [ 6 , 7 ] or negative outcomes in pregnancy and in newborns [ 8 , 9 ].…”