Do women change their health behaviours in pregnancy? Findings from the Southampton Women's Survey

Abstract

A woman's life style choices before and during pregnancy have important implications for her unborn child, but information on behaviour can be unreliable when data are collected retrospectively. In particular there are no large longitudinal datasets that include information collected prospectively before pregnancy to allow accurate description of changes in behaviour into pregnancy. The Southampton Women's Survey is a longitudinal study of women in Southampton, UK, characterised when they were not pregnant and again during pregnancy. The objective of the analyses presented here is to describe the degree to which women comply with diet and life style recommendations before and during pregnancy, and changes between these time points. The analyses are based on 1490 women who delivered between 1998 and 2003 and who provided information before pregnancy and at 11 and 34 weeks' gestation. At each time point a trained research nurse ascertained smoking status and assessed food and drink consumption using a food frequency questionnaire. We derived the proportions of women who complied with recommendations not to smoke, to eat five portions of fruit and vegetables per day and to drink no more than four units of alcohol per week and 300 mg of caffeine per day. There was a notable reduction in smoking when women became pregnant: before pregnancy 27% of women smoked, whereas in early pregnancy 15% smoked. Similarly there were significant reductions in alcohol consumption and intake of caffeinated drinks: before pregnancy 54% of women drank more than four units of alcohol per week and 39% had estimated intakes of caffeine in drinks of>300 mg per day, whereas comparable figures for early pregnancy were 10% and 16% respectively. However, there was little change in fruit and vegetable intake; the percentages of women who did not achieve the recommendation to eat at least five portions of fruit and vegetables per week were 47% before pregnancy and 46% in early pregnancy. Younger women and those with fewer educational qualifications were less likely to comply with public health recommendations. Overall, 81% of women in early pregnancy complied with at least three of the recommendations. Although there is encouraging evidence of changed health behaviours in pregnancy, young women and those with few educational qualifications may particularly benefit from targeted health initiatives.

Changes in beverage consumption from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study

“…A decrease in the consumption of alcohol from prepregnancy to early pregnancy has been reported across many populations (14,15,30,38) , but not all studies have reported the same level of abstinence during pregnancy as the women in the present study (30,32,38) . The toxic effects of alcohol on the fetus have been known for more than 40 years (39) and consumption of alcohol during pregnancy is associated with congenital birth defects (23,40) as well as unfavourable developmental (20) and neurological outcomes (16) .…”

“…An increase in milk consumption from pre-pregnancy to pregnancy has also been found in other populations (15,(30)(31)(32) . However, a British prospective study reported stable consumption of milk from pre-pregnancy to early pregnancy (28,38) . Early pregnancy is a time period where women are highly motivated to adopt a healthier lifestyle, including healthier beverage consumption habits.…”

Women's dietary changes before and during pregnancy: A systematic review

“…Six articles reported data on fruit and vegetable intake with inconsistent findings (Cuco et al, 2006a;Pinto et al, 2008;Crozier et al, 2009a;Crozier et al, 2009b;Paulik et al, 2009;Smedley et al, 2014). Paulik et al (2009) reported an increase in the percentage of women consuming both fruits and vegetables (more than 4 times per week) in pregnancy (85.7% vs 94.8% fruit and 67.6% vs 75.4% vegetables).…”

“…Five articles reported data on beverage intake and the results varied greatly between studies (Hellerstedt et al, 1998;Cuco et al 2006a;Pinto et al, 2008;Crozier et al, 2009b;Skreden et al, 2014). Coffee and tea was the most commonly reported beverage, and consumption was found to decrease from before to during pregnancy in four studies (Hellerstedt et al, 1998;Pinto et al, 2008;Crozier et al, 2009b;Skreden et al, 2014).…”

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

“…Pregnant women usually are very aware of the potential risks for their unborn child [144] and are correspondingly open to changes which would positively affect the health of their unborn child. The majority of pregnant women are prepared to reduce the amount of nicotine and/or alcohol they consume or even to stop smoking or drinking completely and are prepared to eat a healthy diet [145]. Nevertheless, a considerable percentage of pregnant women continue to display health-damaging behaviors, although the data on the incidence of this risky behavior, particularly with respect to nicotine and alcohol consumption in pregnancy, varies considerably depending on the country where the data was collected (cf.…”