Effect of a Mediterranean Diet during Pregnancy on Fetal Growth and Preterm Delivery: Results From a French Caribbean Mother–Child Cohort Study (TIMOUN)

Abstract

Background: Recent studies suggest that a Mediterranean dietary pattern during pregnancy may influence pregnancy outcomes. The aim of this study was to evaluate the effect of adherence to a Mediterranean diet (MD) during pregnancy on fetal growth restriction (FGR) and preterm delivery (PTD) in a French Caribbean island where the population is largely of African descent and presents dietary patterns similar to MD. Methods: Using data from the TIMOUN Mother-Child Cohort Study conducted in Guadeloupe (French West Indies) between 2004 and 2007, we analysed data for 728 pregnant women who delivered liveborn singletons without any major congenital malformations. Degree of adherence to MD during pregnancy was evaluated with a semi-quantitative food frequency questionnaire based on nine dietary criteria. Multiple logistic regression models were used to analyse birth outcomes while taking potential confounders into account. Results: Overall there was no association between MD adherence during pregnancy and the risk of PTD or FGR. However, pre-pregnancy body mass index was a strong effect modifier, and MD adherence was associated with a decreased risk of PTD specifically in overweight and obese women (adjusted odds ratio 0.7, 95% confidence interval 0.6, 0.9) (P heterogeneity <0.01). Conclusions: These results suggest that Caribbean diet during pregnancy may carry some benefits of MD and may contribute to reduce the risk of PTD in overweight and obese pregnant women.

Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

“…Consistent with others, we did not observe an association between maternal diet quality and preterm birth (13,15,16,19), with the exception of 2 studies that showed a lower risk of preterm birth with greater adherence to the DASH diet (21) and a Mediterranean diet (18). The latter study was restricted to participants with low-risk pregnancies (i.e., no pre-existing health conditions, no complications during previous pregnancies, were nonsmokers, etc.…”

“…), and the results may not be applicable to other populations of pregnant women (18). The intake of sweetened beverages was accounted for in the DASH diet (21) but less emphasized in other diet quality indexes (13,15,16,19,30). Earlier studies have shown that the intake of sweetened beverages during pregnancy is associated with an increased risk of preterm birth (47)(48)(49).…”

“…Although greater adherence to the DASH (21) and Mediterranean (18) diets has been associated with a lower incidence of preterm birth, several studies observed no association (13,15,16,19). For birth size, a better-quality diet during pregnancy has generally been associated with higher birth weight (10,14,17) and a lower risk of fetal growth restriction (10,14,20), but other studies have reported no association (9,(11)(12)(13)(14).…”

Maternal Dietary Patterns during the Second Trimester Are Associated with Preterm Birth

“…In a separate study in a cohort of pregnant Norwegian women, no association was found between the Mediterranean-style diet and preterm birth (6). In a retrospective study in women from a French Caribbean Mother-Child Cohort Study (TIMOUN), adherence to a Mediterranean-style diet was associated with a lower risk of preterm birth only in overweight and obese women (OR: 0.70; 95% CI: 0.60, 0.90) (29). With the use of a Mediterranean Diet Score and the Diet Quality Index, no association with preterm birth was found for either of the indices in the year before pregnancy in the National Birth Defects Prevention Study (7).…”

Validity and Reproducibility of a Dietary Questionnaire for Consumption Frequencies of Foods during Pregnancy in the Born in Guangzhou Cohort Study (BIGCS)

“…Dietary factors during pregnancy are very important for maternal health as well as for fetal growth [1,2]. Existing evidence has shown that an imbalanced maternal diet during pregnancy is associated with multiple adverse pregnancy outcomes, such as gestational diabetes mellitus (GDM), gestational hypertension, pre-eclampsia, fetal growth restriction, preterm birth, low birth weight, and macrosomia [1,2,3,4].…”