Effects of maternal diets on preterm birth and low birth weight: a systematic review

Abstract

Current evidence indicates that maternal diets before and during pregnancy could influence rates of preterm birth, low birth weight (LBW) and small for gestational age (SGA) births. However, findings have been inconsistent. This review summarised evidence concerning the effects of maternal diets before and during pregnancy on preterm birth, LBW and SGA. Systematic electronic database searches were carried out using PubMed, Embase, Scopus and Cochrane library using the preferred reporting items for systematic reviews and meta-analyses guidelines. The review included forty eligible articles, comprising mostly of prospective cohort studies, with five randomised controlled trials. The dietary patterns during pregnancy associated with a lower risk of preterm birth were commonly characterised by high consumption of vegetables, fruits, whole grains, fish and dairy products. Those associated with a lower risk of SGA also had similar characteristics, including high consumption of vegetables, fruits, legumes, seafood/fish and milk products. Results from a limited number of studies suggested there was a beneficial effect on the risk of preterm birth of pre-pregnancy diet quality characterised by a high intake of fruits and proteins and less intake of added sugars, saturated fats and fast foods. The evidence was mixed for the relationship between maternal dietary patterns during pregnancy and LBW. These findings indicate that better maternal diet quality during pregnancy, characterised by a high intake of vegetables, fruits, whole grains, dairy products and protein diets, may have a synergistic effect on reducing the risk of preterm birth and SGA.

Maternal Serum Albumin Redox State Is Associated with Infant Birth Weight in Japanese Pregnant Women

“…While it is reasonable that a shorter gestation period would be accompanied by a lower birth weight delivery [ 1 ], the mechanisms that associate serum reduced ALB ratio with gestation period remain to be clarified. A recent systematic review reported a beneficial effect of high protein intake on a reduction in the risk of preterm birth [ 8 ], and recent studies in rats showed that plasma reduced ALB ratio decreased sensitively in response to dietary protein insufficiency [ 23 , 24 , 25 ]. Although the dietary assessment was not conducted, the association between serum reduced ALB ratio in the third trimester and infant birth weight/gestation period observed in this study might reflect the considerable prevalence of maternal dietary protein insufficiency in the third trimester, as observed previously in the Japanese population [ 3 , 20 ].…”

“…Thus, as well as protein intake, the quantity of dietary carbohydrate and fat needs to be considered for better gestational outcomes. Notably, higher intake of n-3 polyunsaturated fatty acids or lower intake of added sugars was positively associated with gestational period and/or infant birth weight [ 8 ], indicating that the “quality” of macronutrients is influential for gestational outcomes. Lastly, a recent study on healthy pregnant women in Canada reported that the protein requirement could be higher than the current DRI recommendation [ 39 ].…”

“…LBW delivery is largely attributed to premature birth and/or fetal growth restriction (FGR) in utero. Pre-pregnant women who are underweight (body mass index (BMI) <18.5 kg/m 2 ) and/or those who have insufficient gestational weight gain are at high risk of LBW delivery resulting from fetal undernutrition [ 2 , 3 , 4 , 5 , 6 , 7 ], and maternal dietary pattern and nutritional status are the pivotal factors specifying the fate of delivery [ 3 , 8 ]. LBW delivery is highly related to neonatal mortality and morbidity [ 1 ], and fetal undernutrition can even inflict epigenetically negative impacts on the fetus, thereby increasing the risk of non-communicative diseases later in life [ 9 ].…”

Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort

“…In a recent systematic review and metaanalysis of the relationship between maternal dietary patterns during pregnancy and risk of preterm birth and birth weight, it was found that unhealthy dietary patterns during pregnancy, characterized by high intake of refined grains, processed meat, and foods high in saturated fat or sugar, were associated with lower birth weight (mean difference: −40 g; 95% confidence interval: −61, −20 g; I2 = 0%) and a higher risk of preterm birth (odds ratio: 1.17; 95% confidence interval: 0.99, 1.39; I2 = 76%) [76]. Furthermore, another systematic review by Gete et al has found that a high consumption of vegetables, fruits, legumes, seafood/fish and milk products was associated with a lower risk of SGA [77]. Together, this suggests that improving the composition of the diet in pregnant women, i.e., a higher proportion of the daily energy intake from nutrient dense foods, including vegetables, fruits, wholegrains, low-fat dairy, and lean proteins, could improve fetal growth and go some way to reducing the high rates of LBW babies born in Indigenous Australian populations, as well as improving the long-term health of the children [78].…”

The Influence of Diet, Exercise and Education Level During Pregnancy on Child Cavities and Tooth Eruption

“…Besides dietary factors, maternal education and physical activity are other health behaviours associated with positive oral health scores [11]. Regular physical activity in all phases of life, including pregnancy, promotes health benefits, such as decreased periodontal disease and caries [12,13]. Specifically, an Italian study noted 9-year-olds involved in physical activity have better oral hygiene, less halitosis, and less gingivitis than inactive counterparts [14].…”