Influence of dietary intake and decision‐making during pregnancy on birth outcomes

Abstract

Aim: This study aimed to examine dietary intake and decision-making in a cohort of pregnant South-East Queensland women to determine compliance with dietary guidelines and the relationships between dietary intake, decisionmaking and birth outcomes.Methods: Pregnant women attending maternity services at participating hospitals reported food frequency and motivations using the Maternal Outcomes and Nutrition Tool, a novel digital instrument. Birth outcomes were sourced from hospital records. A cross-sectional cohort design was used to examine the data.Results: Analysis demonstrated suboptimal intake of core food groups; meat and alternatives (median [IQR]) (2.6 [2.0-3.4] serves/day) and grains (3.1 [2.1-4.1]) fell below recommendations; fruit (3.8 [2.5-5.3]) and discretionary foods (3.1 [2.1-4.4]) exceeded them. Hypertensive disorders demonstrated a negative linear relationship with vegetable intake (P = .017). Cultural diversitywas significantly associated with decreased birthweight (P = .022) but increased intake of meat and alternatives (3.1 vs 2.6, P < .001) compared to Caucasian women; median intake of meat and alternatives was lower in women who reported smoking in the examined time frame. Smokers were less likely to declare health motives for food selection than non-smokers; smoking and health were inversely associated with increasing maternal age. Food choice was primarily sensory-driven.Conclusions: This cohort demonstrated poor adherence to dietary guidelines. Culturally and linguistically diverse women and smokers exhibit dietary behaviours which may contribute to suboptimal birth outcomes; targeted nutrition counselling may improve outcomes in these women. These findings highlight the need for transdisciplinary maternity care and provide a foundation for further research aimed at optimising nutrition-related birth outcomes in at-risk groups. K E Y W O R D Sbirth outcomes, cultural diversity, decision-making, diet, nutritional status, pregnancy

Examining the use of the FIGO Nutrition Checklist in routine antenatal practice: multistakeholder feedback to implementation

“…The findings of our study are in line with other research showing that there is poor adherence to pregnancy dietary recommendations, including intakes of vegetables, wholegrains, folic acid, and iron. 15,16 Fruit, vegetables, wholegrains, and fish are key components of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and following this diet has been associated with lower maternal blood pressure, even in women without hypertensive disorders. 17 The most common dietary issue in our study was self-reported fish intake of less than once a week.…”

“…20 Low consumption of vegetables is associated with hypertensive disorders in pregnancy. 16 Inadequate knowledge of dietary recommendations is one potential barrier for pregnant women to adhere to nutrition guidelines during pregnancy. 21 Percentage of pregnant women agreeing with each statement about the conversaƟon with the healthcare professional using the FIGO NutriƟon Checklist F I G U R E 5 Attitudes of pregnant women and healthcare professionals to the FIGO Nutrition Checklist.…”

Understanding empowerment for a healthy dietary intake during pregnancy

“…A healthy dietary intake during pregnancy is important for maternal and child health (World Health Organization, 2018) which has been defined by the World Health Organization (2018) as one that "contains adequate energy, protein, vitamins and minerals, obtained through the consumption of a variety of foods, including green and orange vegetables, meat, fish, beans, nuts, pasteurized dairy products and fruit (p. 4)". A poor dietary intake is associated with adverse health outcomes for the mother (e.g., increased risk of pre-eclampsia and gestational diabetes, and excessive gestational weight gain), adverse birth outcomes (e.g., premature birth and low birth weight), and adverse health outcomes in childhood and adult life (e.g., increased risk of developing chronic diseases such as diabetes or coronary heart disease) (James-McAlpine et al, 2020;Ramakrishnan et al, 2012;Stang & Huffman, 2016).…”

The first 1000 days: A critical period of nutritional opportunity and vulnerability

“…Several papers in this issue provide further evidence of the importance of adequate and timely nutrition in the first 1000 days and the need for this to be communicated effectively to new mothers and mothers to be. While pregnancy is seen as a critical window of opportunity for promoting healthy eating to women, food choices of pregnant women appear to be driven primarily by sensory and not health motives, 22 as is the case in the general population. In particular, the iodine intake of pregnant women continues to be of concern, with dietary intakes likely to be insufficient, and the importance of iodine in pregnancy is seemingly ineffectively communicated to this target group.…”

“…Sherriff et al investigated the dietary iodine intake of pregnant women attending antenatal classes in Perth and found that only three of five women consumed bread daily 8 . Similarly, James‐McAlpine et al assessed the diets of a cohort of pregnant South East Queensland women and found that the daily serves of grain‐based food were less than half the recommended intake 22 . The implication of both these studies is that the dietary intake of both folate and iodine by pregnant Australian women is likely to be insufficient…”