Maternal Dietary Patterns and Fetal Growth: A Large Prospective Cohort Study in China

Abstract

There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to identify dietary patterns. The following six dietary patterns were identified: “Cereals, eggs, and Cantonese soups” (n 1026, 14.8%), “Dairy” (n 1020, 14.7%), “Fruits, nuts, and Cantonese desserts” (n 799, 11.5%), “Meats” (n 1066, 15.3%), “Vegetables” (n 1383, 19.9%), and “Varied” (n 1224, 17.6%). The mean neonatal birth weight Z scores of women in the above patterns were 0.02, 0.07, 0.20, 0.01, 0.06, and 0.14, respectively. Women in the “Fruits, nuts, and Cantonese desserts” and “Varied” groups had significantly heavier infants compared with those in the “Cereals, eggs, and Cantonese soups” group. Compared with women in the “Cereals, eggs, and Cantonese soups” group, those in the “Varied” group had marginally significantly lower odds of having a small-for-gestational age (SGA) infant after adjustment for other confounders (OR 0.77, 95% CI 0.57, 1.04, p = 0.08). These findings suggest that compared to a traditional Cantonese diet high in cereals, eggs, and Cantonese soups, a diet high in fruits, nuts, and Cantonese desserts might be associated with a higher birth weight, while a varied diet might be associated with a greater birth weight and also a decreased risk of having a SGA baby.

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

“…Maternal dietary patterns, including higher adherence to 'alternative healthy eating index', 'Mediterranean diet', 'health-conscious', 'traditional' and 'varied' diets, were inversely associated with the risk of having SGA infants (19,23,35,44,58) . These findings were contradicted by a study conducted in the USA by Poon et al which did not observe a significant association between dietary patterns ('healthy eating index' and 'Mediterranean diet') and SGA (55) .…”

“…Wheat products: high intake of bread, fruit and vegetable juice, confectionery and soft drinks ↔ ↔ Lu et al (44) Varied or mixed…”

“…In a large prospective cohort study conducted in China, Lu et al reported that maternal consumption of a 'varied or mixed' dietary pattern, with high intakes of 'noodles, bread, root vegetables, mushrooms, melon vegetables, sea vegetables, bean vegetables, poultry, seafood, animal organ meat, bean products, yogurt, sweet beverages, puffed food, confectionery and snacks', was associated with a lower risk of having an SGA infant. However, a 'Western diet' (characterised by high-fat dairy products, red and processed meat) was positively associated with the risk of SGA infants (44) . In addition, in Japan, Okubo et al found that consumption of a 'wheat products' pattern (characterised by a high intake of bread, fruit and vegetable juice, confectionery and soft drinks) was associated with increased risk of having a SGA infant (51) .…”

“…Only one study excluded extremely preterm (<28 weeks) and post-term (>42 weeks) birth in the final analysis between maternal diet and LBW (33) . For the analyses of associations between maternal diet and SGA, five studies (44,47,55,56,58) excluded only preterm birth and two studies (46,51) excluded both pre-and post-term birth from the final samples.…”

Effect of Adherence to a Mediterranean Diet and Olive Oil Intake during Pregnancy on Risk of Small for Gestational Age Infants

“…Most studies published to date that evaluate diet during pregnancy have focused on the association between individual foods or nutrients and fetal growth [ 11 ]. The foods or nutrients associated with a lower risk of SGA are diverse depending on the study considered [ 12 , 13 , 14 , 15 , 16 ]. However, nutrition is a multidimensional exposure; nutrients or foods are not consumed in isolation, and the sources for the same nutrient can be different [ 17 ].…”