Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition
Location: Hall D
Poster Board Number: 416
Objectives: Emerging evidence suggests that nutritional perturbations during pregnancy may impact fetal growth and disease risk in later life, although with inconsistent data on individual foods or nutrients. Data on overall dietary quality during pregnancy in relation to fetal growth are limited. We aimed to investigate the prospective associations of Healthy Eating Index-2010 (HEI-2010) scores during pregnancy, based on adherence to the USDA Dietary Guidelines for Americans, with birthweight z-score and risk of small-for-gestational-age (SGA) and large-for-gestational-age (LGA).
Methods: In a prospective cohort of 2,107 singleton pregnancies in the Pregnancy Environment and Lifestyle Study, maternal dietary intake during the past 3 months was assessed by a food frequency questionnaire during early pregnancy (gestational weeks 10-13). Offspring birthweight and gestational age at delivery were obtained from medical records. Size for gestational age was categorized according to gestational age, sex, and racial/ethnic specific birthweight distribution in the underlying population. Linear regression and Poisson regression with robust standard errors were used, adjusting for major risk factors.
Results: Total HEI-2010 score ranged from 37.5 to 94.2 (mean ± SD 71.2 ± 10.0). After adjusting for covariates, HEI-2010 score was significantly and inversely associated with birthweight z-score [β comparing the highest vs. lowest quartile = -0.14, 95% confidence interval (CI) -0.25, -0.02]. Consistently, HEI-2010 score comparing the highest vs. lowest quartile was associated with a 45% decreased risk of LGA [adjusted relative risk (aRR) = 0.55, 95% CI 0.32, 0.95, P-for-trend = 0.036]. The corresponding aRR was 0.67 (95% CI 0.46, 0.99) comparing good vs. poor diet quality defined by the cutoff of 75th percentile (≥ vs. <78.6). No significant associations were observed for HEI-2010 in relation to SGA risk.
Conclusions: Better diet quality and adherence to dietary guidelines during pregnancy may reduce risk of LGA. Our findings may inform potential upstream prevention strategies to mitigate risk of fetal growth extremities.
This work was supported by grant R01ES019196 from the National Institute of Environmental Health Sciences. Dr. Zhu is also supported by 3K12HD052163-18S1. Drs. Ferrara and Hedderson are also supported by contract award UG3OD023289 from the National Institutes of Health (NIH) Environmental Influences on Child Health Outcomes (ECHO) Program.
Kaiser Permanente Northern California Division of Research