Poster Topical Area: Nutritional Epidemiology
Location: Hall D
Poster Board Number: 747
Objectives: To evaluate the association of dietary patterns (DP) in the pre-gestational period with neonatal outcomes.
Methods: A prospective cohort (n=189) was followed in Rio de Janeiro, Brazil, during pregnancy (5-13th, 20-26th and 30-36th weeks) and 30-40 days postpartum. A food frequency questionnaire was administered at the 1st trimester. The reduced rank regression procedure was used to identify DP that explains the response variables: fiber density, dietary energy density, and % energy from saturated fat. Infants' birth weight and length were retrieved from medical records and classified according to Intergrowth-21st percentiles for sex and gestational age at birth [small and adequate for gestational age, ≤90th percentile vs. large for gestational age (LGA), > 90th percentile]. The Apgar score was measured at the 1st minute [<7(health risk) vs. ≥7 (normal)]. The associations between DP tertiles and the outcomes were determined using multiple logistic regression models. Confounders were established based on a Direct Acyclic Graph.
Results: The pregnant woman had a mean daily energy intake of 2,422 kcal (SD 822). The mean (SD) birth weight and length was 3,277 g (529.7) and 49.6 cm (3.1), respectively. LGA occurred in 16% and Apgar <7in14.2%. Three DP were identified: 'fast food and candies' (characterized by high intakes of fast food and snacks, cakes/cookies/crackers, and candies/ desserts); 'beans, bread and fat' (characterized by high intakes of beans, cakes/cookies/crackers, bread and fats used as spreads); and 'vegetables and dairy' (characterized by high intakes of green vegetables/legumes, dairy products, fish, tea, fruits/fruit juices, and candies/desserts). In the adjusted logistic regression analysis women with the highest adherence to the 'fast food and candies' DP presented higher risk of LGA (OR=4.38, 95%CI: 1.27; 15.02) and birth length > 90thpercentile (OR=5.03, 95%CI: 1.85; 13.64) occurrence. The highest adherence to the 'beans, bread and fat' DP was inversely associated with Apgar at the 1st minute <7(OR=0.14, 95%CI: 0.03; 0.69). We found no associations between the 'vegetables and dairy' DP and neonatal outcomes.
Conclusions: The adherence to a 'fast food and candies' pre-pregnancy DP was positively associated with birth length and increased the risk of LGA births.
The Carlos Chagas Filho Research Foundation from the State of Rio de Janeiro (FAPERJ) (grant numbers E-26/111.400/2010, E-26/110.681/2012; E-26/112.181/2012; E-26/111.698/2013) financially supported the present study. FAPERJ had no role in the design, analysis or writing of this article.
Rio de Janeiro Federal University
Rio De Janeiro, Rio de Janeiro, Brazil