Date Published: March 12, 2019
Publisher: Public Library of Science
Author(s): Samantha M. Garay, Katrina A. Savory, Lorna Sumption, Richard Penketh, Anna B. Janssen, Rosalind M. John, Michael Zulyniak.
Maternal lifestyles, including diet, have been linked to infant birthweight. However, customised birthweight centiles (CBWC), which more accurately identify small babies that have increased fetal growth restriction and are at higher risk of newborn morbidity and later life health complications, are rarely considered when studying maternal diet. This study investigated maternal dietary patterns and their impact on infant CBWC within a cohort of women living in South Wales.
This study utilised cross-sectional data from the longitudinal Grown in Wales (GiW) cohort. Women 18–45 years old were recruited the morning prior to an elective caesarean section (ELCS). Women completed a food frequency questionnaire (FFQ). Additional data on pregnancy and birth outcomes was extracted from medical notes. Data from 303 participants was analysed.
‘Western’ and ‘Health conscious dietary patterns were identified. The ‘Health Conscious’ dietary pattern was significantly associated with maternal BMI, age, education, income and exercise. Adjusted regression analyses indicated that greater adherence to a ‘Health Conscious’ dietary pattern was significantly associated with increased CBWC (AOR = 4.75 [95% CI: 1.17, 8.33] p = .010) and reduced risk of delivering a small-for-gestational age (SGA) infant (AOR = .51 [95% CI: .26, .99] p = .046).
A healthier diet was significantly associated with higher birthweight using CBWC and a reduced risk of delivering an SGA infant suggesting that birthweight will be improved in areas of Wales by focused support encouraging healthier dietary habits.
Diet in pregnancy, whether balanced and healthy or unhealthy, can have important implications for birth weight and later life health. In Wales recent statistics indicate that 11.4% of live births were classified as high birthweight (HBW) , with a general shift towards heavier babies . Despite this general increase in birthweight, 6.9% of live births were classified as low birthweight (LBW), with no significant improvements in LBW prevalence since 2011 . Moreover, the prevalence of low birthweight in live births varies by as much as 3.1% across health boards in Wales, which cover areas of varying socioeconomic status, highlighting disparities in improvements in birthweight . Specific studies of Welsh populations are important due to the devolution of responsibility for the National Health Service to the Welsh Assembly Government in 1999 resulting in differences between the nations on vital areas such as health systems , health priorities and health outcomes. Consequently, it cannot be assumed that outcomes will be the same across nations.
The aim of this study was to investigate dietary patterns during pregnancy and their association with infant birthweight outcomes utilising CBWC in a cohort of women living in Wales. Two dietary patterns were identified within this cohort: ‘Western’ and ‘Health conscious’. Higher adherence to the ‘Health conscious’ dietary pattern was associated with higher maternal age, undertaking strenuous exercise and an income of £18–25,000, whereas lower adherence was associated with higher maternal BMI, lower educational attainment and an income of £25–43,000. A greater adherence to the ‘Health conscious’ dietary pattern was associated with increased CBWC, or higher birthweight, and a significantly reduced risk of delivering an SGA infant.