Abstract
Purpose: Studies of the association between maternal nutrition and birth outcomes have investigated differing nutrients, maternal socioeconomic conditions, and timing within the reproductive cycle; and have produced inconsistent results. We evaluated the association of preconceptional maternal dietary intake with birth outcomes among low socioeconomic status ethnic minority women in a high-income country. Methods: In this prospective cohort study, habitual preconceptional dietary intake was assessed among pregnant Bedouin Arab women in Israel (n = 384), using a short culturally specific, targeted food frequency questionnaire. Multiple nutrients (protein, lysine, calcium, iron, zinc, folate, omega-3 fatty acids) were evaluated simultaneously via a diet quality score derived from principal component analysis. Multivariable logistic regression was used to test associations between the diet quality score and a composite adverse birth outcomes variable, including preterm birth, low birth weight and small for gestational age. Results: Sixty-nine women (18%) had adverse birth outcomes. Women with low preconceptional diet quality scores had low intakes of nutrient-rich plant foods, bioavailable micronutrients, and complete proteins. In multivariable analysis, a woman at the 10th percentile of the diet quality score had a 2.97 higher odds (95% CI 1.28–6.86) of an adverse birth outcome than a woman at the 90th percentile. Conclusion: Low diet quality during the preconceptional period was associated with adverse birth outcomes among low socioeconomic status minority women in a high-income country. The results have implications for the development of appropriate intervention strategies to prevent adverse birth outcomes, and the promotion of adequate nutrition throughout the child-bearing years.
| Original language | English |
|---|---|
| Pages (from-to) | 65-77 |
| Number of pages | 13 |
| Journal | European Journal of Nutrition |
| Volume | 60 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2021 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Funding
We would like to thank the women who participated in the DEPOSIT cohort, the study staff of the S. Daniel Abraham Center for Health and Nutrition at Ben-Gurion University of the Negev, and the staff of the Maternal and Child Health and High Risk Pregnancy clinics. We would also like to thank Dr. Ilya Novikov for conducting the power analysis. This work was supported by a grant from the Israel National Institute for Health Policy and Health Services Research [Grant Number: 2003/136/A]. The funding agency had no role in the design, conduct or analysis of the study; or in the preparation, review, or approval of the manuscript. We would like to thank the women who participated in the DEPOSIT cohort, the study staff of the S. Daniel Abraham Center for Health and Nutrition at Ben-Gurion University of the Negev, and the staff of the Maternal and Child Health and High Risk Pregnancy clinics. We would also like to thank Dr. Ilya Novikov for conducting the power analysis. This work was supported by a grant from the Israel National Institute for Health Policy and Health Services Research [Grant Number: 2003/136/A]. The funding agency had no role in the design, conduct or analysis of the study; or in the preparation, review, or approval of the manuscript.
| Funders | Funder number |
|---|---|
| Israel National Institute for Health Policy and Health Services Research | 2003/136/A |
| Maternal and Child Health and High Risk Pregnancy clinics | |
| Israel National Institute for Health Policy Research |
Keywords
- Adverse birth outcomes
- Diet quality
- Ethnic minority
- Low socioeconomic status
- Preconceptional maternal diet
- Principal component analysis