(01-06-10) Diet quality in early pregnancy and its effects on fetal growth outcomes: the Infancia y Medio Ambiente

(Childhood and Environment) Mother and Child Cohort Study in Spain1,2,3


Clara L Rodr?guez-Bernal, Marisa Rebagliato, Carmen I?iguez, Jes?s Vioque, Eva M Navarrete-Mu?oz, Mario Murcia, Francisco Bolumar, Alfredo Marco and Ferran Ballester

1 From the Centro Superior de Investigaci?n en Salud P?blica Valencia Spain (CLR-B CI MMFB); the Departamento de Salud P?blica Universidad Miguel Hern?ndez Elche-Alicante Spain (CLR-B MR JVEMN-M); CIBER de Epidemiolog?a y Salud P?blica Spain (MR CI JV EMN-M MMFB); the Departamento de Ciencias Sanitarias y Medicosociales Universidad de Alcal? Madrid Spain (FB); the Departamento de Ciencias de la Salud Universidad Rey Juan Carlos Madrid Spain (MR); the Departamento de Cirug?a Infantil Hospital Universitario La Fe Valencia Spain (AM);the Escuela de Enfermer?a Universitat de Val?ncia Valencia Spain (FB).
2 Supported by Instituto de Salud Carlos III (Red INMA G03/176), FIS-FEDER (03/1615, 04/1509, 04/1112, and 07/0314), and Conselleria de Sanitat Generalitat Valenciana (012/2009); all in Spain.
3 Address correspondence to CL Rodr?guez-Bernal, Centro Superior de Investigaci?n en Salud P?blica, Avenida Catalu?a 21, 46020 Valencia, Spain. E-mail: [email protected] .

Background: Maternal diet has been associated with fetal growth outcomes; however, evidence is scarce on the role of dietary quality.
Objective: The objective was to assess the effect of diet quality during the first trimester of pregnancy, as measured by the Alternate Healthy Eating Index (AHEI) adapted for pregnancy, on fetal growth.
Design: We studied 787 women and their newborns from a Spanish cohort study. Diet quality was assessed by using a modification of the AHEI. Adjusted birth weight, birth length, and head circumference were used as continuous outcomes. We used a customized model to define fetal growth restriction in weight, length, and head circumference.
Results: After adjustment of multivariate models, a positive association was observed between diet quality and adjusted birth weight and adjusted birth length. The greatest differences were found between the fourth and first quintiles of the AHEI. Newborns of women in the fourth quintile were on average 126.3 g (95% CI: 38.5, 213.9 g) heavier and 0.47 cm (95% CI: 0.08, 0.86 cm) longer than those in the lowest quintile (P for trend = 0.009 and 0.013, respectively). Women with the highest AHEI scores had a significantly lower risk of delivering a fetal growth?restricted infant for weight (odds ratio: 0.24; 95% CI: 0.10, 0.55; P for trend = 0.001) than did women in the lowest quintile, but this was not the case for fetal growth restriction in length (P for trend = 0.538) or head circumference (P for trend = 0.070).
Conclusion: A high-quality diet in the first trimester of pregnancy is associated with birth size and the risk of fetal growth restriction.

Source: Am J Clin Nutr 91: 1659-1666, 2010.

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