A maternal "mixed, high sugar" dietary pattern is associated with fetal growth.

Stephanie V Wrottesley,Sarah H Kehoe,Shane A Norris,Kate A Ward,Alessandra Prioreschi

doi:10.1111/mcn.12912

Abstract

This study examined associations between a maternal “mixed, high sugar” dietary pattern during pregnancy and ultrasound‐determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m2), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m2; p = .011) and femur length (0.01 cm/+1 kg/m2; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer‐term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.

Highlights

In urban African women, maternal dietary patterns during pregnancy have been associated with gestational weight gain (GWG) and with newborn growth and adiposity (Wrottesley, Ong, Pisa, & Norris, 2018; Wrottesley, Pisa, & Norris, 2017), potentially influencing long‐term risk of noncommunicable diseases for mothers and their offspring (Chiavaroli, Derraik, Hofman, & Cutfield, 2016; Godfrey et al, 2017; Holland, Groth, & Kitzman, 2015; Mochizuki, Hariya, Honma, & Goda, 2017)
Our study shows that, independent of maternal body mass index (BMI) and gestational weight gain, adherence to a “mixed, high sugar"” dietary pattern ‐ high in table sugar, sweet spreads and high‐sugar breakfast cereals and nut spreads ‐ is associated with higher fetal growth across all fetal growth parameters
While improving maternal dietary intake and BMI prior to conception should be a focus for optimising pregnancy and birth outcomes, as well as offspring health in the longer term, this data suggests that dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth, in obese pregnant women circumference is of interest (Hinkle, Johns, Albert, Kim, & Grantz, 2015)

Summary

Introduction

In urban African women, maternal dietary patterns during pregnancy have been associated with gestational weight gain (GWG) and with newborn growth and adiposity (Wrottesley, Ong, Pisa, & Norris, 2018; Wrottesley, Pisa, & Norris, 2017), potentially influencing long‐term risk of noncommunicable diseases for mothers and their offspring (Chiavaroli, Derraik, Hofman, & Cutfield, 2016; Godfrey et al, 2017; Holland, Groth, & Kitzman, 2015; Mochizuki, Hariya, Honma, & Goda, 2017). Traditional dietary pattern adherence was associated with lower GWG as well as lower newborn weight‐to‐length ratio and fat mass index (Wrottesley et al, 2018, 2017). These findings have important implications for this setting, where two thirds of women are either overweight or obese prior to conception and higher GWG is not beneficial for mother or baby (Wrottesley et al, 2018, 2017)

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