Effects of Dietary Patterns during Pregnancy on Preterm Birth: A Birth Cohort Study in Shanghai.

Qi Song,Xueying Cui,Shenglu Zhao,Zehuan Shi,Jiajie Zang,Jin Su,Zhengyuan Wang

doi:10.3390/nu13072367

Abstract

The objective of this study was to analyse representative dietary patterns during pregnancy in Shanghai and explore the effects of dietary patterns during pregnancy on preterm birth. Data were derived from the ‘Iodine Status in Pregnancy and Offspring Health Cohort’ (ISPOHC) study. Multistage, stratified random sampling was used to select survey participants from 16 districts in Shanghai, which were divided into five sampling areas; 40–70 pregnant women were selected from each area. A total of 4361 pregnant women and their offspring were involved in the study. The male-to-female ratio of the babies was 1.04:1, and the incidence of single preterm birth was 4.2%. Three dietary patterns were extracted by factor analysis: a ‘Vegetarian Pattern’, an ‘Animal Food Pattern’ (AFP), and a ‘Dairy and Egg Pattern’. These patterns explained 40.513% of the variance in dietary intake. Binary logistic regression, which was used to analyse the association between birth outcomes and scores measuring maternal dietary patterns, found only the AFP was a significant risk factor for preterm birth. Higher AFP scores were positively associated with preterm birth (Q2 vs. Q1 OR = 1.487, 95% CI: 1.002–2.207; Q3 vs. Q1 OR = 1.885, 95% CI: 1.291–2.754). After adjusting for other potential contributors, a higher AFP score was still a significant risk factor for preterm birth (Q2 vs. Q1 OR = 1.470, 95% CI: 0.990–2.183; Q3 vs. Q1 OR = 1.899, 95% CI: 1.299–2.776). The incidence of preterm birth was 4.2%. A higher score of AFP was significantly associated with a higher risk of preterm birth. The animal food intake of pregnant women should be reasonably consumed during pregnancy.

Highlights

Preterm birth, defined as a live birth before 37 weeks of pregnancy, was the leading cause of neonatal death [1]
The three dietary patterns during pregnancy can be summarised as a ‘Vegetarian Pattern’, an ‘Animal Food Pattern’ (AFP), and a ‘Dairy and Egg Pattern’
After adjusting for educational level, annual family income, age, drinking during pregnancy, pre-pregnancy body mass index (BMI), sex of the baby and the three dietary patterns, a higher score on the AFP was still a risk factor for preterm birth (Q2 vs. Q1 odds ratios (ORs) = 1.470, 95% CI: 0.990–2.183; Q3 vs. Q1 OR = 1.899, 95% CI: 1.299–2.776)

Summary

Introduction

Preterm birth, defined as a live birth before 37 weeks of pregnancy, was the leading cause of neonatal death [1]. Preterm birth is a worldwide problem, with 15 million babies born prematurely each year, and 1 million babies dying each year due to the complications of preterm birth [2]. The rate of preterm birth in China is lower than the rate in many other countries, it is rising year by year. In the past three decades, the rate of preterm birth in China has gradually increased from 5.36% in 1990–1994 to 7.04% in 2016 [5]. Preterm birth has a profound economic effect on families and society and increases the risk of preterm birth during a subsequent pregnancy. The problem of preterm birth requires our urgent attention

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