Abstract

Studies examining prenatal diet quality in the US indicate that pregnant women are not currently meeting national dietary recommendations. Though prenatal diet quality is generally poor, certain population sub-groups may be disproportionately impacted, however, few studies have examined diet quality disparities in pregnant women. In order to better understand disparities in prenatal diet quality, this study seeks to characterize the relationship between maternal sociodemographic factors and prenatal diet quality, specifically examining socioeconomic status, race, pre-pregnancy BMI, and gestational weight gain as an exploratory aim. Cross sectional data from the Infant Feeding Practices Study II informed this secondary analysis. To explore these relationships, we used generalized linear models to examine the associations between socioeconomic status, race, pre-pregnancy BMI, and gestational weight gain and Alternative Health Eating Index for Pregnancy (a measure of diet quality during pregnancy) total and component scores. Models were adjusted for age, energy intake, and relevant covariates. Post-hoc testing with Tukey adjustment was used to compare scores between groups. Findings indicated that prenatal diet quality disparities were present in women with middle- and low-income, non-Hispanic Black women, and women with overweight and obese pre-pregnancy BMIs.

Highlights

  • Evidence suggests that lifelong obesity and chronic disease risk is partially determined in early life (i.e.: prenatal to 2 years of age).[1]

  • Disparities in prenatal diet quality were detected in socioeconomic status (SES), race, and prepregnancy BMI

  • Exploratory analyses showed that the relationship between gestational weight gain (GWG) and Alternative Healthy Eating Index for Pregnancy (AHEI-P) score varied according to pre-pregnancy BMI

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Summary

Introduction

Evidence suggests that lifelong obesity and chronic disease risk is partially determined in early life (i.e.: prenatal to 2 years of age).[1]. Maternal pre-pregnancy obesity and excessive gestational weight gain are risk factors for giving birth to a high birthweight infant, which increases the infant’s risk of obesity and chronic disease development later in life.[5]. In the presence of maternal pre-pregnancy obesity and/or excessive gestational weight gain, the fetus is exposed to increased inflammation and adipokines (signaling protein from adipose), as well as altered insulin, glucose, and lipid metabolism in utero, which are thought to contribute to metabolic alternations in the infant leading to an increase in obesity and chronic disease risk later in life.[2,5]. Objective: To examine differences in prenatal diet quality by socioeconomic status (SES), race, pre-pregnancy BMI, and gestational weight gain ((GWG) exploratory analysis). Post-hoc testing with Tukey adjustment was used to compare scores between groups

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