Predictors of Measurement Error in Energy Intake During Pregnancy

Abstract

Nutrition plays a critical role in maternal and fetal health; however, research on measurement error of energy intake during pregnancy is limited. Data were analyzed from 1,023 women with singleton pregnancies in the Pregnancy, Infection, and Nutrition Cohort Study. Second trimester diet was assessed using a food frequency questionnaire (FFQ). Estimated energy requirement (EER) was calculated using IOM prediction equations with adjustment for energy costs during the second trimester. Implausible values for daily energy intake (EI) were determined using confidence limits of agreement for EI/EER. Prevalence of low energy reporting (LER) and high energy reporting (HER) was 31.8% and 12.9%, respectively. In a multivariable analysis, pre‐gravid BMI was related to both LER and HER; LER was higher in both overweight (OR=1.96, 95% CI=1.26, 3.02) and obese women (OR=3.29, 95% CI=2.33, 4.65) than in normal weight counterparts. Other predictors of LER included marriage and higher levels of physical activity. HER was higher among subjects who were underweight, African American, less educated, and had higher depressive symptom scores. Nutrient density intakes for fat, calcium, riboflavin, and vitamin C differed between LER and non‐LER subjects. LER and HER are prevalent during pregnancy. Identifying their predictors may improve data collection and analysis methods to reduce systematic bias in reproductive studies.Grant Funding Source: ASN