The Association of Maternal Dietary Patterns With Birth Weight and the Mediation of Gestational Weight Gain in a Prospective Birth Cohort

Abstract

Abstract Objectives The aim of this study is to investigate the associations between maternal dietary patterns and birth weight, and further explore whether gestational weight gain (GWG) mediates these associations. Methods A total of 3334 pregnant women who completed a validated semi-quantitative food frequency questionnaire from the Tongji Maternal and Child Health Cohort were included. Dietary patterns were extracted by using principle component analysis. GWG was assessed by the last available weight measurement during pregnancy and self-reported pre-pregnancy weight at enrollment. Birth weight was collected according to medical records. Regression models and mediation analyses were performed to explore the associations between dietary patterns and birth weight and the effects of GWG on these associations. Results Five dietary patterns were identified: “Beans-vegetables”, “Fish-meat-eggs”, “Nuts-whole grains”, “Organ-poultry-seafood” and “Rice-wheat-fruits”. Women following “Beans-vegetables” pattern had significant lower GWG (β = −0.70; 95% CI: −1.15, −0.25) and had 16% lower risk of excessive GWG and 11% higher odd of adequate GWG. While as the score increased by one unit, GWG increased 0.18kg for “Fish-meat-eggs”, 0.23kg for “Nuts-whole grains” and 0.26kg for “Rice-wheat-fruits”, and the risks of insufficient GWG all decreased. Only women following “Beans-vegetables” pattern had heavier newborns (β = 47.39; 95% CI: 12.25 82.54). The association between “Beans-vegetables” pattern and birth weight was negatively mediated by GWG. Conclusions A dietary pattern enriched in beans and vegetables is beneficial for effectively controlling GWG and increasing birth weight. GWG serves as a mediator in the relationship between this pattern and birth weight helping to prevent excess birth weight. Funding Sources This work was supported by the National Program on Basic Research Project of China (NO.2013FY114200) and Fundamental Research Funds for the Central Universities (HUST2016YXZD040) for NY, and the National Natural Science Foundation of China (81973043) for XY.