Abstract
The objective of this study was to assess the relationship between consumption of different types of carbohydrates (CHO) during pregnancy and the risk of having a small for gestational age (SGA) newborn. A retrospective matched case–control design was carried out with a total of 518 mother-offspring pairs. A total of 137 validated items were included in the food frequency questionnaire (FFQ). Conditional logistic regression models were used to calculate crude odds ratios (cORs) and adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Having more than 75 g/day of brown bread showed an inverse association with SGA (aOR = 0.64, CI 0.43–0.96). In contrast, an intake of industrial sweets more than once a day (aOR = 2.70, CI 1.42–5.13), or even 2–6 times a week (aOR = 1.84, CI 1.20–2.82), increased the odds of having a SGA newborn. During pregnancy, the higher the increase of wholegrain cereal and bread, the lower the possibility of having a SGA newborn, but the opposite occurred with refined sugar products—just consuming industrial bakery products or pastries twice a week increased the odds of having an SGA infant. Case–control studies cannot verify causality and only show associations, which may reflect residual confusion due to the presence of unknown factors. It is possible that a high consumption of sugary foods is a marker of a generally poor lifestyle.
Highlights
Around 19% of newborns from low- and middle-income countries are small for gestational age (SGA)—smaller in size than normal for their gestational age—with weight below the 10th percentile for the gestational age [1]
A well-balanced and healthy maternal diet during pregnancy seems to reduce the likelihood of having an SGA newborn [3,4,5]
The same tendency was observed in our sample when pregnant women have a good adherence to the Mediterranean diet pattern [5], and we have found that the total amount of wholegrain cereal and bread in g/day is negatively associated with
Summary
Around 19% of newborns from low- and middle-income countries are small for gestational age (SGA)—smaller in size than normal for their gestational age—with weight below the 10th percentile for the gestational age [1]. A well-balanced and healthy maternal diet during pregnancy seems to reduce the likelihood of having an SGA newborn [3,4,5]. Starchy carbohydrates (pasta, potatoes, bread, cereals and rice), mainly whole grain cereals and complex fiber-rich carbohydrates, are the core of a healthy diet [7,9]. Refined sugar, such as sugar-sweetened carbonated soft drinks (SSC) or foods containing refined sugar, reduces the total vitamin and mineral density of the diet by displacing more nutrient-dense foods [10]. Some randomized controlled trials pointed out that pregnant women with a lower glycemic index (LGI)
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