Ai-Ru Chia1, Jamie V de Seymour2, Marjorelee Colega3, Ling-Wei Chen1, Yiong-Huak Chan4, Izzuddin M Aris3, Mya-Thway Tint1, Phaik Ling Quah3, Keith M Godfrey5, Fabian Yap6,7,8, Seang-Mei Saw9, Philip N Baker2, Yap-Seng Chong1,3, Rob M van Dam10,9, Yung Seng Lee11,12,3, Mary Foong-Fong Chong13,14,3. 1. Departments of Obstetrics and Gynaecology. 2. Liggins Institute, University of Auckland, Auckland, New Zealand. 3. Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore. 4. Biostatistics Unit, Yong Loo Lin School of Medicine. 5. Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom. 6. Department of Paediatrics, KK Women's and Children's Hospital, Singapore. 7. Duke-National University of Singapore Graduate Medical School, Singapore; and. 8. Lee Kong Chian School of Medicine, Nanynag Technological University, Singapore. 9. Saw Swee Hock School of Public Health, National University of Singapore, and. 10. Medicine, and. 11. Paediatrics and. 12. Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore. 13. Saw Swee Hock School of Public Health, National University of Singapore, and mary_chong@sics.a-star.edu.sg. 14. Clinical Nutrition Research Centre.
Abstract
BACKGROUND: Maternal dietary patterns during pregnancy have been shown to influence infant birth outcomes. However, to our knowledge, only a few studies have examined the associations in Asian populations. OBJECTIVE: We characterized maternal dietary patterns in Asian pregnant women and examined their associations with the risk of preterm birth and offspring birth size. DESIGN: At 26-28 wk of gestation, 24-h recalls and 3-d food diaries were collected from the women in the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort. Dietary patterns were derived from exploratory factor analysis. Gestational age was determined by a dating ultrasound scan in the first trimester, and infant birth anthropometric measurements were obtained from hospital records. Associations were assessed by logistic and linear regressions with adjustment for confounding factors. RESULTS: Three maternal dietary patterns were identified: vegetable, fruit, and white rice (VFR); seafood and noodle (SfN); and pasta, cheese, and processed meat (PCP). Of 923 infants, 7.6% were born preterm, 13.4% were born small for gestational age, and 14.7% were born large for gestational age. A greater adherence to the VFR pattern (per SD increase in VFR score) was associated with a lower risk of preterm births (OR: 0.67; 95% CI: 0.50, 0.91), higher ponderal index (β: 0.26 kg/m3; 95% CI: 0.06, 0.45 kg/m3), and increased risk of a large-for-gestational-age birth (RR: 1.31; 95% CI: 1.06, 1.62). No associations were observed for the SfN and PCP patterns in relation to birth outcomes. CONCLUSIONS: The VFR pattern is associated with a lower incidence of preterm birth and with larger birth size in an Asian population. The findings related to larger birth size warrant further confirmation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.
BACKGROUND: Maternal dietary patterns during pregnancy have been shown to influence infant birth outcomes. However, to our knowledge, only a few studies have examined the associations in Asian populations. OBJECTIVE: We characterized maternal dietary patterns in Asian pregnant women and examined their associations with the risk of preterm birth and offspring birth size. DESIGN: At 26-28 wk of gestation, 24-h recalls and 3-d food diaries were collected from the women in the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort. Dietary patterns were derived from exploratory factor analysis. Gestational age was determined by a dating ultrasound scan in the first trimester, and infant birth anthropometric measurements were obtained from hospital records. Associations were assessed by logistic and linear regressions with adjustment for confounding factors. RESULTS: Three maternal dietary patterns were identified: vegetable, fruit, and white rice (VFR); seafood and noodle (SfN); and pasta, cheese, and processed meat (PCP). Of 923 infants, 7.6% were born preterm, 13.4% were born small for gestational age, and 14.7% were born large for gestational age. A greater adherence to the VFR pattern (per SD increase in VFR score) was associated with a lower risk of preterm births (OR: 0.67; 95% CI: 0.50, 0.91), higher ponderal index (β: 0.26 kg/m3; 95% CI: 0.06, 0.45 kg/m3), and increased risk of a large-for-gestational-age birth (RR: 1.31; 95% CI: 1.06, 1.62). No associations were observed for the SfN and PCP patterns in relation to birth outcomes. CONCLUSIONS: The VFR pattern is associated with a lower incidence of preterm birth and with larger birth size in an Asian population. The findings related to larger birth size warrant further confirmation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.
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