ResearchCurrent ResearchDietary Quality during Pregnancy Varies by Maternal Characteristics in Project Viva: A US Cohort
Section snippets
Study Design and Participants
We recruited participants into Project Viva at eight offices of Harvard Vanguard Medical Associates, a large multispecialty urban/suburban group practice in eastern Massachusetts. At the first study visit, which immediately followed the woman's initial clinical prenatal visit, we obtained informed consent, administered a brief interview, and provided a take-home self-administered questionnaire, which included a validated 166-item semiquantitative food frequency questionnaire (FFQ) assessing the
Primary Results: Maternal Characteristics with AHEI-P
Of the 1,777 pregnant women included in this study, 28% classified themselves as belonging to racial/ethnic minorities (Table 2). Reflective of a generally employed and insured managed care population, few participants had less than or equal to a high school education (9%) or had annual household incomes below $40,000 (13%). Mean age at enrollment was 32.4±4.9 years, prepregnancy BMI was 24.6±5.3, gestational age at FFQ completion was 11.7±3.1 weeks, and 49% were nulliparous. Compared with
Discussion
This study shows that diet quality during pregnancy, based on a composite measure of foods and nutrients, varies by maternal characteristics. In our primary analysis, we found that participants who were older, leaner, nulliparous, and more educated had higher AHEI-P scores. After adjusting for sociodemographic characteristics, African American and white participants had similar AHEI-P scores.
It also appears that the AHEI-P is a predictor of at least two pregnancy outcomes, lower screening blood
Conclusions
Women who were younger, less educated, had more children, and who had higher prepregnancy BMI had poorer quality diets in pregnancy. Clinicians could use these results to tailor nutrition education messages to pregnant women to avoid long-term sequelae from suboptimal maternal nutrition.
S. L. Rifas-Shiman is a research associate, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
References (42)
- et al.
Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration
Lancet
(1992) - et al.
Cognitive deficit in 7-year-old children with prenatal exposure to methylmercury
Neurotoxicol Teratol
(1997) - et al.
Eighteen-month outcomes of house dust mite avoidance and dietary fatty acid modification in the Childhood Asthma Prevention Study (CAPS)
J Allergy Clin Immunol
(2003) - et al.
The 1995 dietary guidelines for Americans: An overview
J Am Diet Assoc
(1996) - et al.
Diet quality and major chronic disease risk in men and women: Moving toward improved dietary guidance
Am J Clin Nutr
(2002) - et al.
Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction
Am J Clin Nutr
(2005) - et al.
Calibration of a semi-quantitative food frequency questionnaire in early pregnancy
Ann Epidemiol
(2004) - et al.
Maternal age and other predictors of newborn blood pressure
J Pediatr
(2004) - et al.
Criteria for screening tests for gestational diabetes
Am J Obstet Gynecol
(1982) - et al.
What are pregnant women eating?Nutrient and food group differences by race
Am J Obstet Gynecol
(2002)
Characteristics of diet among a culturally diverse group of low-income pregnant women
J Am Diet Assoc
Ethnicity, nutrition, and birth outcomes in nulliparous women
Am J Obstet Gynecol
Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire
J Am Diet Assoc
Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire
Am J Clin Nutr
Neural-tube defects
N Engl J Med
Congenital malformations resulting from zinc deficiency in rats
Proc Soc Exper Biol Med
The effect of zinc supplementation on pregnancy outcome
JAMA
Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: A meta-analysis of randomized controlled trials
JAMA
Prenatal alcohol exposure and infant information processing ability
Child Dev
Fetal origins of adult disease: Strength of effects and biological basis
Int J Epidemiol
Critical periods in childhood for the development of obesity
Am J Clin Nutr
Cited by (248)
Dietary risk factors for hypertensive disorders of pregnancy
2024, Pregnancy HypertensionIn utero metabolomic signatures of refined grain intake and risk of gestational diabetes: A metabolome-wide association study
2023, American Journal of Clinical NutritionDiet and asthma
2023, Asthma in the 21st Century: New Research Advances
S. L. Rifas-Shiman is a research associate, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
K. P. Kleinman is an associate professor, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
E. Oken is an assistant professor, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
J. W. Rich-Edwards is an assistant professor, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA; the Department of Epidemiology, Harvard School of Public Health, Boston, MA; and the Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA
M. W. Gillman is a professor, Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA, and the Department of Nutrition, Harvard School of Public Health, Boston, MA