Dietary patterns before and during pregnancy and birth outcomes: a systematic review

Ramkripa Raghavan; Carol Dreibelbis; Brittany L Kingshipp; Yat Ping Wong; Barbara Abrams; Alison D Gernand; Kathleen M Rasmussen; Anna Maria Siega-Riz; Jamie Stang; Kellie O Casavale; Joanne M Spahn; Eve E Stoody

doi:10.1093/ajcn/nqy353

Dietary patterns before and during pregnancy and birth outcomes: a systematic review

Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):729S-756S. doi: 10.1093/ajcn/nqy353.

Affiliations

¹ Panum Group, Bethesda, MD.
² Food and Nutrition Service, USDA, Alexandria, VA.
³ Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, CA.
⁴ Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA.
⁵ Division of Nutritional Sciences, Cornell University, Ithaca, NY.
⁶ Department of Family, Community and Mental Health Systems, University of Virginia School of Nursing, Charlottesville, VA.
⁷ Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
⁸ Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD.

PMID: 30982873
DOI: 10.1093/ajcn/nqy353

Abstract

Background: Maternal diet before and during pregnancy could influence fetal growth and birth outcomes.

Objective: Two systematic reviews aimed to assess the relationships between dietary patterns before and during pregnancy and 1) gestational age at birth and 2) gestational age- and sex-specific birth weight.

Methods: Literature was searched from January, 1980 to January, 2017 in 9 databases including PubMed, Embase, and Cochrane. Two analysts independently screened articles using predetermined inclusion and exclusion criteria. Data were extracted from included articles and risk of bias was assessed. Data were synthesized qualitatively, a conclusion statement was drafted for each question, and evidence supporting each conclusion was graded.

Results: Of the 9103 studies identified, 11 [representing 7 cohorts and 1 randomized controlled trial (RCT)] were included for gestational age and 21 (representing 19 cohorts and 2 RCTs) were included for birth weight. Limited but consistent evidence suggests that certain dietary patterns during pregnancy are associated with a lower risk of preterm birth and spontaneous preterm birth. These protective dietary patterns are higher in vegetables; fruits; whole grains; nuts, legumes, and seeds; and seafood (preterm birth, only), and lower in red and processed meats, and fried foods. Most of the research was conducted in healthy Caucasian women with access to health care. No conclusion can be drawn on the association between dietary patterns during pregnancy and birth weight outcomes. Although research is available, the ability to draw a conclusion is restricted by inconsistency in study findings, inadequate adjustment of birth weight for gestational age and sex, and variation in study design, dietary assessment methodology, and adjustment for key confounding factors. Insufficient evidence exists regarding dietary patterns before pregnancy for both outcomes.

Conclusions: Maternal dietary patterns may be associated with a lower preterm and spontaneous preterm birth risk. The association is unclear for birth weight outcomes.

Keywords: birth weight; dietary patterns; maternal; pregnancy; preterm; systematic review.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Systematic Review

MeSH terms

Birth Weight
Diet*
Feeding Behavior*
Female
Fetal Development
Gestational Age
Humans
Male
Maternal Nutritional Physiological Phenomena*
Pregnancy
Pregnancy Outcome*
Premature Birth*