Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

Abstract

Background: Evidence linking maternal diet quality during pregnancy with infant birth outcomes is limited in Asia.

Objective: We investigated the association of maternal diet quality with the risk of preterm birth, offspring birth size, and adiposity in a multiethnic Asian birth cohort.

Design: Dietary intakes of 1051 pregnant women were ascertained at 26-28 wk of gestation with the use of 24-h recalls and 3-d food diaries, from which diet quality (score range: 0-100) was measured by the Healthy Eating Index for pregnant women in Singapore (HEI-SGP). Gestational age was established by first-trimester ultrasound dating scan. Neonatal weight and length were measured at birth. Body composition was assessed by air displacement plethysmography in a subset of infants (n = 313) within 72 h after birth, and abdominal adiposity was assessed by MRI (n = 316) within the first 2 wk of life. Associations were assessed by multivariable linear regression for continuous outcomes and logistic regression for preterm birth.

Results: The mean ± SD maternal HEI-SGP score was 52.1 ± 13.6. Maternal diet quality during pregnancy was not associated with preterm birth or birth weight. Greater adherence to the HEI-SGP (per 10-point increment in HEI-SGP score) was associated with longer birth length [β (95% CI): 0.14 (0.03, 0.24 cm)], lower body mass index (in kg/m2) at birth [-0.07 (-0.13, -0.01)], lower sum of triceps and subscapular skinfold thickness [-0.15 (-0.26, -0.05 mm)], lower percentage body fat [-0.52% (-0.84%, -0.20%)], lower fat mass [-17.23 (-29.52, -4.94 g)], lower percentage abdominal superficial subcutaneous adipose tissue [-0.16% (-0.30%, -0.01%)], and lower percentage deep subcutaneous adipose tissue [-0.06% (-0.10%, -0.01%)].

Conclusions: Higher maternal diet quality during pregnancy was associated with longer birth length and lower neonatal adiposity but not with birth weight and preterm birth. These findings warrant further investigation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.

Keywords: adiposity; birth weight; diet quality; maternal diet; preterm birth.

© 2018 American Society for Nutrition. All rights reserved.

Figures

FIGURE 1

The association between maternal HEI-SGP scores alternately excluding individual components and infant birth outcomes (per 10-point increment). Black dots denote linear regression coefficients and horizontal lines denote 95% CIs. The models were adjusted for infants’ sex and birth order and maternal age, ethnicity, prepregnancy BMI, weight gain up until 26–28 wk of gestation, height, energy intake, educational level, household income, physical activity, alcohol use, smoking during pregnancy, and excluded component. For analysis of infant body composition and abdominal adiposity distribution, the models were additionally adjusted for the infant's exact postnatal age with Pea Pod (Cosmed) and MRI measurements, respectively. *Effect estimates were multiplied by 100/95 to correct for the 100-point scale. †Effect estimates were multiplied by 100/90 to correct for the 100-point scale. HEI-SGP, Healthy Eating Index for pregnant women in Singapore.