Maternal Dietary Patterns during Pregnancy Are Associated with Child Growth in the First 3 Years of Life

Abstract

Background: Child obesity is a major problem in the United States. Identifying early-life risk factors is necessary for prevention. Maternal diet during pregnancy is a primary source of fetal energy and might influence risk of child obesity.

Objective: We prospectively investigated the influence of maternal dietary patterns during pregnancy on child growth in the first 3 y of life in 389 mother-child pairs from the Pregnancy, Infection, and Nutrition study.

Methods: Dietary patterns were derived with the use of latent class analysis (LCA) based on maternal diet, collected with the use of a food-frequency questionnaire at 26-29 wk gestation. Associations between maternal dietary patterns and child body mass index (BMI)-for-age z score and overweight or obesity were assessed with the use of linear regression and log-binomial regression, respectively. We used linear mixed models to estimate childhood growth patterns in relation to maternal dietary patterns.

Results: Three patterns were identified from LCA: 1) fruits, vegetables, refined grains, red and processed meats, pizza, french fries, sweets, salty snacks, and soft drinks (latent class 1); 2) fruits, vegetables, baked chicken, whole-wheat bread, low-fat dairy, and water (latent class 2); and 3) white bread, red and processed meats, fried chicken, french fries, and vitamin C-rich drinks (latent class 3). In crude analyses, the latent class 3 diet was associated with a higher BMI-for-age z score at 1 and 3 y of age and a higher risk of overweight or obesity at 3 y of age than was the latent class 2 diet. These associations were not detectable after adjustment for confounding factors. We observed an inverse association between the latent class 3 diet and BMI-for-age z score at birth after adjustment for confounding factors that was not evident in the crude analysis (latent class 3 compared with latent class 2-β: -0.41; 95% CI: -0.79, -0.03).

Conclusion: In this prospective study, a less-healthy maternal dietary pattern was associated with early childhood weight patterns.

Keywords: child overweight/obesity; dietary patterns; latent class analysis; maternal diet; pregnancy.

FIGURE 1

Flow diagram of the study population for this analysis (n = 389) from the PIN study, 1996–2006. PIN, Pregnancy, Infection, and Nutrition.

FIGURE 2

Predicted child BMI-for-age z score from birth to 3 y of age according to each latent dietary class at 24–29 wk gestation, based on results from our linear mixed model (n = 389) in the Pregnancy, Infection, and Nutrition study, 1996–2005. Child BMI-for-age z score trajectories were predicted for a specific maternal profile [30–34 y of age, nonblack maternal race, higher than college education, >350% of federal poverty level, married, parous, nonsmoker, prepregnancy BMI (in kg/m²) 18.5–24.9]. Latent class 1 represents a high probability of consuming peaches, strawberries, canned fruits, broccoli, green beans or peas, corn, cabbage or coleslaw, white potatoes, sweet potatoes, refined grains, red and processed meats, pizza, french fries, sweets, salty snacks, and soft drinks. Latent class 2 represents a high probability of consuming apples, bananas, oranges, tomatoes, broccoli, spinach, carrots, green salads, whole-wheat bread, low-fat dairy, baked chicken, and water. Latent class 3 represents a high probability of consuming white bread, red and processed meats, fried chicken, french fries, and vitamin C–rich drinks.