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. 2021 Feb;60(1):65-77.
doi: 10.1007/s00394-020-02221-4. Epub 2020 Mar 17.

Preconceptional diet quality is associated with birth outcomes among low socioeconomic status minority women in a high-income country

Kathleen Abu-Saad  1   2 , Vered Kaufman-Shriqui  3 , Laurence S Freedman  4 , Ilana Belmaker  5 , Drora Fraser  6
Affiliations

Preconceptional diet quality is associated with birth outcomes among low socioeconomic status minority women in a high-income country

Kathleen Abu-Saad et al. Eur J Nutr. 2021 Feb.

Abstract

Purpose: Studies of the association between maternal nutrition and birth outcomes have investigated differing nutrients, maternal socioeconomic conditions, and timing within the reproductive cycle; and have produced inconsistent results. We evaluated the association of preconceptional maternal dietary intake with birth outcomes among low socioeconomic status ethnic minority women in a high-income country.

Methods: In this prospective cohort study, habitual preconceptional dietary intake was assessed among pregnant Bedouin Arab women in Israel (n = 384), using a short culturally specific, targeted food frequency questionnaire. Multiple nutrients (protein, lysine, calcium, iron, zinc, folate, omega-3 fatty acids) were evaluated simultaneously via a diet quality score derived from principal component analysis. Multivariable logistic regression was used to test associations between the diet quality score and a composite adverse birth outcomes variable, including preterm birth, low birth weight and small for gestational age.

Results: Sixty-nine women (18%) had adverse birth outcomes. Women with low preconceptional diet quality scores had low intakes of nutrient-rich plant foods, bioavailable micronutrients, and complete proteins. In multivariable analysis, a woman at the 10th percentile of the diet quality score had a 2.97 higher odds (95% CI 1.28-6.86) of an adverse birth outcome than a woman at the 90th percentile.

Conclusion: Low diet quality during the preconceptional period was associated with adverse birth outcomes among low socioeconomic status minority women in a high-income country. The results have implications for the development of appropriate intervention strategies to prevent adverse birth outcomes, and the promotion of adequate nutrition throughout the child-bearing years.

Keywords: Adverse birth outcomes; Diet quality; Ethnic minority; Low socioeconomic status; Preconceptional maternal diet; Principal component analysis.

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