Norwegian mothers-to-be who maintained "prudent"
eating patterns during pregnancy were less likely to have preterm
births compared to women who ate a more typically "western" diet,
according to a new study.
Both prudent and traditional Scandinavian eating patterns
were linked to a lower likelihood of early delivery, according to the results
published in the British Medical Journal. While the observations don't prove
cause and effect, the authors say, the findings support the idea that dietary
advice should be given to pregnant women.
"Diet really matters when it comes to preterm delivery
and it is very important for pregnant women to choose or to increase the intake
of an overall healthy diet consisting of fresh and raw vegetables, fruit,
whole-grain products, certain fish and to drink water," Dr Linda
Englund-Ögge told Reuters Health in an email.
diet can affect baby
A major clinical
Englund-Ögge, who led the new study, is with the Department
of Obstetrics and Gynaecology at the Institute of Clinical Sciences in the
Sahlgrenska Academy at the Sahlgrenska Hospital in Gottenburg, Sweden.
"Preterm delivery is a major clinical problem –
children born preterm are at severe risks of short and long term neonatal
morbidity and almost 75%of all neonatal deaths, are found in this
group," Englund-Ögge said. "In the US more than one in ten deliveries
are considered preterm."
Englund-Ögge added that in recent years there has been an
increased awareness of whether maternal diet can affect the risk of preterm
delivery so her study team wanted to know if the condition could be prevented
by choosing or avoiding certain foods. They identified 66,000 women who
participated in the Norwegian Mother and Child Cohort Study and were pregnant
between 2002 and 2008.
The women answered health questionnaires when they were 15
weeks pregnant and again two to seven weeks later. The first questionnaires
were about their lifestyle, background, illness and related health factors. The
second questionnaire assessed the women's eating habits from the time their
The researchers used the questionnaire information to place
the women into one of three groups of eating
patterns, prudent, traditional or western.
Three different diets
The prudent dietary pattern included raw and cooked
vegetables, salad, onion/leek/garlic, fruit and berries, nuts, vegetables oils,
water as a beverage, whole grain cereals, poultry and fibre-rich bread. The
traditional diet included foods like boiled potatoes, fish products, gravy,
lean fish, margarine, rice pudding, low-fat milk and cooked
vegetables. The Western diet included more salty
snacks, chocolate and sweets, cakes, French fries, white bread, ketchup,
sugar-sweetened drinks, processed meat products and pasta.
The researchers also wanted to assess how well the women
adhered to their diets."It is very rare that someone does not choose any
considered unhealthy food at all during pregnancy, even those women with the
healthiest lifestyles," Englund-Ögge said. "Therefore, all women were
given pattern scores for the dietary patterns."
Englund-Ögge added that women with overall healthy
diets who sometimes chose unhealthy food during pregnancy scored higher on
the healthy dietary patterns than women who usually chose unhealthy
foods. "In this way, there is a gradient created in pattern scores that
was investigated," she said.
"It is also important to keep in mind that a low score
of the healthy dietary pattern could be interpreted as an unwholesome
There were a total of 3 505 preterm deliveries.
'Prudent' was best
The researchers found that women who adhered most closely to
the prudent diet were 11% less likely to have preterm deliveries compared to
women who didn't follow the diet as closely. The women who adhered to the
traditional diet most faithfully were 10% less likely to have preterm
deliveries compared to women who had the lowest adherence scores in that group.
"We would like for doctors, midwives and all others who
work with pregnant women to reinforce the important message that pregnant women
should be encouraged to eat a balanced and healthy diet," she said.
"There are modifiable risk factors that people can address to enhance
their pregnancy outcomes," Dr Louis Muglia told Reuters Health.
Muglia is co-director of the Perinatal Institute and
director of the Centre for Prevention of Preterm Birth at the Cincinnati
Children's Hospital in Cincinnati. He was not involved in the study.
"I actually thought it was quite a nicely done study
and in many respects confirms what we know – that leading a healthier lifestyle
contributes to better pregnancy outcomes – and one substantial component of
that is your overall nutritional intake pattern," he said. Based on this
study, he said, a balanced diet with more foods rich in vitamins and other
micronutrients probably facilitates a full-term pregnancy.
The study authors were cautious about saying the women's
diets were the reason for their outcomes, Muglia noted, "because the
individuals who had the prudent dietary intake patterns also had many other
beneficial lifestyle habits that you might think would also improve the
likelihood of good pregnancy outcomes."
Many factors involved
He explained that the women in the study who followed the
prudent diet generally had healthier weights, they probably smoked less and
they were more educated. "So I think there are a lot of things that go
along with that prudent lifestyle that increases the likelihood of having a
healthy pregnancy and reduces the likelihood of a preterm birth as well,"
In an editorial that accompanied the paper, Lucilla Poston
wrote, "The authors build on several studies that have proposed the
benefit of a diet rich in fruit and/or vegetables in prevention of premature
birth, including a recent report in this journal showing that fruit intake
before pregnancy is a factor that relates to healthy outcome in (first-time
sodas linked to preterm births
Poston is a researcher and head of the Division of Women's
Health at St Thomas Hospital at King's College in London. She was not involved
in the study. "Health professionals would therefore be well advised to
reinforce the message that pregnant women eat a healthy diet," she wrote.
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