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Research

Maternal dietary patterns and preterm delivery: results from large prospective cohort study

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1446 (Published 04 March 2014) Cite this as: BMJ 2014;348:g1446
  1. Linda Englund-Ögge, medical doctor1,
  2. Anne Lise Brantsæter, senior scientist2,
  3. Verena Sengpiel, medical doctor1,
  4. Margareta Haugen, senior scientist2,
  5. Bryndis Eva Birgisdottir, associate professor23,
  6. Ronny Myhre, senior scientist4,
  7. Helle Margrete Meltzer, professor2,
  8. Bo Jacobsson, professor14
  1. 1Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, SE-41685 Gothenburg, Sweden
  2. 2Department of Exposure and Risk Assessment, Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway
  3. 3Unit for Nutrition Research, National University Hospital, Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
  4. 4Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
  1. Correspondence to: L Englund-Ögge linda.englund-ogge{at}vgregion.se
  • Accepted 30 January 2014

Abstract

Objective To examine whether an association exists between maternal dietary patterns and risk of preterm delivery.

Design Prospective cohort study.

Setting Norway, between 2002 and 2008.

Participants 66 000 pregnant women (singletons, answered food frequency questionnaire, no missing information about parity or previously preterm delivery, pregnancy duration between 22+0 and 41+6 gestational weeks, no diabetes, first enrolment pregnancy).

Main outcome measure Hazard ratio for preterm delivery according to level of adherence to three distinct dietary patterns interpreted as “prudent” (for example, vegetables, fruits, oils, water as beverage, whole grain cereals, fibre rich bread), “Western” (salty and sweet snacks, white bread, desserts, processed meat products), and “traditional” (potatoes, fish).

Results After adjustment for covariates, high scores on the “prudent” pattern were associated with significantly reduced risk of preterm delivery hazard ratio for the highest versus the lowest third (0.88, 95% confidence interval 0.80 to 0.97). The prudent pattern was also associated with a significantly lower risk of late and spontaneous preterm delivery. No independent association with preterm delivery was found for the “Western” pattern. The “traditional” pattern was associated with reduced risk of preterm delivery for the highest versus the lowest third (hazard ratio 0.91, 0.83 to 0.99).

Conclusion This study showed that women adhering to a “prudent” or a “traditional” dietary pattern during pregnancy were at lower risk of preterm delivery compared with other women. Although these findings cannot establish causality, they support dietary advice to pregnant women to eat a balanced diet including vegetables, fruit, whole grains, and fish and to drink water. Our results indicate that increasing the intake of foods associated with a prudent dietary pattern is more important than totally excluding processed food, fast food, junk food, and snacks.

Footnotes

  • We are grateful to all the families in Norway participating in this ongoing cohort study.

  • Contributors: All the authors participated in the planning and conduct of this study and approved the final version. ALB, LE-Ö, BEB, BJ, and VS conceived the study. ALB, VS, and LE-Ö did the statistical analyses. LE-Ö, ALB, and BJ wrote the first draft of this manuscript. ALB, MH, BEB, VS, RM, HMM, and BJ revised several versions of this manuscript. LE-Ö is the guarantor.

  • Funding: This work was supported by grants from the Freemasons Directorate board for Children, the Adlerbertska Foundation, the Hjalmar Svensson Foundation, the Norwegian Research Council (FUGE 183220/S10, FRIMEDKLI-05 ES236011), the Jane and Dan Olsson Foundation, the Swedish Medical Society (SLS 2008-21198), and Swedish government grants to researchers in public health service (ALFGBG-2863, ALFGBG-11522). The Norwegian Mother and Child Cohort Study was also supported by the Norwegian Ministry of Health and the Ministry of Education and Research, NIH/NIEHS (contract No N01-ES-75558), NIH/NINDS (grant No.1 UO1 NS 047537-01 and grant No.2 UO1 NS 047537-06A1), and the Norwegian Research Council/FUGE (grant No. 151918/S10). All authors are independent from funders.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: The study was approved by the Regional Committee for Ethics in Medical Research (REK/S-06075a and REK/S-06077a/2008/19291) and the Data Inspectorate in Norway. All participants gave written consent.

  • Transparency declaration: The lead author (the manuscript’s guarantor) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

  • Data sharing: No additional data available.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/.

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