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Maternal nutrition in early and late pregnancy in relation to placental and fetal growth

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7028.410 (Published 17 February 1996) Cite this as: BMJ 1996;312:410
  1. K Godfrey, epidemiologista,
  2. S Robinson, nutritionist D J P Barker, directora,
  3. Djp Barker,
  4. C Osmond, statisticiana,
  5. V Cox, computer analysta
  1. a Medical Research Council Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital, Southampton SO16 6YD
  1. Correspondence to: Dr Godfrey.
  • Accepted 21 November 1995

Abstract

Objective: To assess how nutrient intakes of mothers in early and late pregnancy influence placental and fetal growth.

Design: Prospective observational study.

Setting: Princess Anne Maternity Hospital, Southampton.

Subjects: 538 mothers who delivered at term.

Main outcome measures: Placental and birth weights adjusted for the infant's sex and duration of gestation.

Results: Mothers who had high carbohydrate intakes in early pregnancy had babies with lower placental and birth weights. Low maternal intakes of dairy and meat protein in late pregnancy were also associated with lower placental and birth weights. Placental weight fell by 49 g (95% confidence interval 16 g to 81 g; P=0.002) for each log g increase in intake of carbohydrate in early pregnancy and by 1.4 g (0.4 g to 2.4 g; P=0.005) for each g decrease in intake of dairy protein in late pregnancy. Birth weight fell by 165 g (49 g to 282 g; P=0.005) for each log g increase in carbohydrate intake in early pregnancy and by 3.1 g (0.3 g to 6.0 g; P=0.03) for each g decrease in meat protein intake in late pregnancy. These associations were independent of the mother's height and body mass index and of strong relations between the mother's birth weight and the placental and birth weights of her offspring.

Conclusion: These findings suggest that a high carbohydrate intake in early pregnancy suppresses placental growth, especially if combined with a low dairy protein intake in late pregnancy. Such an effect could have long term consequences for the offspring's risk of cardiovascular disease.

Footnotes

  • Funding The Dunhill Trust and the Medical Research Council. KG was in receipt of a Medical Research Council training fellowship.

  • Conflict of interest None.

  • Accepted 21 November 1995
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