Better Diet Quality during Pregnancy Is Associated with a Reduced Likelihood of an Infant Born Small for Gestational Age: An Analysis of the Prospective New Hampshire Birth Cohort Study

ABSTRACT Background Exposure to aflatoxin has garnered increased attention as a possible contributor to adverse birth outcomes. Objective The objective of this study was to investigate the relation of maternal aflatoxin exposure with adverse birth outcomes such as birth weight, birth length, anthropometric z scores, low birth weight (LBW), small-for-gestational-age (SGA), stunting, and preterm birth (PTB). Methods This study used maternal and newborn data from the AflaCohort Study, an ongoing birth cohort study in Banke, Nepal (n = 1621). Data on aflatoxin B1 (AFB1)-lysine adducts in maternal serum were collected once during pregnancy (at mean ± SD: 136 ± 43 d of gestation). Maternal serum AFB1-lysine adduct concentration was measured via HPLC. Linear and logistic regression analyses were used to determine if maternal aflatoxin exposure was associated with 1) birth weight and length (primary outcomes) and 2) anthropometric z scores, LBW (weight <2.5 kg), SGA (weight <10th percentile for gestational age and sex), stunting at birth (length-for-age z score less than −2), or PTB (born <37 weeks of gestation) (secondary outcomes). Results The geometric mean of maternal serum AFB1-lysine adduct concentration was 1.37 pg/mg albumin (95% CI: 1.30, 1.44 pg/mg albumin). Twenty percent of infants were of LBW and 32% were SGA. Sixteen percent of infants were stunted at birth. In addition, 13% of infants were born preterm. In logistic multivariate regression models, mean maternal serum AFB1-lysine adduct concentrations were significantly associated with SGA (OR: 1.13; 95% CI: 1.00, 1.27; P < 0.05). Conclusions Findings from this study suggest a small but significant association between serum AFB1-lysine adduct concentrations in pregnant women and SGA. Maternal aflatoxin exposure was not associated with other birth outcomes. These results highlight the need for future research on a threshold level of aflatoxin exposure needed to produce detectable adverse birth outcomes. This trial was registered at clinicaltrials.gov as NCT03312049.

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Pathways linking socioeconomic status to small-for-gestational-age (SGA) infants among primiparae: a birth cohort study in China

BMJ Open ◽

10.1136/bmjopen-2017-020694 ◽

2018 ◽

Vol 8 (6) ◽

pp. e020694 ◽

Cited By ~ 1

Author(s):

Xiu Luo ◽

Lingfei Liu ◽

Huaiting Gu ◽

Fang Hou ◽

Xinyan Xie ◽

...

Keyword(s):

Socioeconomic Status ◽

Cohort Study ◽

Birth Cohort ◽

Gestational Age ◽

Small For Gestational Age ◽

Birth Cohort Study

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An observational study on Ca supplementation and dietary intake during pregnancy on low birth weight and small for gestational age

Public Health Nutrition ◽

10.1017/s1368980020004425 ◽

2020 ◽

pp. 1-10

Author(s):

Wei Dai ◽

Xiaohui Deng ◽

Lanlan Li ◽

Jie Qiu ◽

Baohong Mao ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Dietary Intake ◽

Birth Cohort ◽

Gestational Age ◽

Small For Gestational Age ◽

Birth Cohort Study ◽

Nulliparous Women ◽

Reduced Risk

Abstract Objective: To evaluate the effects of dietary Ca intake and Ca supplementation during pregnancy on low birth weight (LBW) and small for gestational age (SGA) infants. Design: A birth cohort study was conducted in 2010–2012 at the Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China. Setting: A birth cohort study. Participants: Totally, 9595 pregnant women who came to the hospital for delivery at 20 weeks of gestation or more, and who were 18 years of age or older. Results: Compared with non-users, Ca supplement users had a reduced risk of LBW infants (OR = 0·77, 95 % CI: 0·63, 0·95) and a reduced risk of nulliparous women giving birth to LBW infants (OR = 0·75, 95 % CI: 0·58, 0·98) (P < 0·05). More specifically, both the use of Ca supplement before conception and during pregnancy (OR = 0·44, 95 % CI: 0·19, 0·99) and during pregnancy only (OR = 0·80, 95 % CI: 0·65, 0·99) had the main effect of reducing risk of nulliparous women giving birth to LBW infants (P < 0·05). There was no association between Ca supplementation and SGA (OR = 0·87, 95 % CI: 0·75, 1·01) (P > 0·05). However, higher dietary Ca intake during pregnancy decreases the risk of both LBW (quartile 2: OR = 0·72, 95 % CI: 0·55, 0·94; quartile 3: OR = 0·68, 95 % CI: 0·50, 0·62) and SGA infants (quartile 2: OR = 0·77, 95 % CI: 0·63, 0·95; quartile 3: OR = 0·71, 95 % CI: 0·57, 0·88, quartile 4: OR = 0·71, 95 % CI: 0·57, 0·88) (P < 0·05). Conclusions: Ca supplementation and adequate dietary intake of Ca during pregnancy are associated with a decreased risk of LBW infants born to nulliparous women.

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