Maternal diet as a counteracting agent of the effect of some well-known risk factors for small for gestational age
JuanMiguel Nutrition Available online 9 December 2019, 110665
HIGHLIGHTS
• Smoking and leanness increase the risk of an SGA newborn; certain foods may counteract this risk.
• Diet does not modify the risk of SGA associated with having had a previous SGA-LBW newborn.
• Fruit intake reduces the risk of SGA associated with tobacco.
• Legume and fish intake reduce the SGA risk associated with maternal BMI < 20.
Objective: To assess whether diet variables can neutralize the risk produced by three well-known SGA risk factors: smoking, body mass index (BMI) ˂ 20 and having a previous preterm/low birthweight newborn.
Methods: A matched case-control study was conducted (518 cases and 518 controls of pregnant women) in Spain. We collected data on demographic characteristics, socioeconomic status, toxic habits and diet. Dietary intake during pregnancy was assessed using a validated food frequency questionnaire, categorized into quintiles. Adjusted odds ratios (aORs) and their 95% confidence intervals (CI) were estimated by conditional regression logistic models.
Results: Women smoking during pregnancy shows a 78% increased risk of having a SGA newborn (aOR=1.78, 95% CI=1.28-2.74). Lean women (BMI˂20 before pregnancy) augmented the risk a 139% (aOR=2.39, 95% CI=1.68-3.40) and those with a previous SGA-LBW an increase of 160% (aOR =2.60, 95% CI =1.53-4.37). Smoking in women with a fruit intake of ≥ 421 g/day was not associated with a higher risk of SGA vs. non-smoking women with the same fruit intake (aOR=0.98; IC 95%=0.41-2.33). A BMI< 20 with an intake of legumes ≥ 33 g/day did not increase the risk of SGA vs. women with a BMI≥ 20 with the same legumes intake (aOR=1.35; IC 95%=0.54-3.37). Diet does not modify the risk by having a previous SGA-LBW newborn
Conclusions: Smoking and leanness increase the SGA risk, nevertheless foods such as fruit, fish and legumes, as well as intake of vitamin D, vitamin B3 and n3 marine fatty acids, may counteract at least partially this increase.