Perinatal & Pediatric
Planetary Health Diet During Pregnancy and Major Pregnancy Complications: Findings From a Multisite, Diverse United States Cohort Shan-Xuan Lim* Shan-Xuan Lim Elizabeth A DeVilbiss Priscilla K Clayton Neil J Perkins Jessica L Gleason Katherine L Grantz Cuilin Zhang Jagteshwar Grewal
Emerging data from non-pregnant populations revealed Planetary Health Diet (PHD)’s role in promoting cardiometabolic health. However, such data during pregnancy is lacking. As such, we aimed to (1) characterize PHD scores in a racially/ethnically diverse cohort of US women, and (2) examine associations between PHD scores and major pregnancy complications.
A FFQ assessed 1st trimester diet, and ASA24 at up to 4 visits assessed 2nd and 3rd-trimester diets of women enrolled in the NICHD Fetal Growth Studies–Singletons (N=1980). Presence of major pregnancy complications was abstracted from medical records. To increase generalizability of findings, the analytical sample was weighted according to the race/ethnic distribution of low-risk US births in 2011. Overall and stratified PHD scores by race/ethnicity, pre-pregnancy BMI and vegetarian status were calculated. Adjusted odds ratios (95% CI) of major pregnancy complications were estimated using logistic regression.
Weighted mean (SD) PHD scores were 95.7 (10.7) during 1st trimester (8-13 weeks) and were lower but remained consistent throughout pregnancy [Mean (SD) of 16-22, 24-29, 30-33, and 34-37 weeks: 87.5 (12.8), 87.5 (13.3), 87.0 (12.5) and 86.9 (12.5)]. Mean PHD scores did not vary significantly by race/ethnicity, pre-pregnancy BMI or vegetarian status. Compared with women in the lowest tertile of the PHD (≤ 91.4), those in the highest tertile (≥ 100.4) had increased odds of gestational anemia [OR (95% CI): 1.09 (0.59, 2.02)] and reduced odds of hypertensive disorders of pregnancy [Mild: 0.38 (0.07, 2.04), Severe: 0.41 (0.09, 1.91)], gestational diabetes mellitus [0.51 (0.16, 1.64)] and preterm birth [0.46 (0.14, 1.46)], although associations were not statistically significant.
Higher PHD adherence was not significantly associated with major pregnancy complications among low-risk singleton pregnancies. Future studies of larger sample sizes are warranted to examine the health implications of PHD during pregnancy.