Reproductive
Preconception dietary patterns in association with live birth and early pregnancy loss: a couples-based approach Kyle Busse* Kyle Busse Stefanie Hinkle Bhaavna Peri Derartu Ahmed Enrique Schisterman Ellen Caniglia Naria Sealy James Mills Erica Johnstone Pauline Mendola Ginny Ryan Matthew Peterson Jim Hotaling Leah Lipsky Sunni Mumford
Infertility affects 1 in 6 U.S. couples. In up to 30% of cases, the cause is unexplained. There is evidence that diet may play a role. Our objective was to estimate associations of live birth and early pregnancy loss (<20 weeks’ gestation) with preconception diet patterns of female and male partners seeking fertility treatment.
Data came from 2370 male participants and female partners in the Folic Acid and Zinc Supplementation Trial. Scores for 4 diet patterns were estimated at baseline, during preconception. These included 2 diet quality indices (Healthy Eating Index-2015 [HEI] and Mediterranean Diet) and 2 fertility-specific patterns (Pro-Fertility and Fertility Diet) associated with greater female fertility in previous studies. Log-binomial models estimated crude and adjusted RRs per 1 SD increase in diet pattern score, separately for each partner and combined (sum of partners’ scores). In pregnancy loss models, inverse probability weights accounted for selecting on pregnant couples (n=1054). RRs were also estimated by infertility diagnosis (any vs. none) and median time trying to conceive (<19.5 vs. ≥19.5 months). Multiple imputation was used for missingness.
Of 2370 couples, 821 had a live birth and 287 had an early pregnancy loss. For females, males, and combined, a 1 SD higher score for HEI and Mediterranean Diet was suggestive of greater likelihood of live birth (Figure). For female partners, a 1 SD higher score for the Fertility Diet pattern was also suggestive of greater likelihood of live birth. HEI score was positively associated with the likelihood of live birth among females without an infertility diagnosis (adjusted RR=1.07 [95% CI 1.01-1.15]) and among females trying to conceive for <19.5 months (adjusted RR=1.08 [1.00-1.16]). No associations were observed for early pregnancy loss.
For couples seeking fertility treatment, higher diet quality may increase the likelihood of a live birth.
