The association of maternal nutrient and dietary pattern intake and maternal health characteristics during pregnancy

Spraggan, Ella Jane Unity (2017) The association of maternal nutrient and dietary pattern intake and maternal health characteristics during pregnancy. Masters by Research thesis (MSc), Manchester Metropolitan University.

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Abstract

Background: Nutritional status of the pregnant mother is pivotal in the health and development of the foetus, although less is known about the effects on maternal health. Nutritional status may be related to the development of gestational diabetes mellitus (GDM) and adverse gestational weight gain (GWG), both of which are thought to play an important role in the health outcomes of both the mother and the offspring. Aim: The study aimed to determine associations between nutrient and dietary intake and maternal health characteristics such as glycaemic status during pregnancy and GWG. Methods: Using guidelines from Cochrane Systematic Reviews, a systematic review of literature and narrative synthesis was conducted in 4 databases to assess whether intake of free sugar during pregnancy is associated with GWG. In the second part of the study, multinomial logistic regression analysis was carried out using data from a prospective cohort of pregnant women (ALSPAC) to analyse the cross-sectional associations of energy, macronutrient and free sugar intake and adherence to data-driven dietary patterns at 32 weeks gestation with glycaemic status (n= 8507) and GWG (n= 7989). Findings: Of the 320 eligible studies identified, 4 were included in the narrative synthesis. Current literature suggests an association of free sugar intake during pregnancy and GWG, however the pool of available studies was small and of low quality. In the ALSPAC cohort, intake of energy from fat was positively associated with glycosuria, adherence to the ‘health conscious’ and the ‘traditional’ dietary pattern groups were negatively associated with glycosuria. Intake of energy from protein was positively associated with both existing DM and GDM. Intake of energy from free sugar and adherence to the ‘confectionary’ dietary pattern was negatively associated with both existing DM and GDM. There was no evidence of any associations between energy or macronutrient intake and GWG, however, adherence to the ‘health conscious’ and the ‘confectionary’ dietary pattern were associated with insufficient and excessive weight gain. Conclusions: The evidence suggests associations of macronutrient and specific dietary patterns with glycaemic status and GWG during pregnancy. This may be important in defining interventions to prevent the negative outcomes associated with adverse glycaemic status and adverse GWG in pregnant women.