Nutrition During Pregnancy: Findings from the NICHD Fetal Growth Studies – Singleton Cohort
Abstract Background Accumulating evidence indicates that maternal diets are important for optimizing maternal and offspring health. Existing research lacks comprehensive profiles of maternal diets throughout pregnancy, especially in a racially/ethnically diverse obstetrical population. Objective To characterize diets in a longitudinal U.S. pregnancy cohort by trimester, race/ethnicity, and pre-pregnancy body mass index (BMI). Methods Data were obtained from pregnant women in the NICHD Fetal Growth Studies - Singleton cohort (2009–2013). A Food Frequency Questionnaire (FFQ) at 8–13 weeks gestation assessed periconception and first trimester diet (n = 1615). Automated, self-administered, 24-hour dietary recalls targeted at 16–22, 24–29, 30–33, and 34–37 weeks gestation assessed second and third trimester diets (n = 1817 women/6791 recalls). Healthy Eating Index-2010 (HEI) assessed diet quality (i.e., adherence to U.S. Dietary Guidelines). Variations in weighted energy-adjusted means for foods and nutrients were examined by trimester, self-identified race/ethnicity, and self-reported pre-pregnancy BMI. Results Mean (95% confidence interval) HEI was 65.9 (64.9,67.0) during periconception to first trimester assessed with an FFQ, and 51.6 (50.8,52.4) and 51.5 (50.7,52.3) during the second trimester and third trimester, respectively, assessed using 24-hour recalls. No significant differences were observed between second and third trimester in macronutrients, micronutrients, foods, or HEI components (P ≥ 0.05). Periconception to first trimester HEI was highest among Asian/Pacific Islander [67.2 (65.9,68.6)] and lowest among non-Hispanic Black [58.7 (57.5,60.0)] women and highest among women with normal weight [67.2 (66.1,68.4)] and lowest among women with obesity [63.5 (62.1,64.9)]. Similar rankings were observed in the second/third trimesters. Conclusions Most pregnant women in this cohort reported dietary intakes that, on average, did not meet U.S. Dietary Guidelines for non-pregnant individuals. Also, diet differed across race/ethnic groups and by pre-pregnancy BMI with lowest overall dietary quality in all trimesters among non-Hispanic Black women and women with obesity. No meaningful changes in dietary intake were observed between the second and third trimesters.