Trimester-specific associations of maternal prenatal dietary patterns with fetal growth: a prospective pre-birth cohort study.

BACKGROUND

The trimester-specific association of prenatal dietary patterns with intrauterine fetal growth and neonatal birth size is unclear. We evaluated the trimester-specific association of prenatal dietary patterns with intrauterine fetal growth and neonatal birth size.

METHODS

A prospective pre-birth cohort study included 1,857 mother-neonate pairs in China. Food frequency questionnaires were used to assess the maternal diet across three trimesters. we used generalized estimating equation models to examine the longitudinal associations of prenatal dietary patterns with intrauterine fetal growth and neonatal birth size. In addition, we used multinomial logistic regression models and multivariable linear regression models to estimate the trimester-specific associations.

RESULTS

5.0% and 6.8% of the neonates were low birth weight and macrosomia births, respectively. We observed longitudinal positive associations of maternal adherence to a "dairy-egg pattern" over three trimesters with the risk of macrosomia births [tertile 3 (T3) vs. tertile 1 (T1): odds ratio = 1.64, 95% confidence interval (CI): 1.01, 2.65], and the association was more pronounced in the first trimester (T3 vs. T1: relative risk ratio = 2.12, 95% CI: 1.08, 4.18). Higher adherence to the "dairy-egg pattern" and the "fish-seafood pattern" in the second and third trimesters were associated with higher and lower risk of estimated fetal weight>90th percentile during corresponding trimesters, respectively.

CONCLUSIONS

Trimester-specific dietary patterns were differentially associated with fetal growth trajectory and neonatal birth size. These findings highlight the importance of trimester-tailored dietary guidance for optimizing fetal growth during pregnancy.