RESUMO
Objectives: Heartburn and constipation are common gastrointestinal symptoms during pregnancy. High fiber and liquid intake have beneficial effects on these symptoms in non- pregnant population. Our aim was to evaluate the association of dietary fiber, fluid intake and lifestyle characteristics with constipation, heartburn, and pregnancy outcome. Study design: Two hundred pregnant women were enrolled in this prospective cohort study during the 1st trimester of pregnancy. Participants completed a self- administered questionnaire concerning bowel symptoms, dietary fiber, liquid intake, and lifestyle characteristics before pregnancy, during pregnancy and post-partum. After exclusions 173 pregnant women participated the study and 173, 173, 136, 109 and 91 completed pre-pregnancy, and 1st, 2nd, and 3rd trimester, and post-partum questionnaires, respectively. Data on deliveries and perinatal outcome (n = 173) were collected from hospital records. In trajectory analysis, the women were clustered in groups based on the intake of fiber and liquids. Generalized linear mixed models and logistic regression analyses were used to find associations of fiber and fluid intake with constipation, heartburn and pregnancy outcome. Results and conclusions: Heartburn increased significantly during pregnancy and the highest prevalence (33%) was during the third trimester. A combination of low fiber and low fluid intake increased the risk of constipation during pregnancy (OR 5.9, 95% CI 2.00-17.4). Low fiber intake increased the risk of combined adverse outcome (cesarean section, premature delivery and/or small for gestational age; OR 3.4, 95% CI 1.2-9.6). Sufficient fiber and liquid intake may be protective against pregnancy-associated constipation and may be associated with improved pregnancy outcome.
RESUMO
Nausea or vomiting in pregnancy (NVP) are among the commonest symptoms experienced in early pregnancy. We wanted to evaluate the association of dietary fibre intake, lifestyle characteristics and bowel function with NVP. One hundred and eighty-eight participants completed a self-administered questionnaire concerning bowel function, dietary fibre intake and lifestyle characteristics. Women suffering from NVP (n = 91) consumed significantly more fibre derived from cereal products (p=.026) and total fibre (p=.043) during pre-pregnancy period was compared to women without NVP (n = 97). In both groups, intake of total fibre and fibre derived from fruit and vegetables increased significantly during the first trimester. Dietary fibre intake did not protect from NVP. However, women suffering from NVP were able to maintain their fibre intake. Dietary fibre is tolerated well during NVP, and this finding can be used when giving diet counselling to women suffering from NVP.Impact statementWhat is already known on this subject? Nausea or vomiting in pregnancy (NVP) are among the commonest symptoms experienced in early pregnancy. The pathophysiology of NVP remains unknown, but it has been suggested to be multifactorial. Diet during pregnancy may have an impact on NVP. It is generally advised to avoid meat, poultry, fish, eggs and spicy and fatty foods during periods of NVP, but there is limited data on the effects of diet of NVP.What do the results of this study add? Women suffering from NVP have been shown to eat less meat (and thus protein) compared to women without NVP. Dietary fibre reduces constipation and heartburn and it also keeps blood glucose levels stable. Because of various beneficial effects of fibre on the digestive system, we hypothesised that a high fibre intake may alleviate the symptoms of NVP.What are the implications of these findings for clinical practice and/or further research? The aim of the present study was to investigate whether the amount or source of dietary fibre are associated with NVP. We wanted to investigate intake of fibre derived from cereal products (mostly representing insoluble fibre) and fibre derived from fruit and vegetables (containing mostly soluble fibre) separately in relationship to NVP, as the mechanisms of action of these fibre groups are different. There are no observational studies including also pre-pregnancy consumption of fibre when focussing on the association between fibre and NVP. The results of this study can be used when giving diet counselling to women suffering from NVP.