Associations between the maternal healthy lifestyle score and its individual components during early pregnancy with placental outcomes.

ABSTRACT

INTRODUCTION: The influence of maternal lifestyle behaviours on placental growth have been investigated individually, but with conflicting results, and their combined effect is under-researched. Therefore, we examined associations between a composite maternal healthy lifestyle score (HLS), and its individual components, during early pregnancy with placental outcomes. METHODS: Participants included Lifeways Cross-Generational Cohort mother-child pairs (n = 202). A composite HLS based on a less inflammatory diet (bottom 40% of the energy-adjusted Dietary Inflammatory Index (E-DII™)), moderate-to-vigorous physical activity (MVPA), healthy pre-pregnancy BMI (18.5-24.9 kg/m2), never smoking, and non-/moderate alcohol intake was calculated. Quantile regression analysed HLS (and individual components) associations with measures of placental development (untrimmed placental weight (PW)) and function (birth weightplacental weight (BWPW) ratio) at the 10th, 25th, 50th, 75th and 90th centiles. RESULTS: A more pro-inflammatory diet was positively, and smoking and heavy alcohol consumption were negatively, associated with PW at median centiles (B 41.97 g, CI 3.71, 80.22, p < 0.05; B -58.51 g, CI -116.24, -0.77, p < 0.05; B -120.20 g, CI -177.97, -62.43, p < 0.05 respectively). Low MVPA was inversely associated with BWPW ratio at the 10th and 90th centiles (B -0.36, CI -0.132, -0.29, p < 0.01 and B -0.45, CI -0.728, -0.182, p < 0.01, respectively). Heavy alcohol intake was positively associated with BWPW ratio at the 10th centile (B 0.54, CI 0.24, 0.85, p < 0.01). Results of sex-stratified analysis provide evidence of sexual dimorphism. DISCUSSION: Associations of certain lifestyle factors, but not the composite HLS, during early pregnancy with measures of placental development (PW) and function (BWPW ratio) varied by quantiles and by sex.