Associations between diet quality and dietary patterns and gestational diabetes mellitus in a low-risk cohort of pregnant women in Australia: a cross-sectional study.

INTRODUCTION: Evidence of associations between the Mediterranean Diet Score (MDS) and Dietary Approaches to Stop Hypertension (DASH) score and gestational diabetes mellitus (GDM) in pregnant women is limited. This study examined changes in MDS and DASH and dietary patterns in Australian pregnant women between early and late pregnancy and their associations with GDM. METHODS: The data from n = 284 participants were analysed. Diet quality indices and empirical dietary patterns were determined in early (15 ± 3 weeks gestation) and late pregnancy (35 ± 2 weeks gestation). Paired t-tests were used to examine changes in scores for diet quality indices and dietary patterns from early to late pregnancy. Logistic regression analysis was used to examine associations between GDM, diet quality indices and dietary patterns. RESULTS: Three major dietary patterns were identified at early pregnancy. The first and second dietary patterns included unhealthier and healthier food groups, respectively, and the third comprised mixed food groups. Although diet quality scores did not change over time, consumption of the first dietary pattern increased (p = 0.01), and consumption of the second dietary pattern decreased by late pregnancy in women without GDM (p < 0.001). CONCLUSION: No associations between DASH score, MDS and GDM were found; however an inverse association was observed between the first dietary pattern and GDM in late pregnancy (p = 0.023). Longitudinal studies are needed to examine diet quality and dietary patterns at early and late pregnancy to inform the development of tailored dietary advice for GDM.

Associations of adherence to the DASH diet and Mediterranean diet with maternal c-reactive protein levels during pregnancy.

BACKGROUND AND AIMS: Elevated C-reactive protein (CRP) during pregnancy, a marker of inflammation, is associated with adverse outcomes. Better understanding the relationship between CRP and modifiable factors, including diet, is essential to assist early pregnancy lifestyle interventions. The aim of this study was to assess the relationship between adherence to the Dietary Approaches to Stop Hypertension diet (DASH-diet) and the Mediterranean diet (MED-diet) during pregnancy with maternal plasma CRP in early and late pregnancy. METHODS AND RESULTS: Secondary analysis of the Creatine and Pregnancy Outcomes (CPO) study was undertaken. Women (n = 215) attending antenatal clinics through Monash Health, Melbourne were recruited at 10-20 weeks gestation. Medical history and blood samples were collected at 5 antenatal visits. Adapted DASH-diet and MED-diet scores were calculated from Food Frequency Questionnaires completed at early ([mean ± SD]) (15 ± 3 weeks) and late (36 ± 1 week) pregnancy. CRP was measured in maternal plasma samples collected at the same time points. Adjusted linear regression models assessed associations of early-pregnancy DASH and MED-diet scores with early and late pregnancy plasma CRP. There were no statistically significant changes in DASH-diet score from early (23.5 ± 4.8) to late (23.5 ± 5.2) pregnancy (p = 0.97) or MED-diet score from early (3.99 ± 1.6) to late pregnancy (4.08 ± 1.8) (p = 0.41). At early-pregnancy, there was an inverse relationship between DASH-diet scores and MED-diet scores with plasma CRP; (ß = -0.04 [95%CI = -0.07, -0.00], p = 0.044), (ß = -0.12 [95%CI = -0.21, -0.02], p = 0.023). CONCLUSION: Adherence to the DASH-diet and MED-diet during early pregnancy may be beneficial in reducing inflammation. Assessment of maternal dietary patterns may assist development of preventive strategies, including dietary modification, to optimise maternal cardiometabolic health in pregnancy.

Maternal diet quality and associations with plasma lipid profiles and pregnancy-related cardiometabolic health.

PURPOSE: To assess the relationship of early pregnancy maternal diet quality (DQ) with maternal plasma lipids and indicators of cardiometabolic health, including blood pressure (BP), gestational diabetes mellitus (GDM) and gestational weight gain (GWG). METHODS: Women (n = 215) aged 18-40 years with singleton pregnancies were recruited at 10-20 weeks gestation. Diet quality was assessed by the Dietary Guideline Index, calculated at early ([mean ± SD]) (15 ± 3 weeks) and late (35 ± 2 weeks) pregnancy. Lipidomic analysis was performed, and 698 species across 37 lipid classes were measured from plasma blood samples collected at early (15 ± 3 weeks) and mid (27 ± 3 weeks)-pregnancy. Clinical measures (BP, GDM diagnosis, weight) and blood samples were collected across pregnancy. Multiple linear and logistic regression models assessed associations of early pregnancy DQ with plasma lipids at early and mid-pregnancy, BP at three antenatal visits, GDM diagnosis and total GWG. RESULTS: Maternal DQ scores ([mean ± SD]) decreased significantly from early (70.7 ± 11.4) to late pregnancy (66.5 ± 12.6) (p < 0.0005). At a false discovery rate of 0.2, early pregnancy DQ was significantly associated with 13 plasma lipids at mid-pregnancy, including negative associations with six triglycerides (TGs); TG(54:0)[NL-18:0] (neutral loss), TG(50:1)[NL-14:0], TG(48:0)[NL-18:0], TG(52:1)[NL-18:0], TG(54:1)[NL-18:1], TG(50:0)[NL-18:0]. No statistically significant associations were found between early pregnancy DQ and BP, GDM or GWG. CONCLUSION: Maternal diet did not adhere to Australian Dietary Guidelines. Diet quality was inversely associated with multiple plasma TGs. This study provides novel insights into the relationship between DQ, lipid biomarkers and cardiometabolic health during pregnancy.

Maternal plasma vitamin D levels across pregnancy are not associated with neonatal birthweight: findings from an Australian cohort study of low-risk pregnant women.

BACKGROUND: In utero environments can be highly influential in contributing to the development of offspring obesity. Specifically, vitamin D deficiency during pregnancy is associated with adverse maternal and child health outcomes, however its relationship with offspring obesity remains unclear. We assessed maternal vitamin D status across pregnancy, change in plasma vitamin D concentrations and associations with neonatal birthweight, macrosomia and large for gestational age. METHODS: Women (n = 221) aged 18-40 years with singleton (low-risk) pregnancies, attending antenatal clinics at a tertiary-level maternity hospital were recruited at 10-20 weeks gestation. Medical history, maternal weight and blood samples at three antenatal clinic visits were assessed; early (15 ± 3 weeks), mid (27 ± 2 weeks) and late (36 ± 1 weeks) gestation. Maternal 25(OH)D was analysed from stored plasma samples via liquid chromatography-tandem mass spectrometry (LC/MS/MS). Neonatal growth parameters were collected at birth. Unadjusted and adjusted linear and logistic regression assessed associations of maternal vitamin D with birthweight, macrosomia and large for gestational age. RESULTS: Mean plasma 25(OH)D increased from early (83.8 ± 22.6 nmol/L) to mid (96.5 ± 28.9 nmol/L) and late (100.8 ± 30.8 nmol/L) gestation. Overall 98% of women were taking vitamin D-containing supplements throughout their pregnancy. Prevalence of vitamin D deficiency (25(OH)D < 50 nmol/L) was 6.5%, 6.3% and 6.8% at early, mid and late pregnancy respectively. No statistically significant association was found between 25(OH)D or vitamin D deficiency at any timepoint with neonatal birthweight, macrosomia or large for gestational age. CONCLUSIONS: Prevalence of vitamin D deficiency was low in this cohort of pregnant women and likely related to the high proportion of women taking vitamin D supplements during pregnancy. Maternal 25(OH)D did not impact offspring birth weight or birth size. Future studies in high-risk pregnant populations are needed to further assess maternal vitamin D status and factors in utero which promote early life obesity.