Category: Prematurity
Poster Session IV
Poor maternal diet has been associated with preterm birth (PTB). However the underlying mechanism for this, and the dietary factors of greatest impact, are unknown. Short mid-trimester cervical length (CL) is a known risk factor for PTB, but the potential association between short CL and diet has not been investigated. The objective of this study was to determine if measures of periconceptional diet are associated with CL and/or PTB.
Study Design:
This is a secondary analysis of 7706 nulliparas from the NuMoM2b cohort who underwent a mid-trimester CL (short CL defined as < 25mm) and who completed a food frequency questionnaire in early pregnancy to assess dietary intake over the prior 3 months. The Alternative Healthy Eating index (AHEI)-2010 and the average daily glycemic index (GI) were computed. A higher AHEI-2010 score suggests a better-quality diet reflecting dietary guidelines, whereas a lower GI score suggests a diet supporting better blood glucose control. Separate logistic regression models were used to estimate associations between dietary parameters (one each for AHEI-2010 and GI) and the odds of i) short CL (adjusted for age, race/ethnicity and smoking status), and ii) PTB before 34 weeks (adjusted for age, race/ethnicity, smoking status, body mass index, gestational hypertension, progesterone use, and CL).
Results:
Table 1 shows study population characteristics - 165 had a short CL (2.1%) and the rate of PTB < 34 weeks was 2.5%. Diet quality by the AHEI-2010 was not associated with the odds of a short CL (OR=0.992, 95% CI: 0.997 to 1.007) or PTB (OR=0.987, 95% CI: 0.973 to 1.002). A higher dietary GI was associated with increased odds of both short CL (OR=1.057, 95% CI: 1.012 to 1.104) (Figure 1) and PTB < 34 weeks (OR=1.069, 95% CI: 1.025 to 1.115). Dietary GI did not moderate the association between CL and PTB.
Conclusion:
After adjusting for potentially confounding factors, a higher dietary GI score was a risk factor for both a short CL and PTB < 34 weeks in a diverse cohort of nulliparas. Further understanding of the potential relationship between dietary GI and short CL is warranted.
Gina F. Milone, MD (she/her/hers)
Fellow Physician
University of California, Irvine
Long Beach, California, United States
Karen L Lindsay, PhD
Assistant Professor
Department of Pediatrics, University of California, Irvine
Irvine, California, United States
Brian M. Mercer, MD
Department Chair of Obstetrics & Gynecology
Case Western Reserve University and The MetroHealth System
Cleveland, Ohio, United States
George R. Saade, MD
Professor & Chief of Obstetrics & Maternal-Fetal Medicine
University of Texas Medical Branch
Galveston, Texas, United States
Bob M. Silver, MD
Chair OB/GYN
Univ. of Utah School of Medicine
Salt Lake City, Utah, United States
David M. Haas, MD, MSCR
Attending Physician
Indiana University Health
Carmel, Indiana, United States
Hyagriv Simhan, MD,MSCR
Magee-Womens Hospital, University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Samuel Parry, MD
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Uma M. Reddy, MD,MPH
Professor and Vice Chair of Research, Department of Obstetrics and Gynecology
Columbia University
New York, New York, United States
Judith H. Chung, MD, PhD
Professor of Clinical Obstetrics and Gynecology
UC Irvine Health
Orange, California, United States