Association between diet quality during preconception or pregnancy and
adverse perinatal outcomes: a systematic review and meta-analysis
Abstract
Background: Although women are encouraged to achieve good diet quality
in preconception and pregnancy, the benefits on perinatal outcomes have
not been established. Objective: To systematically review and quantify
the association between diet quality and adverse perinatal outcomes.
Search strategy: Medline, Embase, Food Science and Technology Abstracts
and CINAHL were searched up to 5th March 2020. Selection criteria: Two
authors independently screened, selected and coded relevant prospective
cohort studies. Data collection and analysis: Thirty-three studies
(315,431 participants) were included in the meta-analysis. Odds ratios
and mean differences from individual studies were pooled using
random-effects models. Main Results: The pooled results for the
association between diet quality and excessive (OR: 0.91; 95 CI: 0.76,
1.10) or inadequate (OR: 0.90; 95 CI: 0.70, 1.17) gestational weight
gain were not statistically significant. Women in the top tertile of
diet quality scores during prepregnancy or pregnancy had a lower risk of
gestational diabetes (OR: 0.77; 95 CI: 0.65, 0.90), hypertensive
disorders of pregnancy (OR: 0.87; 95 CI: 0.83, 0.92), preterm birth (OR:
0.77; 95 CI: 0.66, 0.89), small for gestational age (OR: 0.88; 95 CI:
0.79, 0.99) and low birth weight (OR: 0.60; 95 CI: 0.37, 0.99) compared
to those in the bottom tertile. No studies were found for delivery mode.
Conclusions: Data from prospective cohort studies support the potential
of improving maternal diet quality in the effort to prevent adverse
perinatal outcomes. Funding: Canadian Institutes of Health Research HLT
151517, National Natural Sciences Foundation of China No. 81661128010
Keywords: Diet quality, perinatal outcomes.