Johnry G.

Camahalan Block 2NB

Nutrition during Pregnancy: Findings from the

National Institute of Child Health and Human
Development (NICHD) Fetal Growth Studies–
Singleton Cohort
AUTHORS. Stefanie N Hinkle, Cuilin Zhang, Katherine L Grantz, Anthony Sciscione, Deborah A
Wing, William A Grobman, Roger B Newman, Mary E D'Alton, Daniel Skupski, Michael P
Nageotte, Angela C Ranzini, John Owen, Edward K Chein, Sabrina Craigo, Samrawit F Yisahak,
Aiyi Liu, Paul S Albert, Germaine M Buck Louis, Jagteshwar Grewal

Summary.

The dietary state of a woman during preconception and pregnancy has immediate and
long-term effects on her and her child's health. Multiple micronutrients have been
investigated separately in connection to pregnancy outcomes. Consumption of marine
PUFAs has been associated with a lower risk for preterm delivery and low birth weight;
adequate intakes of calcium, vitamin C, and vitamin E have been linked to a reduced
risk of pre-eclampsia; and greater intakes of dietary iron may be associated with an
increased risk of gestational diabetes in comparison to control groups. Additionally,
higher food quality has been connected with a reduced risk of premature birth.

There is a need for longitudinal data on diets during pregnancies to strengthen the
evidentiary foundation for diet-disease relationships identified during this crucial
developmental stage. In addition, gaps exist about mother adherence to dietary
recommendations, the characterization of diet across the four trimesters of pregnancy,
and if diets change by maternal characteristics (such as race/ethnicity or BMI) in a
modern community. Earlier studies on nutritional consumption during pregnancy lacked
racial/ethnic variety or repeated evaluation among the same women at various periods.

The NICHD Fetal Development Studies–Singletons was a prospective cohort study of

singleton pregnant women conducted between July 2009 and January 2013 at 12 US
clinical locations to determine fetal growth criteria. Longitudinal data were acquired from
2334 non-obese women and 468 obese women (prepregnancy BMI: 30.0–44.9).
Women were enrolled at 8–13 weeks gestation, monitored through birth, and randomly
allocated to 1 of 4 obstetrical ultrasound protocols for evaluating fetal development. The
study's original purpose was to produce a US fetal growth standard. Eligible women
were 18–40 years old with a singleton pregnancy, a known last menstrual cycle date, no
proven or suspected fetal structural or chromosomal defects, and no serious medical
issues. Women with a BMI of 19.0–29.9 were eligible if they hadn't smoked in the last
six months, hadn't used illegal substances in the prior year, and didn't have difficulties in
a previous pregnancy. We've previously detailed the eligibility conditions. Eighteen
women were enrolled but were found to be ineligible for the study. All women gave
written informed permission before participating, and all clinical locations had IRB
approval. According to the local institutional assessment board, women were
reimbursed for their time. Participants received no follow-up or data reporting.

Result. During the second and third trimesters, women of average weight had the most
significant energy consumption and dietary quality (Table 6). Fruit and vegetable
consumption was highest in women of normal weight and lowest in women with obesity.
Furthermore, dietary consumption of numerous micronutrients differed between
prepregnancy BMI groups. There was no variance among pre-pregnancy BMI
categories when analyzed in terms of satisfying the HEI-2010 requirements.
We discovered that the majority of participants reported dietary intakes across all
trimesters that, on average, did not meet the US Dietary Guidelines for nonpregnant
women in this contemporary, diverse cohort of US women with singleton pregnancies
and mostly without major chronic diseases when entering pregnancy. Most individuals'
diets were deficient in vegetables and whole grains and were high in empty calories,
refined grains, and salt. The dietary composition remained largely steady during
pregnancy, especially between the second and third trimesters, when no statistically
significant variations were identified. We discovered that diet varies significantly across
race/ethnic groups, with non-Hispanic Black women having the lowest overall dietary
quality (as measured by the HEI-2010 score) throughout all trimesters. Some nutrition
parameters differed by BMI status before pregnancy, as did quality, which was best
among women of average weight and lowest among women of obesity. These findings
underscore the importance of further developing treatments to enhance food quality
among pregnant women in the United States.

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References.
Stefanie N Hinkle, Cuilin Zhang, Katherine L Grantz, Anthony Sciscione, Deborah A Wing, William A
Grobman, Roger B Newman, Mary E D'Alton, Daniel Skupski, Michael P Nageotte, Angela C
Ranzini, John Owen, Edward K Chein, Sabrina Craigo, Samrawit F Yisahak, Aiyi Liu, Paul S Albert,
Germaine M Buck Louis, Jagteshwar Grewal, Nutrition during Pregnancy: Findings from the
National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies–
Singleton Cohort, Current Developments in Nutrition, Volume 5, Issue 1, January 2021,
nzaa182, https://doi.org/10.1093/cdn/nzaa182