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The Influence of Maternal Nutrition on Fetal Size based on Ultrasound Measurements throughout Pregnancy
Author(s) -
Nguyen Phuong,
Young Melissa F.,
Addo Yaw O,
Nguyen Hieu,
Pham Hoa,
Truong Truong V,
Truong Son V,
Martorell Reynaldo,
Ramakrishnan Usha
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.890.7
Subject(s) - pregnancy , medicine , anthropometry , obstetrics , fetus , body mass index , confounding , birth weight , micronutrient , endocrinology , genetics , pathology , biology
Maternal anthropometry are known to influence birth weight, but there is a paucity of information on the relationships between maternal nutritional status and fetal growth during pregnancy. This study aimed to examine the influence of maternal nutritional status before and during pregnancy on fetal size during early (14–20 weeks), mid (20–30 weeks) and late (>30 weeks) pregnancy. We used prospective data collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Vietnam. Data analysis included 1412 women who had at least one ultrasound exam and delivered a singleton live birth. Fetal anthropometric (head circumferences‐ HC, biparietal diameter‐ BD, abdomen circumference‐ AC and femoral length‐FL) measurements were obtained by trained physicians during early, mid and late pregnancy. Maternal pre‐pregnancy weight, height, and hemoglobin were measured before conception. Conditional weight gain (CWG) on pre‐pregnancy body mass index (PPBMI – kg/m 2 ) were calculated respectively with each ultrasound period. The influence of maternal nutritional status before and during pregnancy on fetal size was assessed using generalized linear models, adjusting for potential confounding factors (maternal age, education, treatment group, child gender, household SES, time from enrolment to conception and repeated measure). PPBMI was a significant independent predictor of all measures of fetal size in the third trimester except for FL. A 1 standard deviation (SD) increase in PPBMI was associated with 0.16, 0.13 and 0.18 SD increase in HC, BD and AC, respectively. CWG in the first trimester was positively associated with all measures of fetal size between 20–30 weeks (effect size 0.18–0.28) and at >30 weeks of gestation (effect size 0.21–0.29) except for AC. Similar results was seen for the association between CWG in the second trimester and fetal size at 20–30 weeks (effect size 0.13–0.24) and at >30 weeks (effect size 0.15–0.28). However, CWG in the third trimester and pre‐pregnancy hemoglobin had no significant effect on fetal size. In conclusion, our study has provided evidence that both maternal BMI before pregnancy and weight gain during early and mid‐pregnancy have important and independent effects on fetal growth. Support or Funding Information Funded by the Mathile Institute for the Advancement of Human Nutrition, the Micronutrient Initiative, and Nestlé Foundation.