Dietary intake and nutritional adequacy prior to conception and during pregnancy: a follow-up study in the north of Portugal

Public Health Nutrition
Q2
Jul 2009
Citations:102
Influential Citations:8
Observational Studies (Human)
84
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Enhanced Details

Methods
Observational follow-up of 249 pregnant women in Porto, Portugal, nested within the Geracao XXI birth cohort; mean age 29 years (SD 5.8); gestational age <13 weeks at first antenatal visit; data collected in each trimester and postpartum; dietary intake assessed with a semi-quantitative FFQ (86 items) administered at FFQ1 (preconception) and FFQ2 (during pregnancy); a subset of 101 completed three 3-day diaries.
Intervention
Folic acid supplementation started in the preconception/first trimester; median initiation 6.5 weeks (IQR 5-9); preconception use 18.6%; first trimester 96.8%; second trimester 90.0%; third trimester 73.5%. Iron supplementation started in early pregnancy; preconception 1.6%; first trimester 42.2%; second 76.7%; third 75.9%; median initiation 16 weeks (IQR 11-20). Magnesium supplementation started in early pregnancy; preconception 0%; first trimester 12.0%; second 28.5%; third 36.1%; median initiation 24 weeks (IQR 14-30). Dosages and exact routes not reported.
Results
Energy and macronutrient intakes were within recommended levels; pregnancy increased intake of vitamins A and E, riboflavin, folate, calcium and magnesium; alcohol and caffeine intake declined. Before conception, inadequacy was highest for vitamin E (83.1%), folate (58.2%), and Mg (18.5%); during pregnancy, inadequacy remained high for folate (90.8%), Fe (88.0%), vitamin E (73.1%), and Mg (21.3%). Folic acid supplementation was common in the first trimester (96.8%), with median initiation at 6.5 weeks; Fe supplementation increased through pregnancy to 75.9% by the third trimester; Mg supplementation rose to 36.1% by the third. Authors conclude that low folate and Mg intakes and late folate supplementation indicate current national guidelines may be ineffective in preventing neural tube defects; suggest folate fortification of staple foods and improved preconception folate strategies; iron status should be monitored during pregnancy.
Limitations
Two-hospital Porto sample may limit generalizability; exclusions (gestational age >13 weeks, miscarriages, very preterm births) and loss to follow-up; preconception diet assessed retrospectively; potential recall and social desirability biases; FFQ limitations; diary subset small (n=101) may not be representative; self-reported supplement use.

Abstract

Abstract Objective To assess maternal diet and nutritional adequacy prior to conception and during pregnancy. Design Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery. Setting Antena...