Prenatal Diet and Infant Growth From Birth to Age 24 Months
Authors: Hedderson Monique M. , Schuh Holly B. , Knapp Emily A. , Bekelman Traci A. , Catellier Diane J. , Westlake Matt , Lyall Kristen , Schmidt Rebecca J. , Dunlop Anne L. , Comstock Sarah S. , Chatzi Leda , Sauder Katherine A. , Dabelea Dana , Switkowski Karen M. , Lin Pi-I Debby , Avalos Lyndsay A. , Zhu Yeyi , Ferrara Assiamira ,   ECHO Cohort Consortium, Smith P Brian , Newby L Kristin , Adair Linda , Jacobson Lisa P. , Catellier Diane , McGrath Monica , Douglas Christian , Duggal Priya , Knapp Emily , Kress Amii , Blackwell Courtney K. , Mansolf Maxwell A. , Lai Jin-Shei , Ho Emily , Cella David , Gershon Richard , Macy Michelle L. , Das Suman R. , Freedman Jane E. , Mallal Simon A. , McLean John A. , Shah Ravi V. , Shilts Meghan H. , Alshawabkeh Akram N. , Cordero Jose F. , Meeker John , Trasande Leonardo , Camargo Carlos A. , Hasegawa Kohei , Zhu Zhaozhong , Sullivan Ashley F. , Dabelea Dana , Perng Wei , Bekelman Traci A. , Wilkening Greta , Magzamen Sheryl , Moore Brianna F. , Starling Anne P. , Rinehart Deborah J. , Koinis Mitchell Daphne , D'Sa Viren , Deoni Sean C.L. , Mueller Hans-Georg , Duarte Cristiane S. , Monk Catherine , Canino Glorisa , Posner Jonathan , Murray Tenneill , Lugo-Candelas Claudia , Dunlop Anne L. , Brennan Patricia A. , Hockett Christine , Elliott Amy , Ferrara Assiamira , Croen Lisa A. , Hedderson Monique M. , Ainsworth John , Bacharier Leonard B. , Bendixsen Casper G. , Gern James E. , Gold Diane R. , Hartert Tina V. , Jackson Daniel J. , Johnson Christine C. , Joseph Christine  L.M. , Kattan Meyer , Khurana Hershey Gurjit K. , Lemanske, Jr. Robert F. , Lynch Susan V. , Miller Rachel L. , O’Connor George T. , Ober Carole , Ownby Dennis , Rivera-Spoljaric Katherine , Ryan Patrick H. , Seroogy Christine M. , Singh Anne Marie , Wood Robert A. , Zoratti Edward M. , Habre Rima , Farzan Shohreh , Gilliland Frank D. , Hertz-Picciotto Irva , Bennett Deborah H. , Schweitzer Julie B. , Schmidt Rebecca J. , LaSalle Janine M. , Hipwell Alison E. , Keenan Kate E. , Karr Catherine J. , Bush Nicole R. , LeWinn Kaja Z. , Sathyanarayana Sheela , Zhao Qi , Tylavsky Frances , Carroll Kecia N. , Loftus Christine T. , Leve Leslie D. , Ganiban Jody M. , Neiderhiser Jenae M. , Weiss Scott T. , Litonjua Augusto A. , McEvoy Cindy T. , Spindel Eliot R. , Tepper Robert S. , Newschaffer Craig J. , Lyall Kristen , Volk Heather E. , Landa Rebecca , Ozonoff Sally , Piven Joseph , Hazlett Heather , Pandey Juhi , Schultz Robert , Dager Steven , Botteron Kelly , Messinger Daniel , Stone Wendy , Ames Jennifer , O'Connor Thomas G. , Miller Richard K. , Oken Emily , Hacker Michele R. , James-Todd Tamarra , O'Shea T. Michael , Fry Rebecca C. , Frazier Jean A. , Singh Rachana , Rollins Caitlin , Montgomery Angela , Vaidya Ruben , Joseph Robert M. , Washburn Lisa K. , Gogcu Semsa , Bear Kelly , Rollins Julie V. , Hooper Stephen R. , Taylor Genevieve , Jackson Wesley , Thompson Amanda , Daniels Julie , Hernandez Michelle , Lu Kun , Msall Michael , Lenski Madeleine , Obeid Rawad , Pastyrnak Steven L. , Jensen Elizabeth , Sakai Christina , Santos Hudson , Kerver Jean M. , Paneth Nigel , Barone Charles J. , Elliott Michael R. , Ruden Douglas M. , Fussman Chris , Herbstman Julie B. , Margolis Amy , Schantz Susan L. , Geiger Sarah Dee , Aguiar Andrea , Tabb Karen , Strakovsky Rita , Woodruff Tracey , Morello-Frosch Rachel , Padula Amy , Stanford Joseph B. , Porucznik Christina A. , Giardino Angelo P. , Wright Rosalind J. , Wright Robert O. , Collett Brent , Baumann-Blackmore Nicole , Gangnon Ronald , McKennan Chris G. , Wilson Jo , Altman Matt , Aschner Judy L. , Stroustrup Annemarie , Merhar Stephanie L. , Moore Paul E. , Pryhuber Gloria S. , Hudak Mark , Reynolds Lyndaker Ann Marie , Lampland Andrea L. , Rochelson Burton , Jan Sophia , Blitz Matthew J. , Katzow Michelle W. , Brown Zenobia , Chiuzan Codruta , Rafael Timothy , Lewis Dawnette , Meirowitz Natalie , Poindexter Brenda , Gebretsadik Tebeb , Osmundson Sarah , Straughen Jennifer K. , Eapen Amy , Cassidy-Bushrow Andrea , Wegienka Ganesa , Sitarik Alex , Woodcroft Kim , Urquhart Audrey , Levin Albert , Johnson-Hooper Tisa , Davidson Brent , Ma Tengfei , Barrett Emily S. , Blaser Martin J. , Dominguez-Bello Maria Gloria , Horton Daniel B. , Jimenez Manuel , Rosen Todd , Palomares Kristy , Avalos Lyndsay A. , Zhu Yeyi , Hunt Kelly J . , Newman Roger B. , Bloom Michael S. , Alkis Mallory H. , Roberts James R. , Mumford Sunni L. , Burris Heather H. , DeMauro Sara B. , Yee Lynn M. , Hamvas Aaron , Olidipo Antonia F. , Haddad Andrew S. , Eiland Lisa R. , Spillane Nicole T. , Suri Kirin N. , Fisher Stephanie A. , Goldstein Jeffrey A. , Mithal Leena B. , DeRegnier Raye-Ann O. , Maitre Nathalie L. , Nguyen Ruby H.N. , JaKa Meghan  M. , Sidebottom Abbey C. , Paidas Michael J. , Potter JoNell E. , Ruby Natale , Duthely Lunthita , Jayakumar Arumugam , Young Karen , Maldonado Isabel , Miller Meghan , Slaughter Jonathan L. , Keim Sarah A. , Lynch Courtney D. , Venkatesh Kartik K. , Whitworth Kristina W. , Symanski Elaine , Northrup Thomas F. , Mendez-Figueroa Hector , Mosquera Ricardo A. , Karagas Margaret R. , Madan Juliette  C. , MacKenzie Debra M. , Lewis Johnnye L. , Rennie Brandon J. , Leventhal Bennett L. , Kim Young Shin , Bishop Somer , Nozadi Sara S. , Luo Li , Lester Barry M. , Marsit Carmen J. , Everson Todd , Loncar Cynthia M. , McGowan Elisabeth C. , Sheinkopf Stephen J. , Carter Brian S. , Check Jennifer , Helderman Jennifer B. , Neal Charles R. , Smith Lynne M. 
Published: November 2024

Importance

Being born either small for gestational age (SGA) or large for gestational age (LGA) and experiencing rapid or slow growth after birth are associated with later-life obesity. Understanding the associations of dietary quality during pregnancy with infant growth may inform obesity prevention strategies.

Objective

To evaluate the associations of prenatal dietary quality according to the Healthy Eating Index (HEI) and the Empirical Dietary Inflammatory Pattern (EDIP) with infant size at birth and infant growth from birth to age 24 months.

Design, Setting, and Participants

This cohort study used data from birthing parent–child dyads in 8 cohorts participating in the Environmental influences on Child Health Outcomes program between 2007 and 2021. Data were analyzed from March 2021 to August 2024.

Exposures

The HEI and the EDIP dietary patterns.

Main Outcomes and Measures

Outcomes of interest were infant birth weight, categorized as SGA, reference range, or LGA, and infant growth from birth to ages 6, 12, and 24 months, categorized as slow growth (weight-for-length z score [WLZ] score difference &amp;lt;−0.67), within reference range (WLZ score difference −0.67 to 0.67), or rapid (WLZ score difference, &amp;gt;0.67).

Results

The study included 2854 birthing parent–child dyads (median [IQR] maternal age, 30 [25-34] years; 1464 [51.3%] male infants). The cohort was racially and ethnically diverse, including 225 Asian or Pacific Islander infants (7.9%), 640 Black infants (22.4%), 1022 Hispanic infants (35.8%), 664 White infants (23.3%), and 224 infants (7.8%) with other race or multiple races. A high HEI score (&amp;gt;80), indicative of a healthier diet, was associated with lower odds of LGA (adjusted odds ratio [aOR], 0.88 [95% CI, 0.79-0.98]), rapid growth from birth to age 6 months (aOR, 0.80 [95% CI, 0.37-0.94]) and age 24 months (aOR 0.82 [95% CI, 0.70- 0.96]), and slow growth from birth to age 6 months (aOR, 0.65 [95% CI, 0.50-0.84]), 12 months (aOR, 0.74 [95% CI, 0.65-0.83]), and 24 months (OR, 0.65 [95% CI, 0.56-0.76]) compared with an HEI score 80 or lower. There was no association between high HEI and SGA (aOR, 1.14 [95% CI, 0.95-1.35]). A low EDIP score (ie, ≤63.6), indicative of a less inflammatory diet, was associated with higher odds of LGA (aOR, 1.24 [95% CI, 1.13-1.36]) and rapid infant growth from birth to age 12 months (aOR, 1.50 [95% CI, 1.18-1.91]) and lower odds of rapid growth to age 6 months (aOR, 0.77 [95% CI, 0.71-0.83]), but there was no association with SGA (aOR, 0.80 [95% CI, 0.51-1.25]) compared with an EDIP score of 63.6 or greater.

Conclusions and Relevance

In this cohort study, a prenatal diet that aligned with the US Dietary Guidelines was associated with reduced patterns of rapid and slow infant growth, known risk factors associated with obesity. Future research should examine whether interventions to improve prenatal diet are also beneficial in improving growth trajectory in children.