Study on the Association between Dietary Patterns of Women of Childbearing Age during Pregnancy and Neonatal Birth Weight in China
Authors: Yan Hui , Dang Shaonong , Zhang Yaodong , Luo Shuying 
Published: March 2020

Abstract
Objective : To understand the type of dietary patterns in the women during pregnancy and the distribution characteristics of children's birth weight and the association between dietary patterns and neonatal birth weight in Shaanxi, China. Methods: Data were derived from a cross-sectional program named “The prevalence and risk factors of birth defects in Shaanxi Province” in July to November in 2013. A stratified multistage random sampling method was used to select women , according to the urban-rural ratio and taking into account the population intensity and fertility level, 10 urban districts and 20 counties were randomly selected. In the sample counties, 6 townships were randomly selected (3 districts in the urban area), and 6 villages were randomly selected from each township (6 communities in the urban districts), each village randomly surveyed 30 (60 in the community) women whose latest dates of pregnancy were during January 2010 to November 2013 and their children. The mother's diet during pregnancy was investigated using semi-quantitative food frequency questionnaire to collect the frequency and amount of food consumption, and the newborn birth weight as well as related social demographic information was collected at the same time. This study selected children aged between 0-1 years old and their mothers with complete dietary survey data as the study subjects. The main dietary patterns were identified according to factor analysis, and latent class analysis (LCA) was used to investigate the social demographic factors affecting dietary patterns. The logistic regression model was used to investigate the association between birth weight and maternal dietary patterns during pregnancy by establishing three adjusting models and the data were stratified for further analysis by urban-rural and regions. Results : Totally 15980 participants were involved in this study, and the birth weight was 1050-6250g (3279.9±454.6). There were 783 newborns with birth weight of <2500g, accounting for 4.9%; and 703 newborns with birth weight >4000g, accounting for 4.4%. The incidence of SGA and LGA was 14.7% and 7.6%, respectively.Factor analysis was used to extract four dietary patterns during pregnancy: "vegetarian pattern", "balance pattern", "traditional pattern" and "processing pattern". The vegetarian pattern was a predominant pattern. LCA analysis indicated that urban women preferred to choose the balance pattern and rural women preferred for the traditional pattern. The balance pattern and processing pattern were the main ones in the southern region, the vegetarian pattern in the northern region and the traditional pattern in the middle region. Further study on the association between dietary patterns and neonatal birth weight, founding that the vegetarian pattern was positively associated with a higher risk of low birth weight in rural areas and middle region, and the traditional pattern was a risk factor for the occurrence of low birth weight in the middle region. The processing pattern was found a protective factor for the occurrence of low birth weight in rural areas but was a risk factor for low birth weight in the southern region. The balance pattern was a protective factor for the occurrence of low birth weight in the northern region. Conclusion : There are four kinds of dietary patterns in the pregnant women of childbearing age in Shaanxi Province, "vegetarian pattern" is predominant, and the dietary structure needs to be improved. The vegetarian and traditional pattern may be positively related to a higher risk of low birth weight while the balanced pattern may keep birth weight of offspring within the appropriate range. Health education of balanced diet and individual nutrition guidance during pregnancy should be strengthened, in order to make dietary structure during pregnancy are more reasonable, reduce the occurrence of adverse birth weight of newborns.