(576) Dietary risk factors for excess weight gain in pregnancy

Excess gestational weight gain (GWG) is associated with adverse pregnancy and metabolic outcomes. Patients are motivated to improve their health during pregnancy but describe a lack of knowledge on dietary recommendations. We investigated dietary components that are most associated with GWG.


Study Design:

This is a nested case control study in a cohort of singleton pregnancies who completed the NIH Dietary Health Questionnaire II (DHQ-II) in the third trimester or within 3 months of delivery. Cases were patients with excess GWG greater than the Institute of Medicine (IOM) recommended guidelines. Controls were patients with GWG within the IOM guidelines. Those with GWG below guidelines were excluded. Exposures of interest were Healthy Eating Index-2015 (HEI-2015) score components and other DHQ-II dietary components. These components were compared between cases and controls. Multivariable logistic regression was used to adjust for BMI at first prenatal visit.


Results:

531 patients completed the DHQ-II, among which 312 (58.8%) had excess GWG and 219 (41.2%) had appropriate GWG. There were no significant socioeconomic differences between those with excess and adequate GWG. The average BMI was 29.60±8.07 kg/m² among patients with excess GWG and 27.20±7.49 kg/m² among patients with appropriate GWG (P=0.001). Overall HEI-2015 scores were not significantly different between cases and controls. However, a diet composed of low whole grains (aOR 1.75, 95% CI 1.18- 2.60) or high dairy intake (aOR 1.84, 95% CI 1.18- 2.81) was associated with excess GWG.


Conclusion:

A diet low in whole grains or high in dairy is associated with excess GWG. Obstetric providers should address specific dietary components when counseling patients about GWG.