A Prospective Study of the Relationship of Infant Adiposity with Maternal Prenatal and Postnatal Diet Quality

OBJECTIVES: This study examines relationships of maternal prenatal and postnatal diet quality with infant birth size and growth, which are known risk factors for child obesity. METHODS: Women completed six 24-hour diet recalls (1 per pregnancy trimester and at 6 weeks, 6 months, and 12 months postpartum); infant anthropometrics were obtained at birth (n = 331 mother-child dyads), 6 weeks, 6 months and 12 months of age. Prenatal and postnatal Healthy Eating Index 2015 total (HEI), adequacy (HEI-adq) and moderation (HEI-mod) scores were calculated by combining recalls across pregnancy and across postpartum. Linear mixed models estimated associations of infant weight-for-length z-scores (WFLz) with prenatal and postnatal diet quality. Logistic regressions estimated odds of small-for-gestational age (SGA, <10th percentile) and large-for-gestational age (LGA, >90th percentile) associated with maternal prenatal diet quality. Covariates included maternal height, demographics, delivery mode, child sex, and gestational age at delivery. Sensitivity analyses examined whether associations were robust to inclusion of maternal total energy intake or early pregnancy BMI. RESULTS: WFLz was inversely associated with prenatal HEI (β±SE = −0.02 ± 0.005, P = 0.004) and HEI-mod (β ± SE = −0.04 ± 0.01, P < 0.001), and with postnatal HEI (β ± SE = −0.01 ± 0.005, P = 0.01) and HEI-adq (β ± SE = −0.02 ± 0.007, P = 0.005). SGA and LGA occurred for 92 (7%) and 172 (12%) babies, respectively. LGA was inversely associated with prenatal HEI (OR = 0.94, 95% CI: 0.90–0.98), HEI-mod (OR = 0.83, 95% CI: 0.74–0.83) and HEI-adq (OR = 0.95, 95% CI: 0.90–1.01). SGA was not associated with prenatal diet quality. Associations were not changed when adjusted for energy intake but were modestly attenuated when adjusted for BMI. CONCLUSIONS: Higher maternal prenatal and postnatal diet quality were associated with more favorable indicators of infant adiposity from birth through 12 months of age. Interventions are needed to determine whether ...