Diet quality from early pregnancy through one year postpartum: a prospective cohort study.

Abstract

Background: Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined.

Objective: This study investigated diet quality from early pregnancy through 12 months postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States.

Methods: Participants completed 24-hour dietary recalls at six study visits (each pregnancy trimester and 6 weeks, 6 months, and 12 months postpartum) (n=383). Between-visit mean HEI scores (Healthy Eating Index-2015; min=0, max=100) were compared using the population ratio method (PR). The NCI usual intakes method estimated the distribution of HEI scores in pregnancy and postpartum; unpaired t-tests compared usual mean HEI scores by covariates; paired t-tests compared differences between mean pregnancy and postpartum.

Results: The total HEI mean ± SE scores (NCI method) were 61.4 ± 0.8 in pregnancy and 61.7 ± 0.9 in postpartum. Mean HEI scores differed by sociodemographic characteristics, particularly education, marital status, and federal assistance participation. The highest scores were observed in participants with at least a bachelor's degree (64.1 ± 0.9 in pregnancy, 64.5 ± 1.0 in postpartum, n = 257) and those with other non-Hispanic white race/ethnicity (64.7±1.8 in pregnancy, 66.4±2.2 in postpartum). There were no between-visit differences in mean total HEI scores (PR). While differences were observed in some mean HEI component scores between pregnancy and postpartum visits, they were small (mostly < 1 point) in magnitude and in inconsistent directions.

Conclusions: Stable total HEI mean scores suggest adherence to dietary guidelines was consistent throughout pregnancy and postpartum in this sample. While some sociodemographic characteristics may identify individuals at greater risk of diet-related pregnancy complications, low diet quality was pervasive throughout all subgroups and reflect an urgent need for widespread improvement.