A periconceptional energy-rich dietary pattern is associated with early fetal growth: the Generation R study

Objective To identify periconceptional maternal dietary patterns associated with crownrump length (CRL), estimated fetal weight (EFW) and birthweight. Design Population-based prospective birth cohort study. Setting Rotterdam, the Netherlands. Participants For this study, 847 pregnant Dutch women were eligible. Women were included between 2001 and 2005. Methods Information on nutritional intake was collected by a semiquantitative food frequency questionnaire. For extracting dietary patterns, principal component factor analysis was used. Fetal growth was assessed using ultrasound measurements. Information on birth outcomes was retrieved from medical records. Multivariate regression analyses were used. Main outcome measures Crown-to-rump length, estimated fetal weight in second and third trimester and birthweight. Results An energy-rich dietary pattern' was identified, characterised by high intakes of bread, margarine and nuts. A significant association was shown between a high adherence to this dietary pattern (difference, mm: 2.15, 95% confidence interval 0.793.50) and CRL (linear trend analyses P=0.015). No association was revealed between increasing adherence to this dietary pattern and EFW in second or third trimester, or birthweight. Conclusion This study suggests that increasing adherence to an energy-rich dietary pattern is associated with increased CRL in the first trimester.