Vegetable, Fruit, and White Rice During Pregnancy Associated with Reduced Preterm Birth and Larger Birth Size – October 18, 2016

vegetables and fruits

According to a new study published in the American Journal of Clinical Nutrition, a vegetable, fruit and white rice dietary pattern during pregnancy is linked to a lower risk of preterm birth and larger birth size among Asian women. 


Worldwide, among low and middle-income countries, 11% of babies are born preterm (i.e., before 37 completed weeks of gestation), and 27% are born small for gestational age (i.e. smaller than usual for the number of weeks of pregnancy, with a birth weight less than 10% of all babies of the same gestational age). Prior research has also shown a rise in the incidence of large-for-gestational-age (i.e., larger than normal for the number of weeks of pregnancy, with a birth weight greater than 90% of all babies of the same gestational age). Infants who are born preterm, small for gestational age or large for gestational age have an increased risk of morbidity, neonatal death, and non-infectious disease later in adulthood.

Maternal dietary habits during pregnancy are important for optimal fetal growth and development and have shown to impact infant birth outcomes. Diets that involve a high intake of processed and fried meats (i.e. the Western diet), are usually related to an increased preterm birth risk, whereas diets characterized by a high consumption of fruits and vegetables (i.e. the prudent diet) are linked to a lower risk of preterm birth. In terms of birth size, prudent dietary patterns, including rice, fish, fruits, vegetables, low-fat dairy, and nonwhite bread, are generally linked to greater birth weight and reduced risk for small for gestational age.  However, only a handful of studies have examined the association between maternal dietary patterns and infant birth outcomes in Asian populations.

In a new study published in the American Journal of Clinical Nutrition, a group of researchers analyzed the maternal dietary habits in Asian pregnant women and examined their relation with offspring birth size and preterm birth. 1247 first-trimester pregnant women who were between 18 and 50 years old, citizens of Singapore or permanent residents, and who had a parental background of Malayan, Chinese, or Indian descent, were selected from KK Women’s and Children’s Hospital and National University Hospital to participate in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. At 26 and 28 weeks of gestation, the researchers determined the participants’ dietary intakes using 3-day food diary and a 24-hour recall. In the first trimester, an ultrasound scan was used to determine gestational age, and hospital records were used to obtain anthropometric measurements.

The researchers established 3 maternal dietary patterns: vegetable, fruit, and white rice (VFR); seafood and noodle (SfN); and pasta, cheese, and processed meat (PCP). The VFR pattern was marked by higher consumptions of fruits, vegetables, whole-grain bread, plain white rice, nuts and seeds, fish, and lower consumptions of fried potatoes, burgers, flavored rice, and sweetened and carbonated drinks. Higher intakes of processed meat, cheese, pasta-, tomato- and cream-based gravies characterized the PCP dietary pattern. The SfN pattern involved higher consumptions of fish, noodles, soup, low-fat red meat, seafood, and lower consumptions of white rice, ethnic bread, legumes, and curry-based gravies.

The findings showed that among 923 infants, 7.6% were born preterm, 13.4% were born small for gestational age, and 14.7% were born large for gestational age.  Mothers who had greater adherence to the VFR dietary pattern during pregnancy had a lower risk of having infants who were born preterm and small for gestational age, and a higher risk of having infants large-for-gestational-age. Furthermore, higher VFR patterns were also related to larger offspring abdominal circumference, head circumference, and body fat percentage at birth. No significant association was shown to exist for PCP and SfN dietary patterns in relation to outcomes related to birth size.

The overall findings suggest that the VFR dietary pattern in Asian pregnant women is linked to a reduced occurrence of preterm birth and to a larger birth size. The researchers note limitations within their research including the use of 24-hour recalls as the primary source of maternal dietary data, which they state may not be a good portrayal of the participants’ normal consumption due to variation in daily consumption. As well, maternal diet at 26 to 28 weeks of gestation was examined, and this time frame may not be representative of the diet taken throughout pregnancy. The researchers assert that further investigation in independent studies is needed to confirm the findings regarding larger birth size.


Written By: Nigar Celep, BASc