Eating Habits During Pregnancy of Women Giving Birth Very Prematurely: An Exploratory Analysis


  • Beatriz Teixeira Faculdade de Ciências da Nutrição e Alimentação. Universidade do Porto. Porto; EPIUnit - Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto.
  • Manuela Cardoso Nutrition Unit. Maternidade Dr. Alfredo da Costa. Centro Hospitalar Universitário de Lisboa Central. Lisbon.
  • Claúdia Camila Dias Knowledge Management Unit and Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS). Porto; CINTESIS @RISE - Health Research Network. Faculdade de Medicina. Universidade do Porto. Porto.
  • Luís Pereira-da-Silva Medicine of Woman, Childhood and Adolescence. NOVA Medical School | Faculdade de Ciências Médicas. Lisbon; Nutrition Group. CHRC - Comprehensive Health Research Centre. NOVA Medical School | Faculdade de Ciências Médicas. Lisbon; Neonatal Intensive Care Unit. Hospital Dona Estefânia. Centro Hospitalar Universitário de Lisboa Central. Lisbon.
  • Diana e Silva Faculdade de Ciências da Nutrição e Alimentação. Universidade do Porto. Porto; Pediatric Nutrition Unit. Centro Materno Infantil. Centro Hospitalar Universitário São João. Porto; Center for Health Technology and Services Research – CINTESIS. Porto.



Feeding Behavior, Hypertension, Pregnancy-Induced, Pregnant Women, Premature Birth


Introduction: Preterm birth is increasing worldwide, representing a major cause of death and long-term loss of human potential among survivors. Some morbidities during pregnancy are well-known risk factors for preterm labor, but it is not yet known whether deviations from adequate dietary patterns are associated with preterm delivery. Diet may be an important modulator of chronic inflammation, and pro-inflammatory diets during pregnancy were reported to be associated with preterm birth. The aim of this study was to assess the food consumption during pregnancy of Portuguese women giving birth
very prematurely and the association between the food consumption and the major maternal morbidities during pregnancy related with preterm delivery.
Material and Methods: A single-center cross-sectional observational study including consecutive Portuguese women giving birth before 33 weeks of gestation was conducted. Recall of eating habits during pregnancy was obtained within the first week after delivery, using a semi quantitative food frequency questionnaire validated for Portuguese pregnant women.
Results: Sixty women with a median age of 36.0 years were included. Of these, 35% were obese or overweight at the beginning of pregnancy, 41.7% and 25.0% gained excessive or insufficient weight during pregnancy, respectively. Pregnancy-induced hypertension was present in 21.7% of cases, gestational diabetes in 18.3%, chronic hypertension in 6.7%, and type 2 diabetes mellitus in 5.0%. Pregnancy-induced hypertension was significantly associated with increased daily consumption of pastry products (31.2 vs 10.0 g, p = 0.022), fast food (39.6 vs 29.7 g, p = 0.028), bread (90.0 vs 50.0 g, p = 0.005), pasta, rice and potatoes (225.7 vs 154.3 g, p = 0.012). In a multivariate analysis, only bread consumption maintained a significant, albeit weak,
association (OR = 1.021; 1.003 – 1.038, p = 0.022).
Conclusion: Pregnancy-induced hypertension was associated with increased consumption of pastry products, fast food, bread, pasta, rice, and potatoes, although only bread consumption had a weak but statistically significant association with pregnancy-induced hypertension in a multivariate analysis.


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Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013;10:S2. DOI:

Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol. 2016;215:103.e1-14.

Petrou S, Yiu HH, Kwon J. Economic consequences of preterm birth: a systematic review of the recent literature (2009-2017). Arch Dis Child. 2019;104:456-65. DOI:

Romero R, Gómez R, Chaiworapongsa T, Conoscenti G, Kim JC, Kim YM. The role of infection in preterm labour and delivery. Paediatr Perinat Epidemiol. 2001;15:S41-56. DOI:

Bloomfield FH. How is maternal nutrition related to preterm birth? Annu Rev Nutr. 2011;31:235-61. DOI:

Sharma AJ, Vesco KK, Bulkley J, Callaghan WM, Bruce FC, Staab J, et al. Associations of gestational weight gain with preterm birth among underweight and normal weight women. Matern Child Health J. 2015;19:2066-73. DOI:

Huang A, Ji Z, Zhao W, Hu H, Yang Q, Chen D. Rate of gestational weight gain and preterm birth in relation to prepregnancy body mass indices and trimester: a follow-up study in China. Reprod Health. 2016;13:93-5. DOI:

Huang J, Qian Y, Gao M, Ding H, Zhang L, Jia R. Analysis of factors related to preterm birth: a retrospective study at Nanjing Maternity and Child Health Care Hospital in China. Medicine. 2020;99:e21172. DOI:

Sureshbabu RP, Aramthottil P, Anil N, Sumathy S, Varughese SA, Sreedevi A, et al. Risk factors associated with preterm delivery in singleton pregnancy in a tertiary care hospital in South India: a case control study. Int J Womens Health. 2021;13:369-77. DOI:

Lu MS, He JR, Chen Q, Lu J, Wei X, Zhou Q, et al. Maternal dietary patterns during pregnancy and preterm delivery: a large prospective cohort study in China. Nutr J. 2018;17:71. DOI:

Rasmussen KM, Habicht JP. Maternal supplementation differentially affects the mother and newborn. J Nutr. 2010;140:402-6. DOI:

Dhobale M, Joshi S. Altered maternal micronutrients (folic acid, vitamin B(12)) and omega 3 fatty acids through oxidative stress may reduce neurotrophic factors in preterm pregnancy. J Matern Fetal Neonatal Med. 2012;25:317-23. DOI:

Waksmańska W, Bobiński R, Ulman-Włodarz I, Pielesz A, Mikulska M. The dietary composition of women who delivered preterm and full-term infants. Appl Nurs Res. 2017;35:13-7. DOI:

Mitku AA, Zewotir T, North D, Jeena P, Naidoo RN. Modeling differential effects of maternal dietary patterns across severity levels of preterm birth using a partial proportional odds model. Sci Rep. 2020;10:5491. DOI:

Michels KB, Schulze MB. Can dietary patterns help us detect diet-disease associations? Nutr Res Rev. 2005;18:241-8. DOI:

McCullough LE, Miller EE, Calderwood LE, Shivappa N, Steck SE, Forman MR, et al. Maternal inflammatory diet and adverse pregnancy outcomes: circulating cytokines and genomic imprinting as potential regulators? Epigenetics. 2017;12:688-97. DOI:

Lecorguillé M, Teo S, Phillips CM. Maternal dietary quality and dietary inflammation associations with offspring growth, placental development, and DNA methylation. Nutrients. 2021;13:3130. DOI:

Pinto E, Severo M, Correia S, dos Santos Silva I, Lopes C, Barros H. Validity and reproducibility of a semi-quantitative food frequency questionnaire for use among Portuguese pregnant women. Matern Child Nutr. 2010;6:105-19. DOI:

Teixeira D, Marinho R, Mota I, Castela C, Morais J, Pestana D, et al. Alimentação e nutrição na gravidez. Lisboa: Direção Geral de Saúde; 2021.

World Health Organization. Obesity: preventions and managing the global epidemic. Report on a consultive meeting. Geneva: WHO; 1997.

Quetelet A. Physique sociale, ou essai sur le développement des facultés de l’homme. Bruxelles: C. Muquardt; 1869.

Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington: National Academies Press; 2009.

Teixeira D, Marinho R, Mota I, Castela C, Morais J, Pestana D, et al. Food and nutrition in pregnancy. Lisboa: Direção-Geral da Saúde; 2021.

Lopes C, Torres D, Oliveira A, Severo M, Alarcão V, Guiomar S, et al. Inquérito alimentar nacional e de atividade física, IAN-AF 2015-2016: relatório de resultados. Porto: Universidade do Porto; 2017.

Brodowski L, Büter W, Kohls F, Hillemanns P, von Kaisenberg C, Dammann O. Maternal overweight, inflammation and neurological consequences for the preterm child: results of the ELGAN Study. Geburtshilfe Frauenheilkd. 2019;79:1176-82. DOI:

Soltani S, Arablou T, Jayedi A, Salehi-Abargouei A. Adherence to the dietary approaches to stop hypertension (DASH) diet in relation to all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Nutr J. 2020;19:37. DOI:

Chatzi L, Mendez M, Garcia R, Roumeliotaki T, Ibarluzea J, Tardón A, et al. Mediterranean diet adherence during pregnancy and fetal growth: INMA (Spain) and RHEA (Greece) mother-child cohort studies. Br J Nutr. 2012;107:135-45. DOI:

Mikkelsen TB, Osterdal ML, Knudsen VK, Haugen M, Meltzer HM, Bakketeig L, et al. Association between a mediterranean-type diet and risk of preterm birth among Danish women: a prospective cohort study. Acta Obstet Gynecol Scand. 2008;87:325-30. DOI:

Haugen M, Meltzer HM, Brantsaeter AL, Mikkelsen T, Osterdal ML, Alexander J, et al. Mediterranean-type diet and risk of preterm birth among women in the Norwegian Mother and Child Cohort Study (MoBa): a prospective cohort study. Acta Obstet Gynecol Scand. 2008;87:319-24. DOI:

Schoenaker DA, Soedamah-Muthu SS, Mishra GD. The association between dietary factors and gestational hypertension and pre-eclampsia: a systematic review and meta-analysis of observational studies. BMC Med. 2014;12:157. DOI:

Nelson SM, Matthews P, Poston L. Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Hum Reprod Update. 2010;16:255-75. DOI:

Lin CJ, DeRoo LA, Jacobs SR, Sandler DP. Accuracy and reliability of self-reported weight and height in the Sister Study. Public Health Nutr. 2012;15:989-99. DOI:

Carrilho T, Rasmussen KM, Farias DR, Costa NC, Batalha MA, Reichenheim ME, et al.; Brazilian maternal and child nutrition consortium. Agreement between self-reported pre-pregnancy weight and measured first-trimester weight in Brazilian women. BMC Pregnancy Childbirth. 2020;20:734. DOI:




How to Cite

Teixeira B, Cardoso M, Dias CC, Pereira-da-Silva L, e Silva D. Eating Habits During Pregnancy of Women Giving Birth Very Prematurely: An Exploratory Analysis. Acta Med Port [Internet]. 2023 Mar. 6 [cited 2023 Jun. 1];:401-7. Available from: