Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study

Thomson, RL; ENDIA Study Group; Brown, JD; Oakey, H; Palmer, K; Ashwood, P; Penno, MAS; McGorm, KJ; Battersby, R; Colman, PG; Craig, ME; Davis, EA; Huynh, T; Harrison, LC; Haynes, A; Sinnott, RO; Vuillermin, PJ; Wentworth, JM; Soldatos, G; Couper, JJ

Author(s): Thomson, RL; ENDIA Study Group; Brown, JD; Oakey, H; Palmer, K; Ashwood, P; Penno, MAS; McGorm, KJ; Battersby, R; Colman, PG; Craig, ME; Davis, EA; Huynh, T; Harrison, LC; Haynes, A; Sinnott, RO; Vuillermin, PJ; Wentworth, JM; Soldatos, G; Couper, JJ;
Details: Publication Year 2024-11,Volume 67,Issue #11,Page 2420-2432
Journal Title: Diabetologia
Abstract: AIMS/HYPOTHESIS: Dietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. The aim of this study was to investigate the relationship between dietary patterns and physical activity during pregnancy and maternal complications and birth outcomes in women with type 1 diabetes. We also compared dietary patterns in women with and without type 1 diabetes. METHODS: Diet was assessed in the third trimester using a validated food frequency questionnaire in participants followed prospectively in the multi-centre Environmental Determinants of Islet Autoimmunity (ENDIA) study. Dietary patterns were characterised by principal component analysis. The Pregnancy Physical Activity Questionnaire was completed in each trimester. Data for maternal and birth outcomes were collected prospectively. RESULTS: Questionnaires were completed by 973 participants during 1124 pregnancies. Women with type 1 diabetes (n=615 pregnancies with dietary data) were more likely to have a 'fresh food' dietary pattern than women without type 1 diabetes (OR 1.19, 95% CI 1.07, 1.31; p=0.001). In women with type 1 diabetes, an increase equivalent to a change from quartile 1 to 3 in 'fresh food' dietary pattern score was associated with a lower risk of pre-eclampsia (OR 0.37, 95% CI 0.17, 0.78; p=0.01) and premature birth (OR 0.35, 95% CI 0.20, 0.62, p<0.001). These associations were mediated in part by BMI and HbA(1c). The 'processed food' dietary pattern was associated with an increased birthweight (beta coefficient 56.8 g, 95% CI 2.8, 110.8; p=0.04). Physical activity did not relate to outcomes. CONCLUSIONS/INTERPRETATION: A dietary pattern higher in fresh foods during pregnancy was associated with sizeable reductions in risk of pre-eclampsia and premature birth in women with type 1 diabetes.
Publisher: Springer
Keywords: Humans; Pregnancy; Female; *Diabetes Mellitus, Type 1/immunology/epidemiology; Adult; *Diet; *Pregnancy Outcome; Surveys and Questionnaires; Prospective Studies; Pregnancy in Diabetics/immunology/epidemiology; Autoimmunity; Pre-Eclampsia/epidemiology/immunology; Premature Birth/epidemiology/immunology; Dietary Patterns; Birth outcomes; Pre-eclampsia; Pregestational diabetes; Pregnancy complications; Type 1 diabetes
Research Division(s): Population Health And Immunity
PubMed ID: 39222156
Publisher's Version: https://doi.org/10.1007/s00125-024-06259-5
Open Access at Publisher's Site: https://doi.org/10.1007/s00125-024-06259-5
Terms of Use/Rights Notice: Refer to copyright notice on published article.
Documents: s00125-024-06259-5.pdf - (1.00MB, application/pdf)

Creation Date: 2024-10-09 01:19:11

Last Modified: 2024-12-05 11:06:36