title: Dietary intake and nutritional adequacy prior to conception and during pregnancy: a follow-up study in the north of Portugal.
abstract: OBJECTIVE
  To assess maternal diet and nutritional adequacy prior to conception and during pregnancy.
  
  
  METHODS
  Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.
  
  
  METHODS
  Antenatal clinics at two public hospitals in Porto, Portugal.
  
  
  METHODS
  Two hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.
  
  
  RESULTS
  Intakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83%), folate (58%) and Mg (19%). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91%, 88%, 73% and 21%, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6.5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.
  
  
  CONCLUSIONS
  The study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.
authors.affiliation: Department of Hygiene and Epidemiology, University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal. ecbpinto@med.up.pt
authors.forename: Elisabete
authors.initials: E
authors.lastname: Pinto
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.forename: Isabel
authors.initials: I
authors.lastname: dos Santos Silva