title: Maternal dietary patterns and preterm delivery: results from large prospective cohort study.
abstract: OBJECTIVE
  To examine whether an association exists between maternal dietary patterns and risk of preterm delivery.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Norway, between 2002 and 2008.
  
  
  METHODS
  66 000 pregnant women (singletons, answered food frequency questionnaire, no missing information about parity or previously preterm delivery, pregnancy duration between 22+0 and 41+6 gestational weeks, no diabetes, first enrolment pregnancy).
  
  
  METHODS
  Hazard ratio for preterm delivery according to level of adherence to three distinct dietary patterns interpreted as "prudent" (for example, vegetables, fruits, oils, water as beverage, whole grain cereals, fibre rich bread), "Western" (salty and sweet snacks, white bread, desserts, processed meat products), and "traditional" (potatoes, fish).
  
  
  RESULTS
  After adjustment for covariates, high scores on the "prudent" pattern were associated with significantly reduced risk of preterm delivery hazard ratio for the highest versus the lowest third (0.88, 95% confidence interval 0.80 to 0.97). The prudent pattern was also associated with a significantly lower risk of late and spontaneous preterm delivery. No independent association with preterm delivery was found for the "Western" pattern. The "traditional" pattern was associated with reduced risk of preterm delivery for the highest versus the lowest third (hazard ratio 0.91, 0.83 to 0.99).
  
  
  CONCLUSIONS
  This study showed that women adhering to a "prudent" or a "traditional" dietary pattern during pregnancy were at lower risk of preterm delivery compared with other women. Although these findings cannot establish causality, they support dietary advice to pregnant women to eat a balanced diet including vegetables, fruit, whole grains, and fish and to drink water. Our results indicate that increasing the intake of foods associated with a prudent dietary pattern is more important than totally excluding processed food, fast food, junk food, and snacks.
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, SE-41685 Gothenburg, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Englund-Ögge
authors.forename: Anne Lise
authors.initials: AL
authors.lastname: Brantsæter
authors.forename: Verena
authors.initials: V
authors.lastname: Sengpiel
authors.forename: Margareta
authors.initials: M
authors.lastname: Haugen
authors.forename: Bryndis Eva
authors.initials: BE
authors.lastname: Birgisdottir
authors.forename: Ronny
authors.initials: R
authors.lastname: Myhre
authors.forename: Helle Margrete
authors.initials: HM
authors.lastname: Meltzer
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult