title: Prepregnancy dietary patterns and risk of pregnancy loss.
abstract: BACKGROUND
  Two previous case-control studies observed associations between specific food groups and risk of miscarriage; however, to our knowledge, no previous studies have investigated dietary patterns and risk of pregnancy loss.
  
  
  OBJECTIVE
  We aimed to assess prepregnancy adherence to the alternate Healthy Eating Index 2010 (aHEI-2010), alternate Mediterranean diet (aMED), and Fertility Diet (FD) and risk of pregnancy loss.
  
  
  METHODS
  Our prospective cohort study included 15,950 pregnancies reported by 11,072 women in the Nurses' Health Study II between 1992 and 2009. Diet was assessed every 4 y starting in 1991 by using a validated food-frequency questionnaire. Prepregnancy dietary pattern scores were computed as the sum of a woman's score on each pattern's predefined components. Multivariable log-binomial regression models with generalized estimating equations were used to estimate RRs and 95% CIs.
  
  
  RESULTS
  Incident spontaneous abortions and stillbirths were reported in 2756 (17.3%) and 120 (0.8%) pregnancies, respectively. None of the 3 dietary patterns were associated with risk of pregnancy loss. In the multivariable model, RR of pregnancy loss for a 1-SD increase in score was 1.02 (95% CI: 0.98, 1.05) for the aMED pattern, 1.01 (95% CI: 0.98, 1.05) for the aHEI-2010 pattern, and 0.98 (95% CI: 0.95, 1.01) for the FD pattern. Results were consistent when pregnancy loss was classified as either a spontaneous abortion (loss at <20 wk) or a stillbirth (loss at ≥20 wk).
  
  
  CONCLUSIONS
  Prepregnancy adherence to several dietary patterns was not associated with risk of pregnancy loss.
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: Gaskins
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Janet W
authors.initials: JW
authors.lastname: Rich-Edwards
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Alan
authors.initials: A
authors.lastname: Penzias
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.affiliation: From the Departments of Nutrition (AJG, MWG, and JEC), Epidemiology (AJG, JWR-E, RH, PLW, SAM, and JEC), Environmental Health (RH), and Biostatistics (PLW), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine (JWR-E, SAM, and JEC) and Connors Center for Women's Health and Gender Biology (JWR-E), Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Biology (SAM), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA (MWG); the Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (AP); and Boston In Vitro Fertilization, Waltham, MA (AP).
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Chavarro
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D004032:Diet; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D039382:Maternal Nutritional Physiological Phenomena; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult