title: A vegetable, fruit, and white rice dietary pattern during pregnancy is associated with a lower risk of preterm birth and larger birth size in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study.
abstract: Maternal dietary patterns during pregnancy have been shown to influence infant birth outcomes. However, to our knowledge, only a few studies have examined the associations in Asian populations.
  
  
  
  We characterized maternal dietary patterns in Asian pregnant women and examined their associations with the risk of preterm birth and offspring birth size.
  
  
  
  At 26-28 wk of gestation, 24-h recalls and 3-d food diaries were collected from the women in the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort. Dietary patterns were derived from exploratory factor analysis. Gestational age was determined by a dating ultrasound scan in the first trimester, and infant birth anthropometric measurements were obtained from hospital records. Associations were assessed by logistic and linear regressions with adjustment for confounding factors.
  
  
  
  Three maternal dietary patterns were identified: vegetable, fruit, and white rice (VFR); seafood and noodle (SfN); and pasta, cheese, and processed meat (PCP). Of 923 infants, 7.6% were born preterm, 13.4% were born small for gestational age, and 14.7% were born large for gestational age. A greater adherence to the VFR pattern (per SD increase in VFR score) was associated with a lower risk of preterm births (OR: 0.67; 95% CI: 0.50, 0.91), higher ponderal index (β: 0.26 kg/m3; 95% CI: 0.06, 0.45 kg/m3), and increased risk of a large-for-gestational-age birth (RR: 1.31; 95% CI: 1.06, 1.62). No associations were observed for the SfN and PCP patterns in relation to birth outcomes.
  
  
  
  The VFR pattern is associated with a lower incidence of preterm birth and with larger birth size in an Asian population. The findings related to larger birth size warrant further confirmation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.
authors.affiliation: Departments of Obstetrics and Gynaecology.
authors.forename: Ai-Ru
authors.identifier: 0000-0003-1694-0235
authors.initials: AR
authors.lastname: Chia
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Jamie V
authors.initials: JV
authors.lastname: de Seymour
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Marjorelee
authors.initials: M
authors.lastname: Colega
authors.affiliation: Departments of Obstetrics and Gynaecology.
authors.forename: Ling-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Biostatistics Unit, Yong Loo Lin School of Medicine.
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Izzuddin M
authors.initials: IM
authors.lastname: Aris
authors.affiliation: Departments of Obstetrics and Gynaecology.
authors.forename: Mya-Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Phaik Ling
authors.initials: PL
authors.lastname: Quah
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Department of Paediatrics, KK Women's and Children's Hospital, Singapore.|Duke-National University of Singapore Graduate Medical School, Singapore; and.|Lee Kong Chian School of Medicine, Nanynag Technological University, Singapore.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, and.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Philip N
authors.initials: PN
authors.lastname: Baker
authors.affiliation: Departments of Obstetrics and Gynaecology.|Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Medicine, and.|Saw Swee Hock School of Public Health, National University of Singapore, and.
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Paediatrics and.|Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.|Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, and mary_chong@sics.a-star.edu.sg.|Clinical Nutrition Research Centre.|Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Mary Foong-Fong
authors.initials: MF
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D001724:Birth Weight; D004032:Diet; D015930:Diet Records; D005260:Female; D005638:Fruit; D006801:Humans; D007223:Infant; D039382:Maternal Nutritional Physiological Phenomena; D008875:Middle Aged; D015596:Nutrition Assessment; D012275:Oryza; D010349:Patient Compliance; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012846:Singapore; D016896:Treatment Outcome; D014675:Vegetables; D055815:Young Adult
keywords: birth weight; dietary patterns; large for gestational age; maternal diet; preterm birth