High intakes of vegetables and fruits before pregnancy shown to reduce the risk of babies being born undernourished

A new study (1) has found that eating a healthy diet, rich in vegetables and fruits, before and during pregnancy is associated with a reduced risk for babies being born “small for gestational age” or undernourished.  The time before pregnancy, and during pregnancy, is a time where eating healthily is crucial.  Making healthful food choices can impact both mother and baby.

The study (1) included women involved in the SCOPE “Screening for Pregnancy Endpoints” study.  This study comprises a large database of women from New Zealand, Australia, Manchester, London  and Cork and aims to develop screening tests for pre-eclampsia, ‘small for gestational age’ infants and spontaneous preterm births.

In this particular part of the research study (1) the scientists looked at mothers who had infants that were small for gestational age.  They divided the women into those  who had normal blood pressure and those who had high blood pressure in late pregnancy.  3513 women were involved, various measurements were taken of the foetus and information was collected about the mother including her own birthweight, her gynaecological history, socio-economic status, smoking history, alcohol consumption and diet.

Scientists discovered that a woman’s diet prior to becoming pregnant had a strong impact on the risk of babies being born ‘small for gestational age’ in women with normal blood pressure.  Specifically it was found that women who consumed a high intake of green leafy vegetables (defined as three or more portions of vegetables a day) were found to have a 50% reduction in ‘small for gestational age’ babies.  Women consuming low amounts of fruit (defined as less than one portion a week) had a 50% increase in ‘small for gestational age’ babies (1,2).  It was also found that women who had a high intake of oily fish  (at least 3 servings per week) had a 60% reduction in ‘small for gestational age’ babies.

Cigarette smoking at 15 weeks which was associated with a 30-60% increase in risk of small for gestational age babies for every five cigarettes smoked per day.

Professor Lesley McCowan, one of the study authors, said in a press release (2)These findings emphasise the influence of pre-pregnancy diet on the baby’s growth and are important as a number of the identified risk factors are amenable to public health interventions.”   It is thought that the nutrients found in vegetables and fruits, and the omega 3 fats found in oily fish, could be protective to the pregnant mother and her developing foetus.  However, this study is only an association study so it could be that women who consume a healthy diet also leady generally healthier lifestyles.

Professor McCowan also stated (2)SGA [small for gestational age] infants are more likely to be stillborn, to have complications in the newborn period and in later life. Less than one third of these at-risk babies are identified before birth in current antenatal practice. Improved identification of these vulnerable infants, by screening early in pregnancy, therefore has the potential to reduce stillbirths and complications in the newborn period”.   “In the SCOPE study, our findings show that the risk factors for the majority group of SGA infants with mothers with normal blood pressure included: low fruit intake (less than weekly) in the three months before pregnancy, cigarette smoking, increasing maternal age, daily vigorous (high intensity) exercise, being a tertiary student, and the pregnant woman being born with a low birthweight herself. Eating green leafy vegetables three or more times daily in the three months before pregnancy reduced the risk by 50% as did having a Rhesus negative blood group. Risk factors for SGA infants in mothers with high blood pressure included conception by in vitro fertilisation and previous early pregnancy loss”.

Professor Philip Steer editor of the journal in which the study is being published said (2)”The importance of taking up and maintaining a healthy lifestyle before and during pregnancy has repeatedly been shown, however we live in an era of fast and convenience foods which are attractive but bad for our health if eaten too often and to the exclusion of healthier options. This study emphasises the importance of good diet and nutrition. Unfortunately, many people find it difficult to resist the temptations of ‘junk’ food”.  He added “If more women can be persuaded to have a better diet during pregnancy, using the motivation of optimising their baby’s health, then as they are commonly in charge of the family diet, we could improve the health of the whole population. The take-home message is: Fewer take-aways, more fresh fruit and vegetables.

The important message is that women can make a difference to the outcome of their pregnancies.  Being motivated enough to change diet and lifestyle habits can really impact the health of mother and child.  Changes need not be drastic, working to include more vegetables and fruits into the daily diet and aiming to perhaps walk an extra 20minutes a day can have a positive influence on health.  These foundations can gradually be built upon.  Maintaining these healthful lifestyles long-term is important so realistic goals need to be set.

(1)McCowan L et al.  2010. Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG.   Article first published online: 6 OCT 2010 | DOI: 10.1111/j.1471-0528.2010.02737.x

(2)Press release.  06/10/10.  Fresh Fruits And Vegetables Consumed For Three Months Before Pregnancy Reduce Chances Of Baby Being Born Undernourished. http://www.bjog.org/details/news/858729/Fresh_fruits_and_vegetables_consumed_in_the_three_months_before_pregnancy_reduce.html


Written by Ani Kowal