Dietary Intake and Its Association with Birth Outcomes in Women with Nausea and Vomiting during the Second Trimester of Pregnancy: A Prospective Cohort Study in Japan
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Nausea and Vomiting in Pregnancy
3.2. Demographic Characteristics
3.3. Dietary Intake
3.4. Gestational Weight Gain, Low Birth Weight, and Preterm Birth
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All (n = 825) | No and Mild (n = 682) | Moderate and Severe (n = 143) | p | ||||
---|---|---|---|---|---|---|---|
Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | |||||
Gestational week while answering the questionnaire | 22.0 | (19.0–24.0) | 22.0 | (19.0–24.0) | 20.0 | (18.0–23.0) | <0.001 a |
Age (n = 790) | 34.0 | (31.0–38.0) | 34.0 | (31.0–38.0) | 34.0 | (31.0–38.0) | 0.959 a |
Parity | |||||||
Primipara | 432 | (52.4) | 352 | (51.6) | 80 | (55.9) | 0.358 b |
Multipara | 393 | (47.6) | 330 | (48.4) | 63 | (44.1) | |
Number of fetuses | |||||||
Singleton | 797 | (96.6) | 656 | (96.2) | 141 | (98.6) | 0.204 b |
Multiple | 28 | (3.4) | 26 | (3.8) | 2 | (1.4) | |
Pre-pregnancy BMI, kg/m2 (n = 822) | |||||||
<18.5 | 114 | (13.9) | 97 | (14.3) | 17 | (12.0) | 0.150 b |
18.5–24.9 | 601 | (73.1) | 502 | (73.8) | 99 | (69.7) | |
25.0–29.9 | 73 | (8.9) | 57 | (8.4) | 16 | (11.3) | |
≥30.0 | 34 | (4.1) | 24 | (3.5) | 10 | (7.0) | |
Marital status | |||||||
Married | 810 | (98.2) | 673 | (98.7) | 137 | (95.8) | 0.031 b |
Not married | 15 | (1.8) | 9 | (1.3) | 6 | (4.2) | |
Education | |||||||
Junior high/High school | 100 | (12.1) | 81 | (11.9) | 19 | (13.3) | 0.468 b |
Vocational training school or junior college | 207 | (25.1) | 165 | (24.2) | 42 | (29.4) | |
College | 445 | (53.9) | 373 | (54.7) | 72 | (50.3) | |
Postgraduate | 73 | (8.8) | 63 | (9.2) | 10 | (7.0) | |
Work | |||||||
Yes | 533 | (64.6) | 435 | (63.8) | 98 | (68.5) | 0.292 b |
No | 292 | (35.4) | 247 | (36.2) | 45 | (31.5) | |
Household income | |||||||
<7 million yen | 402 | (48.7) | 330 | (48.4) | 72 | (50.3) | 0.713 b |
≥7 million yen | 423 | (51.3) | 352 | (51.6) | 71 | (49.7) | |
Smoking during pregnancy | |||||||
No | 796 | (96.5) | 654 | (95.9) | 142 | (99.3) | 0.045 b |
Yes | 29 | (3.5) | 28 | (4.1) | 1 | (0.7) | |
City | |||||||
Yamagata | 159 | (19.3) | 139 | (20.4) | 20 | (14.0) | 0.127 b |
Tokyo | 292 | (35.4) | 239 | (35.0) | 53 | (37.1) | |
Osaka | 223 | (27.0) | 187 | (27.4) | 36 | (25.2) | |
Fukuoka | 151 | (18.3) | 117 | (17.2) | 34 | (23.8) |
All (n = 755) | No and Mild (n = 634) | Moderate and Severe (n = 121) | p | |
---|---|---|---|---|
Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | ||
Energy (kcal) | 1494.0 (1278.1–1767.3) | 1493.2 (1279.7–1765.8) | 1501.0 (1250.3–1779.5) | 0.902 |
Protein (g/kg of body mass) | 1.0 (0.8–1.2) | 1.0 (0.8–1.2) | 1.0 (0.8–1.1) | 0.573 |
Magnesium (mg/1000 kcal) | 122.6 (107.3–138.9) | 122.7 (107.1–139.5) | 121.6 (108.2–136.5) | 0.944 |
Iron (mg/1000 kcal) | 3.9 (3.4–4.5) | 3.8 (3.3–4.5) | 3.9 (3.4–4.5) | 0.797 |
Zinc (mg/1000 kcal) | 4.4 (4.1–4.8) | 4.4 (4.1–4.8) | 4.4 (4.0–4.8) | 0.607 |
Copper (mg/1000 kcal) | 0.6 (0.5–0.7) | 0.6 (0.5–0.7) | 0.6 (0.6–0.7) | 0.355 |
Vitamin B1 (mg/1000 kcal) | 0.4 (0.4–0.5) | 0.4 (0.4–0.5) | 0.4 (0.4–0.5) | 0.666 |
Vitamin B2 (mg/1000 kcal) | 0.7 (0.6–0.8) | 0.7 (0.6–0.8) | 0.6 (0.5–0.7) | 0.179 |
Vitamin B6 (mg/1000 kcal) | 0.6 (0.5–0.7) | 0.6 (0.5–0.7) | 0.6 (0.5–0.7) | 0.766 |
Vitamin B12 (mg/1000 kcal) | 3.4 (2.5–4.8) | 3.4 (2.5–4.7) | 3.6 (2.5–5.4) | 0.215 |
Folate (mg/1000 kcal) | 154.3 (126.1–189.5) | 155.8 (124.9–190.9) | 150.9 (127.9–180.7) | 0.542 |
Vitamin C (mg/1000 kcal) | 56.5 (41.0–73.7) | 56.5 (41.2–73.1) | 57.0 (40.4–77.8) | 0.635 |
All (n = 755) | No and Mild (n = 634) | Moderate and Severe (n = 121) | p | |
---|---|---|---|---|
Median (Q1–Q3) | Median (Q1–Q3) | Median (Q1–Q3) | ||
Rice | 158.7 (104.2–201.3) | 160.9 (104.9–202.3) | 148.3 (101.1–200.6) | 0.372 |
Bread | 19.6 (11.7–33.9) | 19.8 (11.6–33.9) | 19.3 (12.3–33.6) | 0.670 |
Noodles | 38.4 (24.2–59.8) | 36.9 (23.7–56.7) | 48.6 (28.4–72.9) | <0.001 |
Bean | 28.1 (16.1–43.7) | 28.8 (15.9–44.8) | 26.7 (16.8–38.8) | 0.302 |
Vegetables | 110.6 (80.6–151.9) | 111.2 (81.7–154.0) | 106.1 (73.9–141.3) | 0.133 |
Pickled vegetables | 2.1 (0.0–6.4) | 2.0 (0.0–6.0) | 3.1 (0.8–7.9) | 0.013 |
Fruit | 44.4 (0.0–39.9) | 43.9 (0.0–39.4) | 45.4 (0.0–42.5) | 0.576 |
Seaweed | 3.0 (1.4–7.0) | 3.0 (1.4–7.0) | 3.1 (1.4–7.0) | 0.965 |
Red meat | 20.2 (15.7–26.1) | 20.1 (15.5–26.0) | 20.8 (16.1–26.2) | 0.727 |
Processed meat | 20.2 (15.7–26.1) | 20.1 (15.5–26.0) | 20.8 (16.1–26.2) | 0.727 |
Egg | 17.8 (12.3–28.6) | 17.5 (12.3–28.1) | 18.9 (12.6–29.9) | 0.489 |
Alcohol | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.0 (0.0–0.0) | 0.620 |
Tea | 14.0 (0.0–56.7) | 12.7 (0.0–53.7) | 19.3 (0.0–76.4) | 0.031 |
Juice | 42.7 (11.4–89.7) | 36.9 (10.4–85.4) | 65.7 (23.2–122.8) | <0.001 |
Coffee | 6.5 (0.0–39.9) | 6.3 (0.0–39.4) | 6.8 (0.0–42.5) | 0.612 |
All (n = 825) | No and Mild (n = 682) | Moderate and Severe (n = 143) | p | ||||
---|---|---|---|---|---|---|---|
Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | |||||
Number of meals including snack | 4.0 | (3.0–4.0) | 4.0 | (3.0–4.0) | 4.0 | (3.0–4.0) | 0.210 a |
Skip breakfast | |||||||
Yes | 147 | (17.8) | 110 | (16.1) | 37 | (25.9) | 0.008 b |
No | 678 | (82.2) | 572 | (83.9) | 106 | (74.1) | |
Skipped meal (weekday) | |||||||
Yes | 199 | (24.1) | 150 | (22.0) | 49 | (34.3) | 0.003 b |
No | 626 | (75.9) | 532 | (78.0) | 94 | (65.7) | |
Check label: nutrients | |||||||
Yes | 496 | (60.1) | 421 | (61.7) | 75 | (52.4) | 0.048 b |
No | 329 | (39.9) | 261 | (38.3) | 68 | (47.6) | |
Check label: calories | |||||||
Yes | 495 | (60.0) | 417 | (61.1) | 78 | (54.5) | 0.159 b |
No | 330 | (40.0) | 265 | (38.9) | 65 | (45.5) | |
Prepare meals | |||||||
by self | 692 | (92.1) | 575 | (91.9) | 117 | (93.6) | 0.589 b |
the others | 59 | (7.9) | 51 | (8.1) | 8 | (6.4) |
All | No and Mild | Moderate and Severe | p | ||||
---|---|---|---|---|---|---|---|
Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | Median (Q1–Q3) or n (%) | |||||
Total GWG (n = 684) (kg) | 9.9 | (7.8–12.0) | 10.0 | (7.9–12.1) | 9.0 | (6.4–11.4) | 0.007 a |
Pre–pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 94) | 10.4 | (8.4–12.0) | 10.0 | (8.7–12.0) | 9.8 | (7.5–12.0) | 0.415 a |
18.5–24.9 (n = 500) | 10.1 | (8.0–12.1) | 10.1 | (8.1–12.3) | 9.6 | (7.2–11.4) | 0.050 a |
25.0–29.9 (n = 58) | 7.6 | (4.4–11.6) | 7.8 | (3.2–11.1) | 5.8 | (3.3–10.1) | 0.824 a |
≥30.0 (n = 30) | 6.7 | (2.8–8.7) | 7.7 | (2.6–10.7) | 5.2 | (3.5–8.0) | 0.689 a |
GWG (kg) | |||||||
1st trimester (around 12 week, n = 603) | 0.3 | (−1.0–1.6) | 0.5 | (−0.8–1.7) | −0.3 | (−2.0–0.9) | <0.001 a |
Pre-pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 84) | 0.7 | (−0.4–1.7) | 0.8 | (−0.4–1.8) | 0.4 | (−1.0–1.1) | 0.171 a |
18.5–24.9 (n = 434) | 0.4 | (−0.9–1.6) | 0.5 | (−0.8–1.7) | −0.2 | (−1.8–0.9) | 0.003 a |
25.0–29.9 (n = 53) | −0.3 | (−2.8–1.8) | −0.2 | (−2.9–2.1) | −0.9 | (−3.2–1.0) | 0.273 a |
≥30.0 (n = 30) | −0.9 | (−3.7–0.4) | −0.8 | (−4.0–0.4) | −1.1 | (−3.1–1.6) | 0.722 a |
2nd trimester (around 24 week, n = 644) | 4.1 | (2.1–6.0) | 4.1 | (2.4–6.0) | 3.4 | (0.7–5.6) | 0.002 a |
Pre-pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 86) | 4.6 | (2.4–6.4) | 4.7 | (2.9–6.7) | 4.0 | (2.1–5.7) | 0.387 a |
18.5–24.9 (n = 471) | 4.3 | (2.4–6.0) | 4.3 | (2.5–6.0) | 3.4 | (1.0–5.7) | 0.008 a |
25.0–29.9 (n = 55) | 2.8 | (0.3–5.2) | 2.8 | (0.6–5.5) | 3.2 | (−0.4–5.6) | 0.862 a |
≥30.0 (n = 30) | 0.6 | (−1.5–3.8) | 0.6 | (−1.8–3.6) | 0.0 | (−1.4–3.8) | 0.929 a |
Insufficient GWG (n = 654) | |||||||
Yes | 337 | (51.5) | 271 | (50.5) | 66.0 | (56.4) | 0.262 b |
No | 317 | (48.5) | 266 | (49.5) | 51.0 | (43.6) | |
GWG increase rate (kg/week) | |||||||
Through pregnancy (n = 684) | 0.26 | (0.20–0.31) | 0.26 | (0.21–0.32) | 0.24 | (0.17–0.30) | 0.009 a |
Pre-pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 94) | 0.27 | (0.22–0.32) | 0.27 | (0.22–0.32) | 0.27 | (0.20–0.31) | 0.509 a |
18.5–24.9 (n = 497) | 0.26 | (0.21–0.31) | 0.26 | (0.21–0.32) | 0.25 | (0.19–0.30) | 0.050 a |
25.0–29.9 (n = 58) | 0.20 | (0.11–0.30) | 0.21 | (0.14–0.31) | 0.15 | (0.08–0.30) | 0.817 a |
≥30.0 (n = 30) | 0.17 | (0.07–0.24) | 0.19 | (0.07–0.27) | 0.13 | (0.09–0.20) | 0.625 a |
1st trimester (around 12 week, n = 603) | 0.03 | (−0.07–0.12) | 0.03 | (−0.06–0.13) | −0.02 | (−0.15–0.08) | <0.001 a |
Pre-pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 84) | 0.05 | (−0.03–0.12) | 0.05 | (−0.03–0.13) | 0.03 | (−0.08–0.07) | 0.177 a |
18.5–24.9 (n = 434) | 0.03 | (−0.07–0.12) | 0.04 | (−0.06–0.13) | −0.01 | (−0.13–0.08) | 0.005 a |
25.0–29.9 (n = 53) | −0.03 | (−0.21–0.12) | −0.01 | (−0.20–0.14) | −0.08 | (−0.26–0.07) | 0.230 a |
≥30.0 (n = 30) | −0.07 | (−0.28–0.03) | −0.06 | (−0.32–0.03) | −0.11 | (−0.25–0.14) | 0.790 a |
1st to 2nd trimester (around 12–24 week, n = 566) | 0.36 | (0.27–0.46) | 0.36 | (0.27–0.46) | 0.36 | (0.25–0.45) | 0.438 a |
Pre-pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 76) | 0.41 | (0.29–0.48) | 0.41 | (0.30–0.49) | 0.40 | (0.28–0.46) | 0.678 a |
18.5–24.9 (n = 407) | 0.37 | (0.28–0.46) | 0.36 | (0.28–0.46) | 0.38 | (0.28–0.46) | 0.572 a |
25.0–29.9 (n = 51) | 0.29 | (0.20–0.41) | 0.28 | (0.17–0.42) | 0.29 | (0.22–0.42) | 0.559 a |
≥30.0 (n = 30) | 0.24 | (0.05–0.38) | 0.30 | (0.09–0.46) | 0.20 | (0.04–0.25) | 0.114 a |
Birth weight (n = 743) (g) | 3020.0 | (2752.0–3288.0) | 3024.0 | (2751.0–3291.0) | 3000.0 | (2751.5–3223.0) | 0.482 c |
Pre-pregnancy BMI (kg/m2) | |||||||
<18.5 (n = 102) | 2950.0 | (2669.5–3206.5) | 2956.0 | (2657.5–3208.5) | 2880.0 | (2702.5–3086.5) | 0.956 c |
18.5–24.9 (n = 541) | 3024.0 | (2766.0–3294.0) | 3024.0 | (2764.0–3307.0) | 3006.0 | (2772.0–3199.5) | 0.407 c |
25.0–29.9 (n = 66) | 3112.0 | (2792.0–3314.3) | 3130.0 | (2822.5–3288.0) | 3000.0 | (2713.0–3339.8) | 0.782 c |
≥30.0 (n = 32) | 3150.0 | (2868.0–3381.5) | 3146.0 | (2797.0–3350.0) | 3146.0 | (2797.0–3350.0) | 0.711 c |
Low birth weight <2500 g | |||||||
Yes | 48 | (7.0) | 36 | (6.5) | 12.0 | (9.5) | 0.246 b |
No | 635 | (93.0) | 521 | (93.5) | 114.0 | (90.5) | |
Delivery week (n = 736) | 39.0 | (38.0–40.0) | 39.0 | (38.0–40.0) | 39.0 | (37.0–40.0) | 0.783 a |
Preterm birth <37 w | |||||||
Yes | 52 | (7.1) | 44 | (7.3) | 8.0 | (6.0) | 0.604 b |
No | 684 | (92.9) | 558 | (92.7) | 126.0 | (94.0) |
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Nishihara, N.; Haruna, M.; Usui, Y.; Yonezawa, K.; Hikita, N.; Sasagawa, E.; Nakano, K.; Tanaka, M.; Ohori, R.; Aoyama, S.; et al. Dietary Intake and Its Association with Birth Outcomes in Women with Nausea and Vomiting during the Second Trimester of Pregnancy: A Prospective Cohort Study in Japan. Nutrients 2023, 15, 3383. https://doi.org/10.3390/nu15153383
Nishihara N, Haruna M, Usui Y, Yonezawa K, Hikita N, Sasagawa E, Nakano K, Tanaka M, Ohori R, Aoyama S, et al. Dietary Intake and Its Association with Birth Outcomes in Women with Nausea and Vomiting during the Second Trimester of Pregnancy: A Prospective Cohort Study in Japan. Nutrients. 2023; 15(15):3383. https://doi.org/10.3390/nu15153383
Chicago/Turabian StyleNishihara, Nao, Megumi Haruna, Yuriko Usui, Kaori Yonezawa, Naoko Hikita, Emi Sasagawa, Keiko Nakano, Moeko Tanaka, Riko Ohori, Satoko Aoyama, and et al. 2023. "Dietary Intake and Its Association with Birth Outcomes in Women with Nausea and Vomiting during the Second Trimester of Pregnancy: A Prospective Cohort Study in Japan" Nutrients 15, no. 15: 3383. https://doi.org/10.3390/nu15153383