ORIGINAL ARTICLE

Maternal nutritional risk factors for small for gestational age babies in a developed country: a case-control study

E A Mitchell¹, E Robinson², P M Clark¹, D M O Becroft^1,4, N Glavish⁵, N S Pattison⁴, J E Pryor⁶, J M D Thompson¹ and C J Wild³

¹ Department of Paediatrics, University of Auckland, Auckland, New Zealand
² Department of Community Health, Private Bag 92019, University of Auckland
³ Department of Statistics, University of Auckland
⁴ Department of Obstetrics & Gynaecology, University of Auckland
⁵ He Kamaka Oranga, Maori Health Management, Green Lane Hospital, Auckland
⁶ Department of Behavioural and Developmental Psychology, University of Auckland

Correspondence to:
Correspondence to:
Professor Mitchell
Department of Paediatrics, University of Auckland, Private Bag 92019, Auckland, New Zealand; e.mitchell{at}auckland.ac.nz

Aims: To assess the effect of maternal diet during pregnancy on the risk of delivering a baby who is small for gestational age (SGA).

Methods: Case-control study of 844 cases (SGA) and 870 controls (appropriate size for gestational age (AGA)). Only term (37+ completed weeks of gestation) infants were included. Retrospective food frequency questionnaires were completed at birth on the diet at the time of conception and in the last month of pregnancy.

Results: At the time of conception, mothers of AGA infants ate significantly more servings of carbohydrate rich food and fruit, and were more likely to have taken folate and vitamin supplements than mothers of SGA infants. There was some evidence that mothers of AGA infants also ate more servings of dairy products, meat, and fish (0.05 < p < 0.1). However, after adjustment for maternal ethnicity, smoking, height, weight, hypertension, and occupation, fish intake (p  =  0.04), carbohydrate-rich foods (p  =  0.04), and folate supplementation (p  =  0.02) were associated with a reduced risk of SGA. In the last month of pregnancy, only iron supplementation was associated with a reduced risk of SGA (p  =  0.05) after adjustment for potential confounders.

Conclusions: This study suggests that small variations in maternal diets within the normal range during pregnancy in developed countries are associated with differences in birth weight.

Abbreviations: AGA, appropriate size for gestational age; FFQ, food frequency questionnaire; SGA, small for gestational age

Keywords: small for gestational age; nutrition; risk factors; case-control study

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