Predictors of infant birth weights: Role of the Lebanese mediterranean diet, psychosocial factors and maternal health status

Abstract

Background The Mediterranean diet (MeD) is associated with favorable pregnancy outcomes, but contribution of this dietary pattern during pregnancy with small (SGA), appropriate (AGA) and large (LGA) for gestational age births is limited. Methods For this prospective national cohort study 618 Lebanese pregnant women were recruited. Infant birth weight was categorized into SGA (n = 73), AGA (n = 447) and LGA (n = 98). Modifiers of birth weight outcomes included dietary adherence to Lebanese MeD (LMeD), trimestral and total weight gain, MAP (mean arterial pressure) and PP (pulse pressure) and psychosocial, socio-demographic, and maternal health factors. Descriptive statistics compared differences among SGA, AGA, and LGA infants. Hierarchical linear regression modeling identified determinants for birth weight categories and hierarchical logistic regression modeling was used to identify factors associated with increasing the likelihood of SGA or LGA compared to AGA births. Results Adherence to the LMeD was associated with AGA birth weights where intakes of dairy products were associated with lower normal AGA births and dried fruits with higher normal AGA births. Adherence to LMeD did not enter models for SGA or LGA but intakes of specific foods and maternal health status indicators did. For SGA infants, appropriate gestational weight gain (GWG) mitigated against a low birth weight whereas higher burghul intake in T1 and higher MAP in T2 and T3 were linked to increased SGA risk. For LGA infants, greater parity, previous macrosomia and poor sleep quality in T3, and higher intake of olive oil in T2 were associated with higher risk of a LGA birth whereas higher PP in T1 decreased the odds of a LGA birth. Conclusions Screening for family history of diabetes and macrosomia, targeting trimester-specific gestational weight gain, monitoring maternal blood pressure, pulse pressure, and sleep quality, and promoting adherence to the Lebanese Mediterranean diet are important strategies to optimize infant birth outcomes.