MATERNAL NUTRITION IN EARLY AND LATE PREGNANCY IN RELATION TO PLACENTAL AND FETAL GROWTH

Objective-To assess how nutrient intakes of mothers in early and late pregnancy influence placental and fetal growth. Design-Prospective obs ervational study. Setting-Princess Anne Maternity Hospital, Southampto n. Subjects-538 mothers who delivered at term. Main outcome measures-P lacental and birth weights adjusted for the infant's sex and duration of gestation. Results-Mothers who had high carbohydrate intakes in ear ly pregnancy had babies with lower placental and birth weights. Low ma ternal intakes of dairy and meat protein in late pregnancy were also a ssociated with lower placental and birth weights. Placental weight fel l by 49 g (95% confidence interval 16 g to 81 g; P=0.002) for each log g increase in intake of carbohydrate in early pregnancy and by 1.4 g (0.4 g to 2.4 g; P=0.005) for each g decrease in intake of dairy prote in in late pregnancy. Birth weight fell by 165 g (49 g to 282 g; P=0.0 05) for each log g increase in carbohydrate intake in early pregnancy and by 3.1 g (0.3 g to 6.0 g; P=0.03) for each g decrease in meat prot ein intake in late pregnancy. These associations were independent of t he mother's height and body mass index and of strong relations between the mother's birth weight and the placental and birth weights of her offspring. Conclusion-These findings suggest that a high carbohydrate intake in early pregnancy suppresses placental growth, especially if c ombined with a low dairy protein intake in late pregnancy. Such an eff ect could have long term consequences for the offspring's risk of card iovascular disease.