Diet Quality and Weight Gain Among Women in the Aboriginal Family Birthing Program in South Australia

Background: This study assessed diet quality and the association between engagement with nutrition support bundles and weight gain among pregnant women having Aboriginal and Torres Strait Islander babies who participated in the Aboriginal Family and Baby Bundles implementation project at two South Australian maternity sites. Methods: Cross-sectional analysis of dietary data was performed using the Australian Recommended Food Score (ARFS) at enrolment, and 24-h food group servings were compared between enrolment and late pregnancy visits. A composite variable for engagement with nutrition support bundles (low vs. high engagement) used initiation, intensity, and duration of engagement criteria. Separate regression models were applied to examine associations between ARFS, adherence to 24-h food serve recommendations, and maternal characteristics at enrolment. An exploratory univariable association between engagement status and gestational weight gain was examined. Results: The median ARFS score at enrolment was 39 (maximum of 62 out of a total of 73). Women aged above 25 years showed significantly higher ARFS compared with those aged 25 years and below (adjusted β coefficient 3.28, 95% CI 0.38, 6.19, p = 0.027). The number of participants meeting the recommended intake of daily fruit serves increased significantly at the late pregnancy visit (McNemar test p value = 0.004). Across pregnancy, consumption of energy-dense soft drinks or snack foods was common (60–68%). Only 15.4% (8/52) of participants showed adequate weight gain, while 26.9% (14/52) showed inadequate weight gain, and 57.7% (30/52) showed excessive weight gain, as per the recommendations for total gestational weight gain. In the high nutrition support engagement group, a higher proportion of adequate weight gain (24.0% vs. 7.4%) and a lower proportion of excessive weight gain were observed (28.0% vs. 85.2%) (p ≤ 0.001) compared with the low engagement group. Conclusions: This study identified sub-optimal diet quality, including high intake of energy-dense food throughout pregnancy and high proportions of inadequate and excessive weight gain among women having Aboriginal babies in South Australia. Further research is needed to determine the most appropriate ways to support healthy eating in pregnancy among women in South Australia.