Highly Processed Food Consumption, Maternal Sociodemographic Variables, and Pregnancy Outcomes

BACKGROUND: Maternal diet quality during pregnancy is an important modifiable, yet often overlooked, factor in pregnancy outcomes for both the pregnant individual and their baby. Dietary patterns in the United States are often linked to sociodemographic factors and include a significant proportion of highly processed foods (HPF), known contributors to adverse health outcomes. However, these relationships are poorly understood in pregnant populations. OBJECTIVES: The objectives of this retrospective observational study were to use Dietary Screener Questionnaire (DSQ) data to (a) explore the consumption of common HPFs during pregnancy, and (b) examine the relationships between HPF consumption and sociodemographic factors and maternal pregnancy outcomes. METHODS: We collected sociodemographic information, pregnancy outcomes, and DSQs capturing dietary intake during the previous 30 days from women who delivered their infants at a large metropolitan hospital in Boston, Massachusetts, between January 2019 and August 2021. We calculated descriptive statistics for sociodemographic, pregnancy outcome, and HPF intake data. We used separate linear regression models to examine associations between total HPF consumption and sociodemographic and pregnancy outcome variables; we further examined significant relationships with multivariable regression. RESULTS: Ninety-six women participated (most were White), privately insured, and not Hispanic/Latina. Women in this cohort consumed HPFs an average of 1.91 times each day. There was a trend towards lower total HPF consumption among Black/African American and Asian participants compared to White participants. Total HPF consumption was significantly lower among former smokers compared to those without a history of smoking and among participants diagnosed with gestational diabetes compared to those without diabetes. Conversely, participants with chronic hypertension consumed more HPFs than those without a hypertensive disorder. No other significant interactions were noted. DISCUSSION: Future research is needed to assess the relationships between HPF consumption, sociodemographic factors, and health outcomes across diverse populations of pregnant individuals. Obstetric clinicians, particularly nurses, should consider expanding pregnancy nutrition counseling to include methods such as a DSQ to reduce HPF intake.