Pregnant women who eat a “prudent” diet rich in vegetables, fruits, whole grains and who drink water have significantly reduced risk of preterm delivery, according to a study from researchers in Sweden, Norway and Iceland.

The study, published on 4 March 2014 in the British Medical Journal, also found that a “traditional” dietary pattern of boiled potatoes, fish and cooked vegetables was also linked to a significantly lower risk of preterm birth.

The researchers, Dr Linda Englund-Ögge, Ronny Myhre, Margareta Haugen, Anne Lise Brantsæter, Professor Helle Margrete Meltzer, Verena Sengpiel, Associate Professor Bryndis Eva Birgisdottir, and Professor Bo Jacobsson, said that although their findings could not establish causality, they supported dietary advice to pregnant women to eat a balanced diet including vegetables, fruit, whole grains, and fish and to drink water.

Preterm delivery (before 37 weeks of pregnancy) is associated with significant short and long term ill-health and accounts for almost 75 per cent of newborn death.

Study method

Evidence shows that a mother’s dietary habits can directly affect her unborn child, so the researchers set out to examine whether a link existed between maternal diet and preterm delivery.

Using data from the Norwegian Mother and Child Cohort Study, they analysed preterm births among 66,000 women between 2002 and 2008. To be included, participants had to be free of diabetes, have delivered a single baby and completed a validated food frequency questionnaire on their diet during the first four to five months of pregnancy. Factors that may have affected the results, including a mother’s age, history of preterm delivery and education were taken into account. Preterm delivery was defined as delivery between 22 and fewer than 37 weeks of pregnancy.

The researchers identified three distinct dietary patterns: “prudent” (vegetables, fruits, oils, water as a beverage, whole grain cereals, poultry, fibre rich bread), “Western” (salty and sweet snacks, white bread, desserts, processed meat products), and “traditional” (potatoes, fish, gravy, cooked vegetables, low fat milk).

Among the 66,000 pregnant women, preterm delivery occurred in 3,505 (5. 3 per cent) cases. After adjusting for several confounding factors, the team found that an overall “prudent” dietary pattern was associated with a significantly reduced risk of preterm delivery, especially among women having their first baby, as well as spontaneous and late preterm delivery. They also found a significantly reduced risk of preterm delivery for the “traditional” dietary pattern.

However, the “Western” dietary pattern was not independently associated with preterm delivery. The researchers said this indicated that increasing the intake of foods associated with a prudent dietary pattern is more important that totally excluding processed food, fast food, junk food, and snacks. They stressed that a direct (causal) link could not be drawn from their results, but said the findings suggested that “diet matters for the risk of preterm delivery, which may reassure medical practitioners that the current dietary recommendations are sound but also inspire them to pay more attention to dietary counselling”.

The researchers said the findings were important as prevention of preterm delivery was of “major importance” in modern obstetrics. They also indicated that preterm delivery might actually be modified by maternal diet.

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