(P15-161-20) Association Between Diet Quality & Rate of Gestational Weight Gain Among Pregnant Women in Dhulikhel, Nepal

Objectives: The National Academy of Medicine (NAM) guidelines recommend linear gestational weight gain (GWG) in the 2^nd and 3^rd trimester with appropriate rate defined based on pre-pregnancy BMI. Here we prospectively examined the association between diet quality and GWG rate from 2^nd to 3^rd trimester among women receiving prenatal care in a periurban hospital in Nepal.

Methods: A pilot cohort of singleton pregnant women (N=101; age 25.9±4.1 years) was recruited from a tertiary, periurban hospital in Nepal. In the 1st trimester, diet quality was assessed from the adapted Nepali version of the PrimeScreen questionnaire, which assigned diet quality scores (range 0-42; higher scores for better quality) based on consumption frequency of 12 healthy and 9 unhealthy food groups. The GWG rate was calculated as the measured weight at the early-to-mid 3^rd trimester (28-35 wks) minus the weight at 2^nd trimester (13-25 wks), divided by the number of weeks in between. Linear regression estimated the association between diet quality and GWG rate, adjusting for a priori covariates including age, education, ethnicity, pre-pregnancy BMI, and nausea/vomiting. The adequacy of GWG rate was also categorized as inadequate, adequate, or excessive using NAM guidelines.

Results: Most women were of normal (55.4%) or overweight (33.7%) BMI status pre-pregnancy. The mean GWG rate in mid-to-late pregnancy was 0.46±0.2 kg/wk and the mean diet quality score was 23.6±2.5. Based on pre-pregnancy BMI, 49.4% of women had excessive GWG rate, while nearly equal numbers had either adequate GWG or inadequate GWG rate. Pre-pregnancy BMI and GWG rate were inversely correlated (r=-0.21, p=0.049). Education level was positively associated with both GWG rate (p=0.01) and adequacy of GWG (p=0.02). There was no significant association between diet quality and the GWG rate [adjusted β (95% CI) = -0.02 (-0.05, 0.01); p=0.14]. The mean GWG rate was marginally lower (0.44 vs. 0.57 kg/wk; p=0.06) among those with high versus low (2+servings vs. 0-1 serving/wk) intake of red meat; similar findings were seen when comparing red meat intake between women with excessive versus adequate GWG (Cramer's V=0.2; p=0.06).

Conclusions: While overall diet quality is not related to GWG among Nepali women, a high intake of red meat may be a potential risk factor for excessive GWG in this population.

Funding Sources: Rutgers Global Health Institute