Dietary patterns of pregnant women, maternal excessive body weight and gestational diabetes
Padrões alimentares de gestantes, excesso de peso materno e diabetes gestacional
Rev. saúde pública (Online); 53 (), 2019
Publication year: 2019
ABSTRACT OBJECTIVE To investigate the relationship between the dietary patterns of pregnant women with maternal excessive body weight and gestational diabetes mellitus. METHODS A cross-sectional study conducted with a convenience sample of 785 adult pregnant women attended by the Unified Health System of Ribeirão Preto, state of São Paulo, between 2011 and 2012. Two 24-hour dietary recalls, corrected by the multiple source method, were employed . For the classification of the body mass index and the diagnosis of gestational diabetes mellitus, the criteria by Atalah and the World Health Organization were used, respectively. Dietary patterns were obtained by principal component analysis using the Varimax rotation method. The relationship between adherence to patterns, overweight and obesity was analyzed by multinomial logistic regression models and the relationship with gestational diabetes mellitus by adjusted unconditional logistic regression models.
RESULTS We identified four dietary patterns:
"traditional Brazilian"; "snacks"; "coffee" and "healthy". Women with a higher adherence to the "Healthy" (OR = 0.52; 95%CI 0.33-0.83) and "Brazilian Traditional" patterns (OR = 0.61; 95%CI 0.38-0.96) presented a lower chance of obesity, when compared to women with lower adherence, regardless of confounding factors. After adjustment for maternal excessive body weight, there was no association between dietary patterns and gestational diabetes mellitus. CONCLUSIONS Among the pregnant women, greater adherence to "traditional Brazilian" and "healthy" patterns was inversely associated with obesity, but no relationship was identified with gestational diabetes mellitus after adjusting for excessive body weight. Prospective studies are recommended to investigate the relationship between dietary patterns, overweight and gestational diabetes mellitus, reducing the chance of reverse causality.
RESUMO OBJETIVO Investigar a relação entre os padrões alimentares de gestantes com o excesso de peso materno e o diabetes mellitus gestacional. MÉTODOS Estudo transversal conduzido em uma amostra de conveniência de 785 gestantes adultas atendidas pelo Sistema Único de Saúde de Ribeirão Preto, SP, entre 2011 e 2012. Dois inquéritos recordatórios de 24 horas, corrigidos pelo multiple source method, foram empregados . Para a classificação do índice de massa corporal e do diagnóstico do diabetes mellitus gestacional, utilizou-se os critérios de Atalah e da Organização Mundial da Saúde, respectivamente. Os padrões alimentares foram obtidos por análise de componentes principais, utilizando o método de rotação Varimax . A relação entre a adesão aos padrões e sobrepeso e obesidade foi analisada por modelos de regressão logística multinomial e a relação entre adesão aos padrões e diabetes mellitus gestacional, por modelos de regressão logística não condicional ajustados.