Abstract:
<jats:title>ABSTRACT</jats:title>
<jats:p>Babies born small-for-gestational age (SGA) have an increased risk of mortality, morbidity, and adverse functional consequences. Studies suggest that pre-pregnancy maternal diet may influence newborns’ size. This study aimed to determine whether maternal pre-pregnancy dietary patterns (DPs) are associated with delivering SGA newborns in the ProcriAr Cohort Study, Sao Paulo-Brazil. Pre-pregnancy DPs of 299 women were investigated using factor analysis with principal component’s estimation, based on intake reported on a validated 110-item food frequency questionnaire. Newborns were classified as SGA if their weight and/or length, adjusted by gestational age and sex, were below the 10<jats:sup>th</jats:sup> percentile of the INTERGROWTH-21<jats:sup>st</jats:sup> standards. Multivariate Poisson regression modelling with robust error variance was performed to examine associations between the different DPs (in quintiles) and SGA. In a model adjusted by maternal sociodemographic and health behaviours, women who scored in the highest quintile of the DP ‘Snacks, sandwiches, sweets and soft drinks’ (in relation to the women who scored in the lowest quintile), were significantly more likely to deliver SGA babies (Relative Risk, 95% Confidence Interval: 1.92; 1.08-3.39). This study verified that women’s pre-pregnancy dietary behaviour characterized by an energy-dense nutrient-poor food intake was a risk factor for delivering SGA newborns. Investments in education and improved access to healthful food and nutritional information before pregnancy should be prioritized due to its potential positive impact on child health. However, further studies are warranted to identify specific metabolic pathways that may be underlying these associations.</jats:p>