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. 2022 Jul 5;19(1):43.
doi: 10.1186/s12986-022-00678-0.

Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein

Jiaomei Yang  1 , Qianqian Chang  2 , Xueye Tian  3 , Binyan Zhang  2 , Lingxia Zeng  2 , Hong Yan  2   4   5 , Shaonong Dang  6 , Yue-Hua Li  7
Affiliations

Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein

Jiaomei Yang et al. Nutr Metab (Lond). .

Abstract

Background: Previous studies have yielded inconsistent results on the association between maternal dietary protein intake and birth weight. Moreover, little is known about the effects of dietary protein intake from different sources on fetal growth. This study aimed to investigate the associations of different dietary protein sources (total protein, animal protein, plant protein, and major dietary protein sources) during pregnancy with birth weight and the related adverse birth outcomes.

Methods: 7310 women were recruited using a stratified multistage random sampling method at 0-12 months (median: 3; 10-90th percentile: 0-7) after delivery in Shaanxi, China. Maternal diets were gathered by a validated FFQ and other characteristics were collected by a standard questionnaire. Multilevel linear or logistic regression models were used to estimate birth weight changes or ORs (95% CIs) for adverse birth outcomes associated with different dietary protein sources during pregnancy.

Results: The mean percentage of energy from total protein was 11.4% (SD 2.2), with only 27.4% of total protein derived from animal protein. Per 3% increase in energy from total protein, animal protein, and dairy protein was associated with birth weight increases of 19.4 g (95% CI 6.0-32.9), 20.6 g (4.8-36.5), and 18.2 g (4.7-31.7), respectively. Per 3% increase in energy from total protein, animal protein, and dairy protein was also associated with lower risks of low birth weight (LBW) (total protein: OR = 0.78, 95% CI 0.64-0.94; animal protein: 0.79, 0.65-0.96; dairy protein: 0.71, 0.56-0.91), small for gestational age (SGA) (total protein: 0.88, 0.79-0.98; animal protein: 0.87, 0.78-0.97; dairy protein: 0.81, 0.68-0.96), and intrauterine growth retardation (IUGR) (total protein: 0.84, 0.72-0.98; animal protein: 0.86, 0.75-0.98; dairy protein: 0.78, 0.66-0.92). We observed no associations of plant protein and other major dietary protein sources with birth weight and the above birth outcomes. The results did not change when maternal protein was substituted for fat or carbohydrate.

Conclusions: Among Chinese pregnant women with low intake of protein, higher intake of dietary protein, in particular animal protein and dairy protein, is associated with higher birth weight and lower risks of LBW, SGA, and IUGR.

Keywords: Birth weight; Fetal growth; Maternal protein intake; Pregnancy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Birth weight changes associated with per 3% increase in energy from dietary protein intake during pregnancy. Multilevel linear regression models were used to estimate changes and 95% CIs. Model 1 was adjusted for total energy intake, offspring sex, gestational age, and socio-demographic characteristics (including geographic area, residence, childbearing age, education, occupation, household wealth index, and parity). Model 2 was adjusted for all variables in Model 1 plus health-related characteristics (including passive smoking, alcohol drinking, antenatal check visit frequency, folate/iron supplements use, anemia, and medication use) and principal component score based on the nutrient intakes. Models were mutually adjusted for animal protein and plant protein. The black circles represent birth weight changes, and the vertical lines represent 95% CIs
Fig. 2
Fig. 2
Birth weight changes associated with per 3% increase in energy from major dietary protein sources during pregnancy. Multilevel linear regression models were used to estimate changes and 95% CIs. Models were adjusted for total energy intake, offspring sex, gestational age, socio-demographic characteristics (including geographic area, residence, childbearing age, education, occupation, household wealth index, and parity), health-related characteristics (including passive smoking, alcohol drinking, antenatal check visit frequency, folate/iron supplements use, anemia, and medication use), principal component score based on the nutrient intakes, and mutually adjusted for other major dietary protein sources. The black circles represent birth weight changes, and the vertical lines represent 95% CIs. *P = 0.008
Fig. 3
Fig. 3
Birth outcomes associated with per 3% increase in energy from major dietary protein sources during pregnancy. Multilevel logistic regression models were used to estimate ORs and 95% CIs. Models were adjusted for total energy intake, socio-demographic characteristics (including geographic area, residence, childbearing age, education, occupation, household wealth index, and parity), health-related characteristics (including passive smoking, alcohol drinking, antenatal check visit frequency, folate/iron supplements use, anemia, and medication use), principal component score based on the nutrient intakes, and mutually adjusted for other major dietary protein sources. Models for low birth weight were additionally adjusted for offspring sex and gestational age. The black boxes represent ORs, with the size inversely proportional to the variance of the logarithm of the OR, and the horizontal lines represent 95% CIs
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