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Dietary patterns and birth outcomes in the ELSPAC pregnancy cohort
  1. Ondřej Mikeš1,
  2. Anne Lise Brantsæter2,
  3. Helle Katrine Knutsen2,
  4. Liv Elin Torheim3,
  5. Julie Bienertová Vašků1,
  6. Tomáš Pruša1,4,
  7. Pavel Čupr1,
  8. Karel Janák2,
  9. Ladislav Dušek1,5,
  10. Jana Klánová1
  1. 1 RECETOX, Masaryk University Faculty of Science, Brno, Czech Republic
  2. 2 Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
  3. 3 Department of Nursing and Health Promotion, Norwegian Institute of Public Health, Oslo, Norway
  4. 4 Department of Public Health, Masaryk University Faculty of Medicine, Brno, Czech Republic
  5. 5 Institute of Biostatistics and Analyses, Masaryk University Faculty of Medicine, Brno, Czech Republic
  1. Correspondence to Dr Pavel Čupr, RECETOX, Masaryk University Faculty of Science, Brno 625 00, Czech Republic; pavel.cupr{at}


Objectives The aim of this study was to identify dietary patterns in a Czech pregnancy cohort established in the early postcommunist era and investigate associations between dietary patterns, maternal characteristics and birth outcomes.

Methods Pregnant women were recruited for the Czech part of the European Longitudinal Study of Pregnancy and Childhood. A self-reported questionnaire answered in late pregnancy was used to assess information about the weekly intake of 43 food items. Information about birth outcomes (birth weight, height, ponderal index, head circumference, cephalisation index, gestational length and Apgar score) was obtained from the National Registry of Newborns. Complete details on diet and birth outcomes were available for 4320 mother–infant pairs.

Results and conclusion The food items were aggregated into 28 variables and used for extraction of two dietary patterns by principal component factor analysis. The patterns were denoted ‘unhealthy’ and ‘healthy/traditional’ based on the food items with the highest factor loadings on each pattern. The ‘unhealthy’ pattern had high positive loadings on meat, processed food and confectionaries. In contrast, the ‘healthy/traditional’ pattern had high positive loadings on vegetables, dairy, fruits and wholemeal bread. Following adjustment for covariates, we found that high adherence to the unhealthy pattern (expressed as beta for 1 unit increase in pattern score), that is, the higher consumption of less healthy foods, was associated with lower birth weight: −23.8 g (95% CI −44.4 to −3.2) and length: −0.10 cm (95% CI −0.19 to −0.01) and increased cephalisation index: 0.91 μm/g (95% CI 0.23 to 1.60). The ‘healthy/traditional’ pattern was not associated with any birth outcomes. This study supports the recommendation to eat a healthy and balanced diet during pregnancy.

  • diet
  • pregnancy
  • birth weight
  • longitudinal studies

Data availability statement

Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data may be obtained from a third party and are not publicly available.

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  • Contributors The work presented here was carried out in collaboration between all authors. OM, ALB, JBV, HKK, LET, KJ, PČ and JK defined the design and research theme. OM and ALB evaluated the data inputs, analysed the data and coworked with JBV and TP on the results of the analyses. LD coevaluated the statistical approaches. All coauthors worked on the discussion and conclusion parts of the manuscript. OM had full access to all of the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. All authors have contributed to, read and approved the final manuscript. OM is the guarantor of the study.

  • Funding This study was supported by the Research Infrastructure RECETOX RI (No LM2018121) financed by the Ministry of Education, Youth and Sports, and Operational Programme Research, Development and Innovation—project CETOCOEN EXCELLENCE (No CZ.02.1.01/0.0/0.0/17_043/0009632) and CETOCOEN Plus (No CZ.02.1.01/0.0/0.0/15_003/0000469). This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 857340.

  • Disclaimer This publication reflects only the authors' view and the European Commission is not responsible for any use that may be made of the information it contains. The authors of this study (ie, not the ELSPAC Scientific Council) are responsible for the content of this publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.