Association of Maternal Dietary Pattern and Neural Tube Defects; A Case-control Study in Addis Ababa, Ethiopia
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Date
2020-07
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Addis Abeba University
Abstract
Background: Neural Tube Defects (NTDs) are significant public health problems with complex
etiology. Maternal nutrition is one of the environmental factors to contribute to the etiology of
NTDs. This study aims to assess the relationship of diet with NTDs among pregnant women who
received antenatal care services in Zewditu Memorial Hospital.
Methods: We conducted a matched case-control study from January 1, 2020 to April 30, 2020 in
Zewditu Memorial hospital, Addis Ababa. A total of 252 pregnant women (63 cases and 189
controls) were included in the study. Pregnant women were matched on age, gestational age and
gravidity. We used a 70-item food frequency questionnaire to assess the dietary intake of pregnant
women. Factor analysis was used to identify major dietary patterns. Cases and controls were
confirmed by specialist gynecologists. Conditional logistic regression was used to assess the
association between dietary patterns and neural tube defects.
Result: We identified seven major dietary patterns using factor analysis: prudent pattern,
traditional pattern, western pattern, Mediterranean pattern, raw meat and alcohol pattern, refined
cereal and vegetable pattern and sugar and caffeine pattern. In the adjusted model, the odds of
having a fetus affected with NTDs was 83% lower among women who had high intake of prudent
pattern compared to those who had low intake (high vs. low intake: AOR=0.17; CI: 0.05 - 0.52).
Likewise, women with high intakes of Mediterranean pattern scores were less likely to have a fetus
affected with NTD (high vs. low intake: AOR=0.20; CI: 0.06 - 0.59). The odds of having NTDaffected
fetus was 3 times higher among women with high consumption of traditional pattern
scores (high vs. low intake: AOR=3.37; CI: 1.23 - 9.19) compared to those who with low
consumption. There was no statistically significant association between western pattern adherence
before pregnancy and neural tube defect in the adjusted model (high vs. low intake: AOR=1.40;
CI: 0.41 - 4.73)
Conclusion and recommendations: This study demonstrated that maternal adherence to high
intake of prudent and Mediterranean diets a year before pregnancy have protective effects against
NTDs. Conversely, pregnant women with high intake of traditional pattern one year prior to
pregnancy are more likely to have a fetus affected with NTDs. Promoting healthy diet prior to
pregnancy is one possible way to optimize reproductive outcomes. We suggest the application of dietary patterns as an approach to communicate healthy dietary choices to the public and formulate
dietary guidelines.
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Keywords
Maternal dietary pattern , Neural tube defects