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Adherence to Nordic dietary patterns and risk of first-trimester spontaneous abortion

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Abstract

Purpose

Evidence on the influence of modifiable risk factors on spontaneous abortion (SAB) is scarce. We investigated associations for adherence to national dietary guidelines and a healthy Nordic diet with first-trimester (≤ 12 weeks’ gestation) SAB in a Danish cohort of couples trying to conceive.

Methods

Participants completed a questionnaire on sociodemographics, lifestyle and reproductive history and a validated food frequency questionnaire (FFQ). We ascertained pregnancies from follow-up questionnaires and restricted analyses to 3,043 women who became pregnant. We assessed adherence to the Danish Dietary Guidelines Index (DDGI, range of 0–6, from low to high), covering intake of fruit, vegetables, fish, red and processed meat, whole grains, saturated fat and added sugar. The Healthy Nordic Food Index (HNFI, range 0–6) covered intake of fish, cabbage, rye bread, apples, pears, root vegetables and oatmeal. Pregnancy outcomes were identified through Danish medical registries or self-reported. We used Cox proportional hazards regression to compute hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for sociodemographics and lifestyle.

Results

Fifteen percent of participants had a first-trimester SAB. Compared with a DDGI score < 3, adjusted HRs (95% CIs) for scores 3 to < 4, 4 to  < 5 and ≥ 5 were 0.85 (0.59–1.23), 0.78 (0.54–1.12) and 0.71 (0.44–1.13), respectively. Compared with an HNFI score < 2, adjusted HRs (95% CIs) for scores 2 to < 3, 3 to < 4, 4 to < 5 and ≥ 5 were 0.84 (0.62–1.15), 0.88 (0.66–1.19), 0.94 (0.69–1.28) and 0.69 (0.49–0.96), respectively.

Conclusion

Greater pre-pregnancy adherence to Danish dietary guidelines or a healthy Nordic diet was associated with a lower rate of first-trimester SAB, although estimates were imprecise.

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Acknowledgements

This study complies with Danish and European regulations about data protection and is registered with the Danish Data Protection Agency (Aarhus University Record Number: 2016-051-000001, # 431). Because the study did not include human tissue, separate ethical approval was not required. The study participants provided online informed consent at enrollment. We acknowledge the valuable contributions of Snartforældre.dk participants and staff. Snartforældre.dk was supported by National Institute of Child Health and Human Development (Grant Number: R01-HD086742).

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Correspondence to Anne Sofie Dam Laursen.

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Dr. Wise is a consultant on uterine fibroids and abnormal uterine bleeding for AbbVie, Inc. In the past three years, Dr. Wise has accepted in-kind donations for primary data collection for Pregnancy Study Online from FertilityFriend.com (fertility apps), Kindara.com (fertility apps), Sandstone Diagnostics (semen tests), LabCorp (semen tests), and Swiss Precision Diagnostics (home pregnancy tests). The remaining authors have no conflicts of interest to report.

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Laursen, A.S.D., Johannesen, B.R., Willis, S.K. et al. Adherence to Nordic dietary patterns and risk of first-trimester spontaneous abortion. Eur J Nutr 61, 3255–3265 (2022). https://doi.org/10.1007/s00394-022-02886-z

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