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Dietary Habits and Supplement Use in Relation to National Pregnancy Recommendations: Data from the EuroPrevall Birth Cohort

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Abstract

Assessing maternal dietary habits across Europe during pregnancy in relation to their national pregnancy recommendations. A collaborative, multi-centre, birth cohort study in nine European countries was conducted as part of European Union funded EuroPrevall project. Standardised baseline questionnaire data included details of food intake, nutritional supplement use, exposure to cigarette smoke during pregnancy and socio-demographic data. Pregnancy recommendations were collected from all nine countries from the appropriate national organisations. The most commonly taken supplement in pregnancy was folic acid (55.6 % Lithuania–97.8 % Spain) and was favoured by older, well-educated mothers. Vitamin D supplementation across the cohort was very poor (0.3 % Spain–5.1 % Lithuania). There were significant differences in foods consumed in different countries during pregnancy e.g. only 2.7 % Dutch mothers avoided eating peanut, while 44.4 % of British mothers avoided it. Some countries have minimal pregnancy recommendations i.e. Lithuania, Poland and Spain while others have similar, very specific recommendations i.e. UK, the Netherlands, Iceland, Greece. Allergy specific recommendations were associated with food avoidance during pregnancy [relative rate (RR) 1.18 95 % CI 0.02–1.37]. Nutritional supplement recommendations were also associated with avoidance (RR 1.08, 1.00–1.16). Maternal dietary habits and the use of dietary supplements during pregnancy vary significantly across Europe and in some instances may be influenced by national recommendations.

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Acknowledgments

We thank all families who participated in the EuroPrevall birth cohort study and the medical and nursing staff at the obstetric departments of the participating hospitals, especially: GRE: P. Saxoni-Papageorgiou, P. Xepapadaki, K. Zannikos, A. Vasilopoulou, C. Michopoulou, C. Skordali (P y A Kyriakou Hospital); S. Gavrili, G. D. Vlachos (Alexandra Hospital); A. Malamitsi-Puchner, D. Hasiakos, L. Kontara (Areteion Hospital); N. Paparisteidis (Elena Venizelou Maternity Hospital, Athens, Greece); ICE: A.G. Gunnarsdottir, H. Sigurdardottir, G.L. Gudjonsdottir (Landspitali - The National University Hospital Reykjavik), prenatal care nurses at The Primary Health Care of the Reykjavik Capital Area (Reykjavik, Iceland); GER: S. Travis, S. Paschke-Goossens, S. Siegert, S. Dufour, A. Kafert, K. Dobberstein, G. Schulz, A. Rohrbach, A. Scholz, A. Reich, L. Grabenhenrich (Berlin, Germany); POL: L. Podciechowski (Polish Mother’s Memorial Hospital, Lodz, Poland); SPA: M. Martı´n-Esteban, S. Quirce, R. Gabriel, J. I. Larco, I. Bobolea, T. Cuevas (Madrid, Spain); UK: K. Foote, L. Gudgeon, T. Kemp, K. Scally, E. Gatrell, L. Bellis, A, Acqua, R. Kemp, T. Bryant (Southampton, UK); NL: Midwives, Zorggroep Almere, Department of Gynaecology and Obstetrics, Flevo Hospital Almere, N.v.d. Berg, De Kinderkliniek Almere, W.M.C. van Aalderen, L Hulshof, NCM Petrus Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital Academic Medical Center (Amsterdam, the Netherlands); LIT: Audrone Arlauskiene, Jolita Zakareviciene, Laura Stoskute-Malinauskiene (Lithuania); ITA: A. Martelli, P. Realini and F. Brandi (both from Allegria, the Italian Research Foundation for Childhood Allergy and Asthma), G.R. Bouygue, O. Mazzina, T. Sarratud, G. Pezzoli (Milan, Italy). This birth cohort study was conducted within the collaborative research initiative EuroPrevall, an integrated project funded by the European Commission under the 6th Framework Programme (FOOD-CT-2005-514000). The Icelandic birth cohort received additional funds by Landspitali - The National University Hospital of Iceland Science Fund and by GlaxoSmithKline, Iceland. Four study sites were funded outside of EuroPrevall: the United Kingdom birth cohort by the UK Food Standards Agency; the Lithuanian birth cohort by unrestricted grants from Grida and MSD; the Dutch birth cohort by unrestricted grants from Nutricia Advanced Medical Nutrition Netherlands, AstraZeneca Netherlands, TEVA Netherlands, and GlaxoSmithKline, Netherlands; and the Italian birth cohort by own hospital funds and Allegria—the Italian Research Foundation for Childhood Allergy and Asthma. None of the funding bodies had any influence on the study design, data analysis or manuscript preparation.

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Authors and Affiliations

  1. Clinical and Experimental Sciences Academic Unit, Level F, South Academic Block, Faculty of Medicine, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK

    E. M. Oliver, K. E. C. Grimshaw & G. Roberts

  2. Department of Paediatric Respiratory Medicine and Allergy, Emma Children’s Hospital Academic Medical Center, Amsterdam, The Netherlands

    A. A. Schoemaker & A. B. Sprikkelman

  3. Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany

    T. Keil & D. McBride

  4. Faculty of Nursing, University of Iceland, Reykjavík, Iceland

    H. S. Ragnarsdottir

  5. Department of Immunology, Landspitali - National University Hospital, Reykjavík, Iceland

    H. S. Ragnarsdottir

  6. Department of Paediatric Pneumology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany

    V. Trendelenburg & K. Beyer

  7. Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece

    E. Emmanouil

  8. Department of Allergy, Hospital la Paz, Madrid, Spain

    M. Reche & A. Fiandor

  9. Division of Allergy, Pediatric Department, Bambino Gesù Pediatric Hospitaln, Piazza S. Onofrio 4, Rome, Holy See, Vatican City, Italy

    A. Fiocchi & M. Busacca

  10. Department of Pediatrics, Clinical Immunology and Cardiology, Medical University of Lodz, Lodz, Poland

    A. Stanczyk-Przyluska

  11. Department of Fetal-Maternal Medicine and Gynecology, Polish Mothers Memorial Hospital Research Institute, Lodz, Poland

    J. Wilczynski

  12. Department of Immunology, Faculty of Medicine, Landspitali- National University of Iceland, Reykjavík, Iceland

    S. T. Sigurdardottir

  13. Faculty of Medicine, Vilnius University, Vilnius, Lithuania

    R. Dubakiene & O. Rudzeviciene

  14. Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece

    G. D. Vlaxos

  15. Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany

    T. Keil

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  1. E. M. Oliver
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  2. K. E. C. Grimshaw
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  4. T. Keil
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  6. A. B. Sprikkelman
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  7. H. S. Ragnarsdottir
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  16. S. T. Sigurdardottir
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  17. R. Dubakiene
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  18. O. Rudzeviciene
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  19. G. D. Vlaxos
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  20. K. Beyer
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  21. G. Roberts
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Corresponding author

Correspondence to E. M. Oliver.

Additional information

E. M. Oliver and K. E. C. Grimshaw have contributed equally to this work.

Appendices

Appendix 1

See Table 5.

Table 5 Change in food consumption during pregnancy
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Appendix 2

See Table 6.

Table 6 National pregnancy recommendations across Europe
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Appendix 3

See Tables 7 and 8.

Table 7 Factors associated with folic acid supplement use
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Table 8 Factors associated with Vitamin D supplement use
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Oliver, E.M., Grimshaw, K.E.C., Schoemaker, A.A. et al. Dietary Habits and Supplement Use in Relation to National Pregnancy Recommendations: Data from the EuroPrevall Birth Cohort. Matern Child Health J 18, 2408–2425 (2014). https://doi.org/10.1007/s10995-014-1480-5

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