Influência da ingestão materna de nutrientes durante a gestação nos dados antropométricos do bebê ao nascimento

Abstract

Introduction: Maternal food intake during pregnancy, which could interfere in the baby anthropometric measurements at birth, represents one of the most important modifiable factors for child health. Therefore, a systematic review was performed, and a search without publication time limits was carried out in the Cinahl, Embase, Pubmed, Scopus, Web of Science databases, and a manual search in reference studies. The important pregnancy nutrients and the main baby anthropometric measurements at birth were included as descriptors. Observational studies in English, Portuguese and Spanish were included as well. The quality analysis of the studies was carried out in duplicate by two independent reviewers using the STROBE tool (STrengthening the Reporting of OBservational Studies in Epidemiology). The review included 30 articles, with 15.39 (SD 2.36) points of quality (maximum value: 22). 36 associations were found: 17 works with direct associations between nutrient intake and newborn anthropometric data; 8 with inverse associations and 11 articles showed no significant associations. Calcium, magnesium and vitamin C intake directly influenced the baby birth weight, while carbohydrate intake presented an inverse influence. Objective: To evaluate the influence of nutrients intake during pregnancy on the baby anthropometric measurements at birth. Methods: A cross-sectional study was performed with 626 mother-infant pairs hospitalized in a rooming-in unit of a reference public maternity in a Brazilian metropolis. Maternal food intake was measured through a validated food frequency questionnaire. A descriptive analysis and some tests were performed: Kolmogorov-Smirnov, T-Student, ANOVA, Spearman's correlations and multiple linear regression. The regression was adjusted by maternal energy intake, education, gestational age, physical activity, and supplementation during pregnancy. Results: Maternal intake of vitamins B3 and C was associated with birth weight increase (β=0.01; 95% CI 0.01–0.02; p=0.01 and β=0.01; CI 0.01–0.02; p=0.02, respectively). Higher maternal pre-pregnancy body mass index (β=0.01; 95% CI 0.01–0.02; p=0.001), gestational weight gain (β=0.02; 95% CI 0.01–0.02; p<0.001), parity (β=0.05; 95% CI 0.02–0.09; p=0.001) and male babies (β=0.08; 95% CI 0.01–0.02; p=0.02) also influenced birth weight positively (R²=0.27; p<0.001). There was no association with other nutrients (p>0.05). Conclusion: The systematic review showed a considerable influence of the intake of calcium, magnesium, vitamin C and carbohydrates on the baby birth weight. Moreover, the cross-sectional study detected a positive contribution of maternal intake of vitamins B3 and C to the same outcome, denoting the importance of nutritional counseling during pregnancy.