Contributions of physical activity, diet and their composition in pregnancy to the development of foetal macrosomia

<p dir="ltr">Background: Foetal macrosomia has a global prevalence of 10% of pregnancies. Previous studies suggest a focus on the composition of maternal diet and physical activity in pregnancy, rather than quantity.</p><p dir="ltr">Aim: To determine the contributions of maternal physical activity, diet, and their composition in pregnancy to the development of foetal macrosomia.</p><p dir="ltr">Methods: The study was designed in two phases (systematic review and an observational cross-sectional study). A total of 292 free-living pregnant women were recruited for the cross-sectional observational study from the East of England, and lifestyle factors were compared with birth weight.</p><p dir="ltr">Results: Systematic review findings suggest links between specific components of maternal diet and physical activity, maternal serum biomarkers and epigenetic modification of the foetus to become macrosomic. Chi-squared analysis revealed no significant associations between foetal macrosomia and maternal physical activity. Significant associations were however found with maternal consumption of dairy products/food types including soft dairy [Chi-squared (df=6, N=292) =15.56, p>0.016], low fat spread [Chi-squared (df=6, N=292) = 15.34, p>0.018], very low fat spread [Chi-squared (df=4, N=292) = 9.70, p>0.046], milk puddings[Chi-squared (df=6, N=292) =15.47, p>0.017]), Cocoa/hot chocolate [Chi-squared (df=6, N=292) =16.12, p>0.013], and vitamin B12 [Chi-squared (df=6, N=292) =15.56, p>0.010]. Logistic regression analysis revealed that soft dairy consumption of 5-6 glasses per day increases the likelihood of having macrosomic babies [OR = 4.12 ]. Maternal cocoa/hot chocolate consumption 1-3 times per month reduced the likelihood of foetal macrosomia [OR = 0.13].</p><p dir="ltr">Conclusion: Lifestyle interventions for the prevention of foetal macrosomia should seriously consider the effects of the specific composition of maternal diet, particularly milk, soft dairy, low-fat spread, cocoa/hot chocolate and vitamin B12, on increasing the likelihood of having macrosomic babies.. Future studies on the topic should also focus on specific types of foods, particularly those highlighted by the findings of this observational cross-sectional study.</p>