Investigating relationships between maternal micronitrient intakes, dietary patterns and alcohol consumption during pregnancy
Background: Evidence from animal models of fetal alcohol spectrum disorders (FASD) suggests that the risk of ethanol-induced harm to the developing fetus is greater in the presence of inadequate maternal nutrition. Findings from observational studies in the general population have also indicated that heavy drinking is associated with poorer quality diets. Aims: The aims of this thesis were to explore relationships between patterns of alcohol consumption and dietary intake during pregnancy, and to investigate whether they influence the risk of adverse infant and childhood outcomes. Methods: Five interrelated studies were undertaken. The initial study involved the design and validation of a food frequency questionnaire (FFQ). This was followed by two cross-sectional studies to explore relationships between dietary intake and alcohol consumption in two different samples of pregnant women: 1) a small sample recruited from across the UK (n=350); 2) a secondary analysis of the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort (n=11,457). This was then followed by two further studies, which comprised of secondary analyses of the ALSPAC cohort to investigate whether relationships between diet and alcohol influence the risk of adverse offspring outcomes: 1) small for gestational age (SGA) (n=9,935); and 2) IQ scores at 8 years (n=5,557). Results: Results suggest that heavy drinking during pregnancy is associated with diets characterised by low intakes of fruit and vegetables, and high intakes of processed, fried foods, which showed weak correlation with important micronutrients. Women in quartile one for vitamin E intake, who reported binge drinking, were significantly more likely to have a SGA baby compared to women in other quartiles who also reported binge drinking during pregnancy. Micronutrient intakes were not associated with childhood IQ scores at 8 years in women who reported alcohol consumption during pregnancy. Conclusion: The investigations undertaken as part of this thesis have highlighted a number of new and important findings. The results highlighted the clustering of potentially harmful patterns of dietary intake and alcohol consumption during pregnancy, and suggest that the potential harm from antenatal alcohol consumption may be exacerbated in the presence of inadequate micronutrient intakes.
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