Dietary Patterns In Pregnancy, Breastfeeding And Mental Development In Infants: A Population-based Cohort Study

Objectives To examine the association between dietary pattern during pregnancy,breastfeeding practices and intelligence development of infants aged6to30months,and to provide guide for pregnant women on diet and breastfeeding practices, in orderto provide evidence for promoting intellectual development in Infants.Methods A population-based birth cohort was established in Ma’anshan city ofAnhui province as part of the China-Anhui Birth Cohort Study (C-ABCS). A total of5084women were recruited in the1st and2nd trimesters of pregnancy. Informationsabout sociodemographic data, diet, breastfeeding were collected by self-administerquestionnaire. Trained psychologists assessed intelligence development of2838infants aged6~30months by using the neuropsychological development examinationtable for children aged0~6years old and the revised version of Bayley Scales ofInfant Development in China (BSID-CR). Principal component analysis (PCA) wasused to identify dietary patterns based on the FFQ. Five factor scores werecategorized into tertiles and the lowest category of intake was the reference category.Binary logistic regression models were further formed to estimate the associationsbetween dietary pattern, feeding patterns, duration of breastfeeding and intelligencedevelopment of children.Results Five major dietary patterns were summarized and labeled as ‘animalprotein’,‘healthy’ and ‘traditional’,‘processed’ and ‘caffeine’. About7.4%of infantsunder six months of age are exclusively breastfed rate and10.5%of infants under sixmonths of age are almost exclusive breastfeeding. After adjusting for confounders,binary logistic regression analyses revealed that high intake of ‘animal protein’ diet was negatively associated with fine motor development quotient, the odds ratio were0.79(95%CI:0.62to0.99);‘healthy’ diet and ‘traditional’ diet was both positivelyassociated with language development quotient, the odds ratio respectively were1.33(95%CI:1.06to1.67) and1.28(95%CI:1.01to1.62). Compared to children ofartificial feeding (AF), exclusive breastfeeding (EBF) was positively associated withtotal development quotient (DQ), large motor development quotient and socialbehavior development quotient, the odds ratio respectively were1.64(95%CI:1.05to2.56),1.85(95%CI:1.17to2.92) and1.61(95%CI:1.01to2.56); almostexclusive breastfeeding (AEBF) was positively associated with fine motordevelopment, the odds ratio respectively were1.75(95%CI:1.17to2.61). Comparedto children of never breastfeeding, duration of any breastfeeding (DABF) for up to5~6months was positively associated with total development quotient, the odds ratiowas1.52(95%CI:1.06to2.17)；duration of full breastfeeding (DFBF) for up to3~4months and DABF for up to3~4、5~6and more than6months were positivelyassociated with fine motor development quotient, the odds ratio respectively were1.29(95%CI:1.04to1.61)、1.56(95%CI:1.03to2.38)、1.73(95%CI:1.20to2.49)and1.62(95%CI:1.19to2.22)；DFBF for up to3~4months and DABF more than6months were positively associated with language development quotient, the odds ratiorespectively were1.33(95%CI:1.07to1.65) and1.38(95%CI:1.01to1.87).Compared to children of AF, mixed feeding (MF) was positively associated with MDI,the odds ratio was1.76(95%CI:1.04to3.00). Compared to children of neverbreastfeeding, DFBF within2months was positively associated with PDI, the oddsratio was1.71(95%CI:1.04to2.83), DABF for up to3~4months was positivelyassociated with MDI, the odds ratio was2.28(95%CI:1.03to5.06).Conclusions ‘Healthy’ and ‘Traditional’ dietary patterns are beneficial to infant’sintellectual development. EBF and AEBF are associated with improved intelligencedevelopment in infants less than6months of age, it is showed an increased trend inthis role with the increase of DABF and DFBF. Besides, it is still have positive effects on intelligence development when DABF more than6months.