Maternal dietary diversity and pattern during pregnancy is associated with low infant birth weight in the Cape Coast metropolitan hospital, Ghana: A hospital based cross-sectional study

Background: This study investigated the associations between mother's dietary diversity score and dietary patterns during pregnancy and the odds of low birth weight at the Cape Coast Metropolitan Hospital in Ghana. Methods: Mothers attending the postnatal clinic from January to August 2016 at the Cape Coast Metropolitan Hospital were included. Dietary information during pregnancy was assessed with a food frequency questionnaire. In reference to the women's dietary diversity score, women were categorized into low, medium or high dietary diversity score groups. The primary outcome was low birth weight and was defined as weight <2500 g at birth. Factor analysis was conducted to identify maternal dietary patterns and a multivariable logistic regression analysis was used to determine the associations between dietary diversity score and dietary patterns with low birth weight. Results: The prevalence of low birth weight in infants was 43.8% (95% CI = 39%–49%). After adjusting for covariates, the odds of low birth weight was four times higher in the low dietary diversity score group compared to the high dietary diversity score group (odds ratio [OR] = 4.29, 95% confidence interval [CI], 1.24–6.48). Three dietary patterns namely "Western", “Traditional” and "Healthy", which explained 58.23% of the total variance in food intake were identified. The subjects in the highest quartiles of “healthy” and “traditional” dietary pattern scores had significantly lower odds of low birth weight (healthy: OR = 0.23, 95% CI, 0.19–0.39, P trend <0.0001; traditional: OR = 0.14, 95% CI, 0.06–0.35, P trend <0.0001, respectively) compared to those in the lowest quartiles of dietary pattern score. Conclusion: Low dietary diversity score during pregnancy was associated with higher odds of infant low birth weight whereas dietary patterns considered as “healthy” and “traditional” during pregnancy were associated with lower odds of infant low birth weight. Findings of this study suggests that higher dietary diversity and “healthy” and “traditional” dietary patterns during pregnancy may be protective of LBW in the study area.