A recent study published in Nutrients has examined the beverage consumption habits of pregnant women in Shanghai and their impact on maternal and neonatal health. This research highlights the growing concern over the intake of sugar-sweetened beverages (SSB) and non-sugar-sweetened beverages (NSS) among pregnant women.
Background
Rising consumption of both sugary and non-sugary drinks has raised health concerns, particularly for pregnant women and their children. Excessive intake of SSBs is linked to dental issues, weight gain, and higher risks of chronic diseases like diabetes and hypertension. Pregnant women consuming high amounts of sugary drinks are at an increased risk of developing gestational diabetes mellitus (GDM), preeclampsia, and complications such as premature birth and birth defects.
Regulating SSB intake during pregnancy is crucial for the health of both mother and baby. Previous research focused mainly on packaged SSBs, offering limited insights into freshly prepared and NSS drinks.
About the Study
This prospective cohort study aimed to determine if high beverage consumption among pregnant women was associated with adverse outcomes for mothers and their children. Surveys were conducted from April to June in 2022 and 2023. Researchers selected participants from 16 districts in Shanghai using multi-stage random sampling.
Participants included cognitively unimpaired pregnant women who had been residing in community settings for at least six months and were able to walk independently. The researchers divided Shanghai into five zones, choosing two towns per zone and 30 women from each town, covering various stages of pregnancy. They followed the American College of Obstetricians and Gynecologists (ACOG) guidelines to determine the pregnancy period.
In-person interviews and surveys collected data on demographics, including age, education, employment status, marital status, household income, pre-pregnancy alcohol consumption, use of nutritional supplements, and beverage intake. Participants reported their beverage consumption over the past month, choosing from categories such as never, one to three times per month, one to three times per week, four to seven times per week, and more than once per day.
Beverages were categorized into pure fruit juices (PFJ), carbonated beverages (CB), vegetable protein-type beverages (VPB), juice beverages (JB), sugar-sweetened dairy beverages (SDB), sugar-sweetened tea (STB), lactic acid bacteria beverages (LBB), and NSS. Total beverage (TB) intake included all listed types, while SSBs included all beverages except NSS.
Researchers tracked neonatal outcomes within 12 months of the survey, with all participants having given birth by March 31, 2024. Logistic regression was used to analyze the odds ratios (OR) for various outcomes.
Results and Discussion
The study involved 4,824 pregnant women, with 82% under the age of 35, from 160 towns. The rates of TB, SSB, and NSS intake were 73%, 73%, and 14%, respectively, with median volumes of 67 mL, 65 mL, and 17 mL.
SSBs accounted for 94% of total beverage consumption, with SDB, PFJ, and STB being the most consumed types. The incidence of GDM was 17% among SSB consumers compared to 5% among non-consumers.
Pregnant women consuming TB up to three times per week had a 38% higher risk of GDM (OR, 1.4) and a 64% higher risk of gestational hypertension (GH) (OR, 1.6). Those consuming TB at least four times weekly faced a 154% higher risk of GDM (OR, 2.5) and a 169% higher risk of GH (OR, 2.7). Similar trends were observed with SSB consumption.
In terms of neonatal health, TB intake at least four times per week was associated with a significantly increased risk of macrosomia (OR, 2.1) and large-for-gestational-age (LGA) infants (OR, 1.7). NSS consumption also showed higher risks for macrosomia (OR, 6.6) and LGA (OR, 7.6).
High SSB intake can elevate blood glucose levels and induce insulin resistance, contributing to gestational diabetes and hypertension. Additionally, pregnancy-related increases in maternal blood glucose can lead to fetal insulin production and macrosomia. NSS consumption might affect gut flora and metabolic processes, potentially causing glucose intolerance and insulin resistance.
Conclusion
The study concludes that excessive beverage intake during pregnancy is linked to higher risks of gestational hypertension and diabetes, with NSS having a significant impact on newborns’ LGA and macrosomia risks. Pregnant women consuming sugary beverages four or more times a week face considerably higher risks. Healthcare providers should recommend reducing SSB and NSS consumption to improve maternal and fetal health. Implementing these findings in clinical practice could help manage high-risk pregnancies and improve outcomes for both mothers and babies.
