392 Association of Diet Quality with Third Trimester Anemia

Anemia in pregnancy is a significant contributor to maternal morbidity including risk for cesarean delivery and need for transfusion. The relationship between antepartum diet and anemia is not yet well established. A more thorough understanding of this relationship represents a potentially modifiable risk factor for adverse outcomes. This was a secondary analysis of a previously collected dataset from the nuMoms2B study that included 9,289 low risk primiparous patients from September 2010 through June 2014. The American Healthy Eating Index (AHEI-2010) was completed by participants in the first trimester to assess quality of diet in the 3 months prior to conception. AHEI scores were categorized by quartile, with the lowest quartile representing the lowest quality diet. Sociodemographic information was compared by quartile using chi square test and ANOVA for categorical and continuous variables, respectively. Antenatal anemia was defined as a third trimester hemoglobin of less than 11 g/dL measured after 24 weeks. Logistic regression was used to assess the association between AHEI-2010 quartile and anemia, adjusted for confounders. A total of 6,071 patients were included in our analysis. Patients with the lowest AHEI-2010 scores (22.6 – 46) differed in demographic characteristics including a lower education level (39%), higher likelihood to identify as Black race (22.3%), and higher BMI. Adjusting for confounders, only those in the lowest AHEI2010 quartile had a significant independent association with the presence of third trimester anemia (aOR 1.40 95% CI 1.09 to 1.78, p = 0.007). Pregnant patients with the lowest pre-conception diet quality are more likely to have anemia in the third trimester. Screening for diet quality preconception or earlier in pregnancy may represent an important way of identifying patients at risk of third trimester anemia, and allow for early intervention.