Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women

Pereira, Monique Tavares; Cattafesta, Monica; Santos Neto, Edson Theodoro dos; Salaroli, Luciane Bresciani

doi:10.1055/s-0040-1712996

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Revista Brasileira de Ginecologia e Obstetrícia

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Original Article, Obstetrics • Rev. Bras. Ginecol. Obstet. 42 (07) • July 2020 • https://doi.org/10.1055/s-0040-1712996 copy

Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women

Fatores maternos e sociodemográficos influenciam o consumo de alimentos ultraprocessados e minimamente processados em gestantes

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze the consumption of minimally-processed and ultraprocessed foods in relation with sociodemographic variables, maternal habits, educational activity received during prenatal care and clinical history.

Methods

A cross-sectional, analytical and descriptive study with 1,035 pregnant women who lives in the municipalities of the metropolitan region of Grande Vitória, Espírito Santo, Brazil (RMGV-ES), and who were hospitalized in establishments of the Unified Health System (SUS) due to childbirth (April-September 2010). The food frequency questionnaire, pregnant woman’s card and information from the medical records of the health facility unit were analyzed. The Chi-square test and the binary logistic regression model were used to investigate the association between the independent variables and the consumption of ultraprocessed foods.

Results

It was identified that pregnant women ≤ 19 years of agewere 2.9 timesmore likely to consume ultraprocessed foods (confidence interval [CI] 95% 1.683-5.168, p< 0.001), while those ≥ 35 years old were less likely to consume them (odds ratio [OR] 0.265, 95% CI 0.105-0.666, p= 0.005). Maternal smoking increased the odds of consumption of ultraprocessed foods by 2.2 times (95% CI 1.202-4.199, p= 0.011) and pregnant womenwho did not obtain information on healthy food during prenatal care presented 54.1% less chances of consuming minimally-processed foods (OR 0.459, 95% CI 0.307-0.687, p< 0.001).

Conclusion

Smoking during the gestational period and being a teenager are factors that influence the consumption of ultraprocessed foods of pregnant women. Race/ color, head of household, age group, receiving of information about feeding in the prenatal period and not having smoked in gestation determined the consumption of minimally-processed foods.

Keywords:
feeding behavior; dietary habits; ultraprocessed foods; pregnant; maternal nutrition

Variable	Minimally-processed food consumption^* * The distribution of the consumption of foods was evaluated in quartiles.								P^† † The differences between quartiles were tested by the Chi-square test.	Total
	Q1		Q2		Q3		Q4			Total
	n	%	n	%	n	%	n	%		n	%
Age, y (n 1,035)									0.015
≤ 19	76	32.8	54	23.3	61	26.3	41	17.7		232	22.4
20–34	177	24.5	200	27.7	165	22.8	181	25.0		723	69.9
≥ 35	15	18.8	18	22.5	21	26.3	26	32.5		80	7.7
Race/color (n = 977)									0.096
White	21	15.7	33	24.6	41	30.6	39	29.1		134	13.7
Brown	188	27.5	180	26.3	156	22.8	160	23.4		684	70.0
Black	41	25.8	43	27.0	36	22.6	39	24.5		159	16.3
Marital status (n = 1,030)									0.294
Living with a partner	214	25.8	208	25.0	203	24.4	206	24.8		831	22.5
Not living with a partner	54	27.1	61	30.7	42	21.1	42	21.1		199	70.2
Maternal occupation (n = 1,034)									0.002
No paid work	212	28.6	197	26.6	171	23.1	160	21.6		740	71.6
Paid work	55	18.7	75	25.5	76	25.9	88	29.9		294	28.4
Householder (n 1028)									0.073
House owner	21	18.9	32	28.8	20	18.0	38	34.2		111	10.8
Partner's house	179	26.5	168	24.9	168	24.9	160	23.7		675	65.7
Others	65	26.9	70	28.9	57	23.6	50	20.7		242	23.5
Socioeconomic classification (n = 913)									0.994
D/E	73	25.5	74	25.8	69	24.1	70	24.5		286	31.3
C1/C2	152	26.2	157	27.0	139	23.9	133	22.9		581	63.6
A/B	11	23.9	14	30.4	10	21.7	11	23.9		46	5.0
Information on prenatal diet (n = 1,012)									< 0.001
No	161	32.7%	128	26.0%	98	19.9%	106	21.5%		493	48.7
Yes	94	18.1%	137	26.4%	147	28.3%	141	27.2%		519	51.3
Alcohol use during pregnancy (n = 1,034)									0.215
No	238	25,5	239	25.6	229	24.5	228	24.4		934	90.3
Yes	30	30.0	32	32.0	18	18.0	20	20.0		100	9.7
Smoking during pregnancy (n = 1,026)									< 0.001
No	211	23.5	241	26.9	212	23.7	232	25.9		896	87.3
Yes	53	40.8	29	22.3	33	25.4	15	11.5		130	12.7
Prenatal consultations (n = 948)									0.134
≤ 5	83	34.2	67	27.5	61	27.1	59	25.0		270	28.5
> 6	160	65.8	177	72.5	164	72.9	177	75.0		678	71.5
Parity^‡ ‡ Number of parturitions. (n 997)									0.991
1	106	26.9	102	25.9	94	23.9	92	23.4		394	39.5
2	76	25.6	76	25.6	71	23.9	74	24.9		297	29.8
3 or more	74	24.2	80	26.1	75	24.5	77	25.2		306	30.7

Variable	Ultraprocessed food consumption^∗								P^† † The differences between quartiles were tested by the chi-square test.	Total
	Q1		Q2		Q3		Q4			Total
	n	%	n	%	n	%	n	%		n	%
Age, y (n = 1,035)									< 0.001
≤ 19	36	15,5	55	23.7	59	25.4	82	35.3		232	22.4
20–34	199	27.5	185	25.6	173	23.9	166	23.0		723	69.9
≥ 35	32	40.0	27	33.8	15	18.8	6	7.5		80	7.7
Race/color (n = 977)									0.270
White	38	28.4	34	25.4	30	22.4	32	23.9		134	13.7
Brown	182	26.6	167	24.4	168	24.6	167	24.4		684	70.0
Black	34	21.4	50	31.4	29	18.2	46	28.9		159	16.3
Marital status (n = 1,030)									0.631
Living with a partner	209	25.2	219	26.4	201	24.2	202	24.3		831	80.7
Not living with a partner	56	28.1	45	22.6	46	23.1	52	26.1		199	19.3
Maternal occupation (n = 1,034)									0.023
No paid work	177	23.9	190	25.7	174	23.5	199	26.9		740	71.6
Paid work	90	30.6	77	26.2	72	24.5	55	18.7		294	28.4
Householder (n = 1,028)									0.004
Own	36	32.4	22	19.8	24	21.6	29	26.1		111	10.8
Companion	187	27.7	183	27.1	146	21.6	159	23.6		675	65.7
Others	41	16.9	62	25.6	73	30.2	66	27.3		242	23.5
Socioeconomic classification (n = 913)									0.695
D/E	75	26.2	82	28.7	64	22.4	65	22.7		286	31.3
C1/C2	153	26.3	147	25.3	136	23.4	145	25.0		581	63.6
A/B	9	19.6	11	23.9	15	32.6	11	23.9		46	5.0
Information on prenatal diet (n = 1,012)									0.534
No	135	27.4	133	27.0	114	23.1	111	22.5		493	48.7
Yes	128	24.7	132	25.4	125	24.1	134	25.8		519	51.3
Alcohol use during pregnancy (n = 1,034)									0.066
No	248	26.6	247	26.4	216	23.1	223	23.9		934	90.3
Yes	19	19.0	20	20.0	31	31.0	30	30.0		100	9.7
Smoking during pregnancy (n = 1,026)									< 0.001
No	246	27.5	235	26.2	215	24.0	200	22.3		896	87.3
Yes	19	14.6	31	23.8	31	23.8	49	37.7		130	12.7
Prenatal consultations (n = 948)									0.590
≤ 5	67	27.0	68	27.0	69	32.1	66	28.3		270	28.5
> 6	181	73.0	184	73.0	146	67.9	167	71.7		678	71.5
Parity^‡ ‡ number of parturitions. (n 997)									0.161
1	93	23.6	104	26.4	94	23.9	103	26.1		394	39.5
2	66	22.2	77	25.9	80	26.9	74	24.9		297	29.8
3 or more	96	31.3	77	25.1	64	20.9	69	22.5		306	30.7

Variable	Ultraprocessed food consumption
	Gross values				Adjusted values
	P^a a Statistical significance ≤ 0.2% in the Chi-square test were included in the analysis.	OR^* * ORs were adjusted to the other variables using binary logistic regression with 95%CIs.	CI		P^a a Statistical significance ≤ 0.2% in the Chi-square test were included in the analysis.	OR^* * ORs were adjusted to the other variables using binary logistic regression with 95%CIs.	CI
			LL 95%	UL 95%			LL 95%	UL 95%
Age, y
20–34		1				1
≤ 19	< 0.001	2.731	1.754	4.251	< 0.001	2.95	1.683	5.168
≥ 35	0.001	0.225	0.092	0.551	0.005	0.265	0.105	0.666
Maternal occupation
No paid work		1				1
Paid work	0.002	0.544	0.367	0.804	0.225	0.762	0.491	1.182
Householder
Own		1				1
Companion	0.842	1.056	0.62	1.798	0.98	0.992	0.543	1.814
Others	0.03	1.998	1.069	3.735	0.243	1.543	0.745	3.194
Alcohol use during pregnancy
No		1				1
Yes	0.067	1.756	0.9613	3.2074	0.298	1.480	0.708	3.092
Smoking during pregnancy
No		1				1
Yes	< 0.001	3.1721	1.809	5.5622	0.011	2.247	1.202	4.199
Parity
1		1				1
2	0.956	1.012	0.656	1.563	0.089	1.548	0.935	2.563
3 or more	0.042	0.649	0.427	0.985	0.562	1.170	0.689	1.987

Variable	Minimally-processed food consumption
	Gross values				Adjusted values
	P ^a a Statistical significance ≤ 0.2% in the Chi-square test were included in the analysis.	OR^* * ORs were adjusted to the other variables using binary logistic regression with 95%CIs.	CI		P ^a a Statistical significance ≤ 0.2% in the Chi-square test were included in the analysis.	OR^* * ORs were adjusted to the other variables using binary logistic regression with 95%CIs.	CI
			LL 95%	UL 95%			LL 95%	UL 95%
Age, y
20–34		1				1
≤ 19	0.004	0.528	0.342	0.813	0.024	0.547	0.324	0.923
≥ 35	0.122	1.695	0.869	3.307	0.388	1.411	0.646	3.081
Race/color
White		1				1
Brown	0.007	0.458	0.259	0.811	0.008	0.426	0.226	0.803
Black	0.057	0.512	0.257	1.019	0.053	0.469	0.217	1.011
Marital status
Living with a partner		1				1
Not living with a partner	0.349	0.808	0.517	1.263	0.273	0.749	0.447	1.256
Maternal occupation
No paid work		1				1
Paid work	< 0.001	2.12	1.429	3.145	0.281	1.295	0.809	2.072
Householder
Own		1				1
Companion	0.016	0.494	0.278	0.877	0.017	0.432	0.217	0.859
Others	0.01	0.425	0.222	0.813	0.125	0.544	0.25	1.184
Information on prenatal feeding
No		1				1
Yes	< 0.001	2.278	1.593	3.259	< 0.001	2.177	1.455	3.257
Smoking during pregnancy
No		1				1
Yes	< 0.001	0.2574	0.1409	0.4703	< 0.001	0.269	0.132	0.545
Prenatal consultations
<5		1				1
>6	0.0287	1.5562	1.047	2.3132	0.1684	1.3771	0.8734	2.1713

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[1] Address for correspondence Luciane Bresciani Salaroli, PhD, Universidade Federal do Espírito Santo, Av. Marechal Campos, 1468, Vitória, ES, 29040-090, Brazil (e-mail: lucianebresciani@gmail.com).