Previous studies have suggested the importance of nutrition during pregnancy. For instance, adequate gestational weight gain, a major determinant of normal fetal growth, is dependent on overall nutritional adequacy during pregnancy. There are, however, large areas of uncertainty regarding the effects of diet on fetal growth, especially the roles of types of fat and certain micronutrients. Even less is known about the dietary determinants of gestational length. The investigators propose a cohort study to explore these and other uncharted areas of research in nutrition during pregnancy. The cohort will comprise approximately 10,000 low-income pregnant women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program of North Dakota. Using a food frequency questionnaire previously validated among low-income pregnant women for seven important nutrients, they will collect detailed dietary information at two points during pregnancy. They will also have available data concerning sociodemographics, gestational duration and weight gain, smoking and other habits, pregnancy and newborn complications, and child's birth weight. The main questions they will address concern the relationships of foods and nutrients with length of gestation and birth weight. Specific hypotheses include the potential beneficial effects of n-3 fatty acids, folate, and fruits and vegetables, and the possible harmful effects of trans fatty acids. They will also conduct a validation study of the FFQ among 300 pregnant participants in WIC. This study will include 150 Native Americans and 150 Caucasians. Three 24-hour diet recalls will be collected by trained nutritionists over a one-year period and compared to the FFQ data. The investigators have worked with North Dakota WIC to improve the quality of nutritional data collected for this study at no direct cost to the study. This allows the requested support to be used for data management and analysis. In addition, the investigators note that the study will involve a substantial number of Native American women, an understudied population. The investigators state that the discovery of new relations of nutrition in pregnancy with infant health has potentially great importance. They point out that any finding that can explain part of altered fetal growth or prematurity has the potential to affect morbidity and mortality not only in childhood, but perhaps decades later as well.
