Retrospective Study on the Association between Maternal Macronutrient Intake and Urogenital Infections during Pregnancy in a Swiss Cohort

Abstract

Aims: Urogenital infections during pregnancy have been linked to adverse pregnancy outcomes. The objective of this study was to test the hypothesis that macronutrient intake and relative macronutrient contribution to diet is related to the risk of developing urogenital infections during pregnancy. Study Design: This is a retrospective single center cohort study. Place and Duration of Study: Outpatient Clinic of Obstetrics at the University Hospital Zurich, Switzerland; between January 2009 and December 2010. Methodology: We included 774 pregnant women of ages ranging from 16 to 47 years with data on urogenital infections and diet history. A diet history of these pregnant women based on food intake during the last seven days was collected in a nutritional counselling program. Diet information of these same women was matched with vaginal/urinary/cervical specimens collected within 90 days (range) prior to the nutrition assessment. The pathogens analyzed included Gram-negative rods, Gram-positive rods, Gram-positive cocci (including group B Streptococcus), Gardnerella vaginalis, Chlamydia trachomatis, and Candida spp. The covariates were maternal age, body mass index (BMI), origin, and parity. Crude and adjusted odds ratios (ORs) were determined by logistic regression. Results: Among the 774 pregnant women, 47.7% had some kind of infection. High fat intake was positively associated with Gardnerella vaginalis (adjusted OR=3.6; 95% confidence interval (CI)=1.3–10; p=0.01). No association was seen between macronutrients or their distribution and other pathogens. However, significant associations were found between infections and covariates. Conclusions: Findings suggested that increased dietary fat intake is associated with vaginal infections, thereby predisposing women to adverse pregnancy outcomes. This signified the importance of appropriate diet during pregnancy.