Socio-economic and racial prenatal diet quality disparities in a national US sample

Objective: To examine differences in prenatal diet quality by socio-economic status (SES) and race/ethnicity. Design: A secondary, cross-sectional analysis. Race and SES were self-reported prenatally; SES was categorized into four groups: high-income, middle-income and low-income WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) participant/non-participant. The Alternative Healthy Eating Index for Pregnancy (AHEI-P) measured diet quality, including four moderation and nine adequacy components (higher scores = healthier diet). Generalized linear models adjusted for covariates and post hoc testing with Tukey adjustment compared AHEI-P scores between groups, using a threshold of P < 0 center dot 05. Setting: Infant Feeding Practices Study II, conducted in a national US convenience cohort. Participants: Women in their third trimester (n 1322) with dietary history. Results: Participants were of 28 center dot 9 (se 5 center dot 6) years on average and predominantly non-Hispanic White (84 %); approximately one-third participated in WIC and 17 % were high-income. The mean AHEI-P score was 61 center dot 7 (se 10 center dot 8) of 130 points. High-income women had higher total (62 center dot 4 (se 1 center dot 0)) and moderation component AHEI-P scores than middle-income (60 center dot 1 (se 0 center dot 8), P = 0 center dot 02), low-income WIC participants (58 center dot 3 (se 0 center dot 8), P < 0 center dot 0001) and non-participants (58 center dot 9 (se 0 center dot 9), P = 0 center dot 001). Non-Hispanic Black participants had lower total (57 center dot 8 (se 1 center dot 4)) and adequacy scores than Other races (i.e. neither non-Hispanic Black nor White, 62 center dot 1 (se 0 center dot 9), P = 0 center dot 02). Conclusions: Disparities in prenatal diet quality were observed, with non-Hispanic Black women, low-/middle-income and WIC participants having lower diet quality. However, interventions are needed to improve prenatal diet quality broadly among US women.