Public Health Nutrition

HOT TOPIC – Nutrition in pregnancy

Pre-pregnancy obesity and maternal nutritional biomarker status during pregnancy: a factor analysis

Laura E Tomedia1, Chung-Chou H Changa2, PK Newbya3a4a5, Rhobert W Evansa1, James F Luthera1, Katherine L Wisnera1a6a7 and Lisa M Bodnara1a6a7 c1

a1 Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, USA

a2 Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

a3 Department of Pediatrics and Program in Medical Nutrition Sciences, Boston University School of Medicine, Boston, MA, USA

a4 Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

a5 Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University Metropolitan College, Boston, MA, USA

a6 Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

a7 Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA


Objective Pre-pregnancy obesity has been associated with adverse birth outcomes. Poor essential fatty acid (EFA) and micronutrient status during pregnancy may contribute to these associations. We assessed the associations between pre-pregnancy BMI and nutritional patterns of maternal micronutrient and EFA status during mid-pregnancy.

Design A cross-sectional analysis from a prospective cohort study. Women provided non-fasting blood samples at ≤20 weeks’ gestation that were assayed for red cell EFA; plasma folate, homocysteine and ascorbic acid; and serum retinol, 25-hydroxyvitamin D, α-tocopherol, soluble transferrin receptors and carotenoids. These nutritional biomarkers were employed in a factor analysis and three patterns were derived: EFA, Micronutrients and Carotenoids.

Setting The Antidepressant Use During Pregnancy Study, Pittsburgh, PA, USA.

Subjects Pregnant women (n 129).

Results After adjustment for parity, race/ethnicity and age, obese pregnant women were 3·0 (95 % CI 1·1, 7·7) times more likely to be in the lowest tertile of the EFA pattern and 4·5 (95 % CI 1·7, 12·3) times more likely to be in the lowest tertile of the Carotenoid pattern compared with their lean counterparts. We found no association between pre-pregnancy obesity and the Micronutrient pattern after confounder adjustment.

Conclusions Our results suggest that obese pregnant women have diminished EFA and carotenoid concentrations.

(Received August 03 2012)

(Revised February 04 2013)

(Accepted February 05 2013)

(Online publication March 25 2013)


  • Nutrition;
  • Pregnancy;
  • Obesity;
  • Factor analysis


c1 Corresponding author: Email