A China Healthy Diet Index-based evaluation of dietary quality among pregnant women in coastal areas across trimesters and residential areas

Good dietary quality among pregnant women is critical for maternal and fetal health. The primary objective of our study was to analyze the dietary quality of pregnant woman and its influencing factors. Pregnant women were enrolled using a multistage, stratified, random-sampling method in Shanghai. We used a personal food frequency questionnaire and a household condiment weighing method for dietary assessments. Participants' scores on the China Healthy Diet Index (CHDI) were analyzed to evaluate diet quality. Significant differences in the median daily intake of almost all food types were found across all trimesters, and all food types were found across all residential areas (urban, suburban and rural). The median of total CHDI score was 71.6 in all subjects, 71.1 in early pregnancy, 71.5 in middle pregnancy and 72.3 in late pregnancy. The results of uni-variate analysis showed that significant differences in CHDI scores were found across trimesters and residential areas. Eighty one point six percent of participants scored below 80 points, indicating general or poor dietary quality. Logistic regression models showed that participants in early and middle pregnancy had lower scores than those in late pregnancy. Women in urban areas had higher scores than those in suburban and rural areas. Most of pregnant women living in Shanghai suffer from a general or poor dietary quality. Education on balance diet should be strengthened to guide pregnant women in making reasonable food choices and intake, especially those living in suburban and rural areas and those in their first and second trimesters.