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

Abstract Background: Good dietary quality among pregnant women is critical for maternal and fetal health. Comprehensive assessments of large representative samples are lacking. Methods: 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.Results: 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). Significant differences were found in the median total CHDI scores across trimesters, and on all CHID components, except whole grains, dry beans and tubers, across all residential areas; 13.7% of participants scored below 60 points, indicating “poor” dietary quality. Significant differences in CHDI scores were found across trimesters and residential areas. 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.Conclusions: Pregnant women living in coastal areas of China suffer from an unbalanced diet of average quality. Pregnant women in the early and middle stages of pregnancy had worse scores than those in the late stage, while suburban and rural women had worse scores than urban women.