Pregnancy
Study reveals ‘urgent need’ for diet improvement of pregnant women
New research has found a pervasive low-quality diet among pregnant and postpartum individuals, reflecting “an urgent need for widespread improvement.”
The study assessed diet quality in the same individuals from the beginning of pregnancy through one year postpartum. Few studies have analysed diet quality in pregnancy and postpartum in the same participants.
Researchers used the USDA’s Healthy Eating Index (HEI), which is based on federal dietary guidelines, to develop a diet quality score for participants in the Pregnancy Eating Attributes Study (PEAS).
Because diet quality during pregnancy and postpartum impacts short- and long-term health outcomes for parent and child, the team of perinatal nutritionists and epidemiologists aimed to identify risk factors for low diet quality to develop effective interventions.
The overall average HEI score for the study participants’ diets was ranked on a 0-100 scale at 61.6. On a traditional A-F scale, the grade would be barely passing, a D, although that score is 10 per cent higher than the average HEI score of the overall U.S. adult population.
The HEI score is based on the adequate consumption of nine foods – total fruit, whole fruit, total vegetables, greens and beans, whole grains, dairy, total protein, seafood, plant proteins, as well as fatty acids — and the consumption of four foods in moderation — refined grains, sodium, added sugars and saturated fats.
Among all the study participants, HEI scores were stable from early pregnancy through one year postpartum. But researchers noted differences in scores according to sociodemographic characteristics, weight status, lactation duration and tobacco smoking.
“You would think that pregnant women are highly motivated to eat better during pregnancy, precisely because they are pregnant. And that’s true in certain populations,” said senior author Anna Maria Siega-Riz at UMass Amherst School of Public Health and Health Sciences.
“You saw higher-income women having a higher-quality diet, and lower-income women having a lower-quality diet.”
Siega-Riz notes that lower-income women may be working multiple jobs and either don’t have access to higher quality foods, can’t afford them or need more overall support from family, friends and healthcare providers.
“You’re only capable of changing your diet if your income and your environment support it. And that, I think, is something that a lot of people forget,” she said.
Unmarried study participants and those participating in more than one federal assistance programme recorded the lowest mean HEI scores. In addition, a higher body mass index (BMI) was associated with a lower-quality diet. The highest mean HEI scores were seen in participants with higher education and among those who reported never smoking.
“What women eat during pregnancy is mostly the same things they eat in the postpartum period, with the exception of a few foods,” she said. They sometimes return to caffeine and alcohol and resume eating more refined carbohydrates after giving birth.
The study participants’ diets were assessed at six points — in each trimester of pregnancy and two months, six months and one year postpartum.
Overall, they scored high — A+ (100) — on eating enough whole fruits, total protein and greens and beans. They scored lowest — a failing grade — on eating adequate whole grains and fatty acids, and lower on dairy products. On the moderation side, they scored a lower grade on sodium intake and saturated fats than on added sugars and refined grains, though there were no high scores.
“Healthcare needs to change, to be more comprehensive. And right now, that’s not our model,” Siega-Riz said.
“Policymakers and prenatal care providers need to understand that even pregnant women need support and guidance to be able to change their dietary habits for the better.”
In a related study, Siega-Riz and team performed a genomic analysis of the gastrointestinal microbiome of participants during the second trimester of pregnancy after collecting faecal swabs.
“We wanted to look at the relationship between diet and what’s in the microbiome. And then also how the microbiome might be at interplay with what’s happening in utero that the foetus ends up being imprinted by,” she said.
The researchers found an association between a diet with higher saturated fat and added sugar and the composition and function of the microbiome during pregnancy. But they don’t know yet what that means. They will continue to examine both the parent’s and the child’s microbiome in ongoing and future research.
“Although the results provide an initial landscape of microbial factors that are associated with specific dietary components, such as dietary sugar, fat and dairy, the story is complicated and evolving, and we hope that these findings will be a foundation for future hypothesis-driven research and investigation,” the paper concludes.
A £50m maternity consortium will bring together UK clinicians, researchers and communities to tackle the most critical gaps in maternal care.
Funding from the National Institute for Health and Care Research has established the NIHR Inequalities Challenge: Maternity Disparities Consortium under the leadership of the University of Birmingham and Newcastle University.
Higher education bodies, NHS organisations, community groups and voluntary organisations from across the UK will work together through the programme.
The NIHR has committed £50m over five years to support research led by clinicians, researchers and communities across the consortium.
Professor Joht Singh Chandan, consortium co-lead for research at the University of Birmingham, said: “National attention on maternity safety and equity has never been greater, but ambition must now be matched by evidence and implementation.
“Through this consortium, we will work across the UK to understand what works, for whom and in what contexts, and to ensure that research leads to practical changes in care for the women, babies and families who need them most.”
The launch comes at a pivotal moment for UK maternity care, with growing national attention on improving safety, equity and women’s experiences of care.
The government’s renewed Women’s Health Strategy highlights the need to improve care before and between pregnancies for underserved communities.
Against that backdrop, the consortium will generate the evidence, interventions and research capacity needed to help turn national ambition into practical improvements for women, babies and families.
University of Birmingham is leading work to improve maternity care pathways across the antenatal, intrapartum and postnatal periods.
Antenatal care covers pregnancy before labour, while intrapartum care refers to care during labour and birth.
The consortium will examine how women and families can be better supported before pregnancy and between pregnancies.
This includes improving access to advice and care that can help people prepare for pregnancy, manage existing health conditions and reduce risks before they build up.
Other research will focus on improving care during pregnancy, birth and the early weeks after birth.
This will include work on major causes of poor maternal health, such as high blood pressure, diabetes in pregnancy, obesity, perinatal mental health and complications during recovery after birth.
Professor Judith Rankin OBE, consortium co-lead for research and capacity development at Newcastle University, said: “This funding represents a critical opportunity to make the step change we need to improve outcomes for women and their babies.
“Alongside the research, the Consortium will be investing in tomorrow’s research leaders today to ensure we have the capacity to deliver on improving pregnancy outcomes, access to, and experience of, care.”
The University of Liverpool has secured £1.8m to test a device for postpartum bleeding and launch a new women’s health studio.
The PPH Butterfly is designed to help control postpartum haemorrhage, which is severe bleeding after childbirth and a leading cause of maternal death worldwide.
The funding will support research into how the device can be used in clinical practice and generate evidence to inform its wider adoption.
The university has launched the Women’s Health Innovation Studio, known as the WIN Studio, alongside the project.
The £1.8m initiative is predominantly funded by the National Institute for Health and Care Research, which is providing £1.5m, with additional support from the university.
The PPH Butterfly project will involve a multi-centre clinical trial across the UK and a global feasibility study looking at how practical it would be to use the device in different healthcare settings.
The WIN Studio is led by Andrew Weeks, professor of international maternal health care at the University of Liverpool and a senior investigator at the National Institute for Health and Care Research, and Dr Teesta Dey, a tenure track fellow in the department of women’s and children’s health.
Dr Dey will also lead the PPH Butterfly project.
Its work will cover conditions linked to female biology, including endometriosis, menopause and pregnancy-related complications.
It will also support technologies for diseases that affect women differently or disproportionately, even when they are not usually classed as gender-specific conditions.
Dr Dey said: “Women’s health has often been marginalised within healthcare systems and innovation markets, resulting in treatments, devices and care models that fail to adequately account for women’s specific needs. WIN Studio seeks to change this status quo and reconfigure how health technologies are conceived and delivered.
“The funding from NIHR for this £1.8m project is precisely the kind of innovation the WIN Studio exists to foster: clinically urgent, women-centred, and with the potential to save lives at scale.”
The studio recently hosted an event at Liverpool Women’s University Hospital as part of the Liverpool City Region Combined Authority’s Innovation Investment Fortnight.
Seven innovations are currently undergoing clinical testing through the studio, with three developed internally.
The studio will work closely with NHS University Hospitals Liverpool Group and provide clinical, regulatory and commercial support to people developing women’s health technologies.
It will also involve patients and members of the public in shaping research priorities and product development.
Its wider programme includes collaborations involving clinicians, engineers, economists, academics and policymakers.
The project team says the PPH Butterfly is a simple, low-cost device designed to control severe bleeding quickly and with minimal training.
According to the team, postpartum haemorrhage causes around 70,000 deaths globally each year, equal to about one death every seven minutes.
The device previously received £1.1m in funding from the National Institute for Health and Care Research.
The latest £1.5m grant will support a randomised UK trial, in which participants are allocated to different treatment groups by chance, and a global feasibility assessment.
Weeks said: “In an area where women face deep health inequalities, WIN Studio has a vital role to play. By working in partnership with the NHS, local government and communities, we can ensure that research leads to real-world impact.
“Liverpool has a highly integrated ecosystem of academic, clinical and commercial expertise. By bringing these together under a single platform, the WIN Studio aims to act as a national exemplar for equitable health innovation. Transforming the way medical technologies are developed is essential to addressing gender disparities in healthcare outcomes.”
Another product supported by the university, the LifeStart Trolley, has already reached commercialisation.
The small mobile resuscitation trolley allows newborn care to be carried out at the bedside while the baby’s umbilical cord remains intact, enabling delayed cord clamping.
Delayed cord clamping means waiting before cutting the cord so blood can continue flowing from the placenta to the baby after birth.
Clinical trials conducted around 10 years ago found that life-saving care could be provided successfully at the bedside using the trolley.
It was later commercialised by Inspiration Healthcare and is now used in more than 70 UK maternity units and in 36 countries, including Norway, Italy and the US.
Type 2 diabetes diagnoses are rising twice as fast in women under 40 as in women over 40, new data shows.
Type 2 diabetes is a serious condition and can lead to complications such as heart attacks and strokes. When it develops in younger people, it can be more aggressive and have more severe and acute effects.
Diagnoses in women under 40 rose by 47 per cent between 2017/18 and 2023/24. By comparison, diagnoses rose by 22 per cent in women aged 40 to 79.
During the same period, type 2 diabetes diagnoses in men under 40 increased by 34 per cent.
Diabetes UK said it is concerned about the follow-up care offered to women who have had gestational diabetes, also known as GDM, which increases the risk of developing type 2 diabetes after pregnancy.
Gestational diabetes is high blood sugar that develops during pregnancy and usually goes away after birth, but it raises the risk of type 2 diabetes later.
Colette Marshall, chief executive at Diabetes UK, said: “These figures should be a wake-up call. Type 2 diabetes is rising twice as fast in younger women compared to older women, and a crucial opportunity for prevention is being missed. Every diagnosis is life-changing, but when it develops in younger people, type 2 diabetes is even more aggressive.
“Pregnancy shouldn’t be a pathway to ill health. Yet despite facing a much higher risk of type 2 diabetes, too many women with GDM receive little or no follow-up care after pregnancy.
“As the Government turns its Strategy into action, support for women who have had gestational diabetes must not be overlooked.”
Last year, the NHS published the first national GDM audit for England in 2024/25, which revealed inconsistencies in follow-up care.
Only 57 per cent of women with GDM received an annual HbA1c test, which should be offered to every woman with GDM.
An HbA1c test measures average blood sugar levels over the previous two to three months.
Only 4.5 per cent of women had received support through the NHS Diabetes Prevention Programme.
The report also found that 11 per cent of women developed prediabetes within five years of having GDM, while 15 per cent developed type 2 diabetes within 10 years.
Prediabetes means blood sugar levels are higher than normal and a person has a higher risk of developing type 2 diabetes.
A recent survey funded by Diabetes UK also found that more than a third of women with GDM felt abandoned by healthcare services after giving birth.
If you live in England and have had gestational diabetes, you can self-refer to the NHS Diabetes Prevention Programme, which supports people at risk of developing type 2 diabetes. If you live in Northern Ireland, Scotland or Wales, you can speak to your GP about support.
Diabetes UK has written to women’s health minister Baroness Merron calling for urgent improvements to postnatal support for those diagnosed with GDM during pregnancy.
GDM affects between 10 and 20 per cent of pregnant women, but Diabetes UK said cases have long been underreported and UK-wide data on the condition has not been readily available.
The charity said poor follow-up care for women who have had GDM may be contributing to rising rates of type 2 diabetes in younger women.
It is calling for consistent postnatal follow-ups for women after GDM, more referrals to the NHS Diabetes Prevention Programme, greater accountability for improvements in postnatal care, and action on inequalities affecting women from deprived and minority ethnic communities.
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