Affective and interaction social support early in pregnancy are associated with a healthy dietary pattern among pregnant Brazilian women

Santos, Francine Silva dos; Valério, Inaê Dutra; Freitas-Vilela, Ana Amélia; Kac, Gilberto; Vaz, Juliana dos Santos

doi:10.1590/1414-462X202533040402

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Original Article • Cad Saúde Colet. 33 (4) • 2025 • https://doi.org/10.1590/1414-462X202533040402 linkcopy

Affective and interaction social support early in pregnancy are associated with a healthy dietary pattern among pregnant Brazilian women

Apoio social afetivo e de interação no início da gestação está associado a padrão alimentar saudável em gestantes brasileiras

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction: Social support is an essential factor for health-related behavior, including eating habits. Little is known about whether social support could promote healthier eating habits during pregnancy.

Objective: The aim of the study was to test the association between social support early in pregnancy and gestational dietary patterns.

Methods: This is a secondary analysis of a prospective cohort study with data from 185 healthy adult pregnant women from Rio de Janeiro, Brazil. Social support was assessed at 5–13 weeks of gestation using the Medical Outcomes Study Social Scale, and five dimensions (material, affective, emotional, information, and interaction) were evaluated. Diet was investigated using a food frequency questionnaire applied at 30–36 weeks of gestation. Three gestational dietary patterns were identified ("Healthy," "Common-Brazilian," and "Processed") using principal component analyses.

Results: Women's age was 26.8±5.5 years, and the highest mean social support scores were for the affective (91.2±17.0) and the interaction dimensions (83.5±17.4). In adjusted linear regression models, the affective (β 0.011; 95% confidence interval [95%CI] 0.001;0.021) and the interaction (β 0.011; 95%CI 0.002–0.020) domains of social support were positively associated with the "Healthy" dietary pattern. No association was observed with the "Common-Brazilian" and "Processed" dietary patterns.

Conclusion: Affective and interactional social support in the early stage of pregnancy can promote healthier eating habits during pregnancy.

Keywords:
cohort studies; dietary patterns; food consumption; pregnancy; social support

		Overall sample (n=185)	Gestational Dietary Pattern (score)
			Healthy			Common-Brazilian			Processed
			1st–2nd (n=121)	3rd (n=64)	p-value	1st–2nd (n=123)	3rd (n=62)	p-value	1st–2nd (n=119)	3rd (n=66)	p-value
		Mean (SD) or median (IQR)	Mean (SD) or median (IQR)	Mean (SD) or median (IQR)	p-value	Mean (SD) or median (IQR)	Mean (SD) or median (IQR)	p-value	Mean (SD) or median (IQR)	Mean (SD) or median (IQR)	p-value
Continuous variables
	Age (years)	26.8 (5.5)	26.1 (5.5)	28.0 (5.5)	00.02*	25.8 (5.0)	28.7 (6.0)	<0.01*	26.5 (5.3)	27.2 (6.0)	00.41*
	Education (years)	8.7 (2.9)	8.5 (3.1)	9.1 (2.7)	00.14*	8.9 (2.8)	8.3 (3.2)	00.21*	8.7 (2.9)	8.7 (3.0)	00.85*
	Per capita monthly household income (US$)§	277.8 (175.4–384.2)	253.8 (156.1–370.2)	316.4 (194.7–444.4)	00.04†	292.4 (188.6–408.5)	238.6 (152.0–380.1)	00.15†	277.8 (176.6–390.1)	278.7 (162.6–389.8)	00.76†
Categorical variables		n (%)	n (%)	n (%)	p-value	n (%)	n (%)	p-value	n (%)	n (%)	p-value
Marital status
	Without partner	37 (20.0)	22 (59.5)	15 (40.5)	00.40‡	28 (75.7)	09 (24.3)	00.19‡	18 (48.7)	19 (51.3)	00.03‡
	With partner	148 (80.0)	99 (66.9)	49 (33.1)	00.40‡	95 (64.2)	53 (35.8)	00.19‡	101 (68.2)	47 (31.8)	00.03‡
Parity
	0–1	138 (74.6)	90 (65.2)	48 (34.8)	00.93‡	95 (68.8)	43 (31.2)	00.25‡	88 (63.8)	50 (36.2)	00.79‡
	≥2	47 (25.4)	31 (66.0)	16 (34.0)		28 (59.6)	19 (40.4)		31 (66.0)	16 (34.0)
Alcohol consumption
	No	153 (82.7)	97 (63.4)	56 (36.6)	00.21‡	102 (66.7)	51 (33.3)	00.91‡	97 (63.4)	56 (36.6)	00.57‡
	Yes	32 (17.3)	24 (75.0)	08 (25.0)		21 (65.6)	11 (34.4)		22 (68.7)	10 (31.3)
Current smoking habit
	No	175 (94.6)	113 (64.6)	62 (35.4)	00.32‡	116 (66.3)	59 (33.7)	00.81‡	114 (65.1)	61 (34.9)	00.33‡
	Yes	10 (5.4)	08 (80.0)	02 (20.0)		07 (70.0)	03 (30.0)		05 (50.0)	05 (50.0)
Unplanned pregnancy
	No	76 (41.1)	51 (67.1)	25 (32.9)	00.69‡	51 (67.1)	25 (32.9)	00.88‡	48 (63.2)	28 (36.8)	00.78‡
	Yes	109 (58.9)	70 (64.2)	39 (35.8)	00.69‡	72 (66.1)	37 (33.9)	00.88‡	71 (65.1)	38 (34.9)	00.78‡
Major depression//
	No	157 (84.9)	101 (64.3)	56 (35.7)	00.47‡	102 (65.0)	55 (35.0)	00.30‡	99 (63.1)	58 (36.9)	00.39‡
	Yes	28 (15.1)	20 (71.4)	08 (28.6)	00.47‡	21 (75.0)	07 (25.0)	00.30‡	20 (71.4)	08 (28.6)	00.39‡
Generalized anxiety//
	No	166 (89.7)	109 (65.7)	57 (34.3)	00.83^‡	114 (68.7)	52 (31.3)	00.06^‡	108 (65.1)	58 (34.9)	00.54^‡
	Yes	19 (10.3)	12 (63.2)	07 (36.8)		09 (47.4)	10 (52.6)		11 (57.9)	08 (42.1)

	Gestational Dietary Pattern (score)*,†
	Overall sample	Healthy			Common-Brazilian			Processed
	Overall sample	1st–2nd	3rd		1st–2nd	3rd		1st–2nd	3rd
	(n=185)	(n=121)	(n=64)		(n=123)	(n=62)		(n=119)	(n=66)
Social support‡	Mean (SD)	Mean (SD)	Mean (SD)	p-value§	Mean (SD)	Mean (SD)	p-value§	Mean (SD)	Mean (SD)	p-value§
Material	78.1 (19.7)	74.2 (19.8)	76.9 (19.5)	0.38	76.3 (19.5)	72.7 (19.9)	0.25	74.2 (19.5)	76.7 (20.1)	0.40
Affective	91.2 (13.8)	90.0 (15.4)	93.4 (9.8)	0.11	90.4 (14.8)	92.8 (11.6)	0.27	91.0 (13.3)	91.5 (14.8)	0.82
Emotional	80.4 (18.3)	80.0 (18.8)	81.1 (17.6)	0.71	79.6 (18.1)	81.9 (18.8)	0.42	81.1 (17.8)	79.2 (19.3)	0.50
Interaction	83.5 (16.0)	81.9 (16.6)	86.4 (14.6)	0.07	83.2 (16.8)	84.0 (14.4)	0.73	83.3 (15.7)	83.8 (16.8)	0.84
Information	79.9 (18.2)	79.3 (18.8)	80.9 (17.1)	0.57	78.5 (19.4)	82.6 (15.3)	0.15	80.5 (17.5)	78.7 (19.4)	0.51

Social support‡		Gestational Dietary Pattern (score)*,†
		Healthy		Common-Brazilian		Processed
		β (95%CI)	p-value	β (95%CI)	p-value	β (95%CI)	p-value
Material
	Crude	0.006 (-0.001–0.013)	0.10	-0.001 (-0.009–0.006)	0.72	0.001 (-0.006–0.009)	0.69
	Adjusted§	0.004 (-0.004–0.012)	0.29	-0.0002 (-0.008–0.008)	1.00	0.002 (-0.006–0.010)	0.65
Affective
	Crude	0.011 (0.001–0.021)	0.04	0.002 (-0.008–0.013)	0.65	-0.001 (-0.011–0.010)	0.91
	Adjusted§	0.011 (0.001–0.021)	0.04	0.003 (-0.008–0.014)	0.63	0.001 (-0.011–0.012)	0.88
Emotional
	Crude	0.003 (-0.005–0.011)	0.42	0.002 (-0.006–0.010)	0.57	-0.002 (-0.010–0.006)	0.62
	Adjusted§	0.005 (-0.003–0.013)	0.22	0.005 (-0.003–0.014)	0.20	-0.002 (-0.011–0.007)	0.69
Interaction
	Crude	0.010 (0.002–0.019)	0.02	0.001 (-0.008–0.010)	0.82	0.001 (-0.009–0.010)	0.91
	Adjusted§	0.011 (0.002–0.020)	0.02	0.003 (-0.007–0.012)	0.59	0.002 (-0.008–0.012)	0.74
Information
	Crude	0.004 (-0.004–0.011)	0.36	0.004 (-0.004–0.012)	0.29	-0.003 (-0.011–0.005)	0.48
	Adjusted§	0.004 (-0.004–0.012)	0.32	0.006 (-0.002–0.014)	0.17	-0.002 (-0.011–0.006)	0.61

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Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro Avenida Horácio Macedo, S/N, CEP: 21941-598, Tel.: (55 21) 3938 9494 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@iesc.ufrj.br

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[TFN1] SD: standard deviation; IQR: interquartile range.

[TFN2] ^*
Student's t-test;

[TFN3] ^†
Wilcoxon rank-sum; or

[TFN4] ^‡
χ² test;

[TFN5] ^§
Variable with one piece of missing data;

[TFN6] ^//
M.I.N.I. The International Neuropsychiatric Interview (DSM-IV; version 5.0.0.) referred to the first trimester.