FRIDAY, April 6 (HealthScout) -- Pregnant women who don't eat three meals a day with a few snacks in between run an increased risk of premature delivery, a study finds.
　　That pattern of eating was recommended in 1990 by an expert panel of the Institute of Medicine, which said that pregnant women should "eat small to moderate-sized meals at regular intervals, and eat nutritious snacks." The new study is the first to look at the effect of eating habits on the risk of preterm delivery, says Dr. David A. Savitz, chairman of the epidemiology department at the University of North Carolina School of Medicine in Chapel Hill.

"The strength of the analysis is its novelty," says Savitz, a member of the team reporting the finding in the April 1 issue of the American Journal of Epidemiology. "This is the first systematic look at the issue to date."
　　
　　There has been indirect evidence about the effect before, Savitz says. For example, one study found a dramatic increase in spontaneous deliveries among Jewish women who fasted for 24 hours during Yom Kippur, and laboratory studies found the same effect in animals.

"Meal patterns during pregnancy may be important because pregnant women who sustain prolonged periods of time without food by skipping meals and/or snacks may be inducing a physiologic stress on their pregnancy," the researchers write.

To see what that stress might do, the researchers had 2,247 pregnant women fill out forms describing not only how many meals and snacks they had a day, but also the timing of their food intake.

Emphasis on slight risk

Most of the women -- nearly three out of four -- did have the recommended three daily meals with two or more snacks in between. "Women who consumed food at a less optimal frequency were at a slightly higher risk for delivering preterm in general and were more likely to deliver after premature rupture of the membranes."

The emphasis should be on "slightly," says Dr. Allen Toles, associate attending physician at Long Island Jewish Hospital in Mineola, N.Y., and a spokesman for the American College of Obstetrics and Gynecology (ACOG). The basic recommendation for pregnant women is that "they eat healthy," he says.

"An ACOG pamphlet that I hand out during pregnancy gives information on a healthy diet, which should be a three-meal-a-day diet, but they don't have to adhere to it strictly," Toles says. "I don't want to drive them crazy about it."

The new study "may inspire other researchers to take a look at the effect of frequency of eating," Savitz says. "It joins the list of many factors affecting premature delivery, where before it was not on the list at all."

By Edward Edelson
　　From HealthScout