A Retrospective Cross-Sectional Population-Based Study on Prenatal Levels of Adherence to the Mediterranean Diet: Maternal Profile and Effects on the Newborn

Abstract

The Mediterranean diet (MD) is a dietary pattern with important benefits. The objectives of this study were to assess the adherence to the MD among pregnant women in Valencia (Spain) and characterize the pregnant women according to their level of adherence. Finally, we aimed to examine the role of MD adherence during pregnancy in the anthropometric development of the newborn. The study included 492 pregnant women who were followed at La Fe Hospital in 2017. The self-administered “Kidmed” questionnaire for data collection on dietary information evaluation was used and a clinical history review of mothers and newborns was performed. Two groups of mothers were identified: those with low adherence (LA) and optimal adherence (OA). The study revealed that 40.2% of the women showed LA to the MD. The newborns born to these women presented a higher risk of being small for gestational age (SGA) {adjusted odds ratio (aOR) = 1.68; 95% confidence interval (CI) 1.02–5.46} when adjusting for parental body mass index (BMI) and multiple gestation, but not when adjusting for all significant possible confounders (aOR = 2.32; 95% CI 0.69–7.78). The association between MD and SGA was not significantly affected by the use of iron and folic acid supplements (aOR = 2.65; 95% CI 0.66–10.65). The profile of the pregnant woman with LA is that of a young smoker, with a low level of education and a low daily intake of dairy products. These results suggest that LA to the MD is not associated with a higher risk of giving birth to a SGA newborn.

The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health

“…Fernandez-Barres, et al [30] evaluated associates between adherence to the MD during pregnancy, but found no risk to childhood obesity, however, it was associated with a lower waist circumference, which is related to abdominal obesity and is an important health marker. Peraita-Costa et al [40] administered the “Kidmed” questionnaire to collect dietary information from mothers on adherence to the MD. Of the 492 women, 40.2% showed low adherence to the MD, but this study did not directly correlate the results to low birth weight due to potentially confounding factors including smoking, low education levels, and low dairy intake.…”

Effect of Adherence to Mediterranean Diet during Pregnancy on Children’s Health: A Systematic Review

“…An association between low maternal MDA and risk of SGA in new-borns was evidenced in another Spanish retrospective, cross-sectional population-based study involving 492 pregnant women [43]. A 16 items semi-quantitative FFQ was self-administered after delivery, and adherence to the MD was evaluated according to a modified version of the KidMed score [44] considering optimal (>7 score) and low (<7 score) adherence.…”

Maternal Adherence to the Mediterranean Diet during Pregnancy: A Review of Commonly Used a priori Indexes

“…In total, 27 observational studies were included in the review: 17 (63.0%) cohort studies [20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][36][37]; 7 (25.9%) cross-sectional studies [38][39][40][41][42][43][44]; 2 (7.4%) case-control studies [23,45]; and, 1 (3.7%) nested case-control study [46]. Table 2 provides a summary of the key characteristics of these 27 studies.…”

“…All studies included fruits as a beneficial component in their index . Seven studies specified the inclusion of fruit juices in the fruit component [20,33,[40][41][42]44,46]. Only one study explicitly excluded fruit juices from inclusion in the fruit component of their index [22].…”

“…Moreover, nine studies grouped fruits and nuts together as a single component [21,22,24,[27][28][29][30]37,39] in line with the original designs of the MDS-2003 [13] and rMed [49] employed by these studies. [20][21][22][23][24][27][28][29][30][32][33][34]36,37,[39][40][41][42][43][44][45][46], including only the PREDIMED score of Martínez-Galiano et al (2018) [23]. Thirteen studies categorized nuts as a separate component from fruits [20,23,[32][33][34]36,[40][41][42][43][44][45][46].…”