Maternal profile according to Mediterranean diet adherence and small for gestational age and preterm newborn outcomes

Abstract

Objective: The objective was to evaluate maternal Mediterranean diet (MD) pattern adherence during pregnancy and its association with small for gestational age (SGA) and preterm birth. A secondary objective of the current study was to describe the sociodemographic, lifestyle and obstetric profile of the mothers studied as well as the most relevant paternal and newborn characteristics. Design: The current study is a two-phase retrospective population-based study of maternal dietary habits during pregnancy and their effect on newborn size and prematurity. The descriptive first phase examined maternal dietary habits during pregnancy along with the maternal sociodemographic, lifestyle and obstetric profile in a cross-sectional period study. In the second phase, newborn outcomes were evaluated in a nested case–control study. Adherence to MD during pregnancy was measured with the Spanish version of Kidmed index. Setting: Obstetrics ward of the La Fe Hospital in Valencia. Participants: All mother–child pairs admitted after delivery during a 12-month period starting from January 2018 were assessed for eligibility. A total of 1118 provided complete outcome data after signing informed consent. Results: 14·5 % met the criteria of poor adherence (PA); 34·8 %, medium adherence (MA); and 50·7 %, optimal adherence (OA). Medium adherence to MD was associated in the adjusted scenarios with a higher risk of giving birth to a preterm newborn. No association was found between MD adherence and SGA. Conclusions: Early intervention programmes geared towards pregnant women, where women were aided in reaching OA to MD, might reduce the risk of preterm newborn.

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.…”

“…The studies were published from 2008 to 2020. 20 studies were conducted in Europe of which 17 were conducted in the Mediterranean countries of Spain [21][22][23][25][26][27][28][29][30][40][41][42]44,46], Greece [20,28,29,38], and Italy [43], whereas the other three were conducted in Norway [31], Denmark [35], and the United Kingdom [24]. Seven studies were conducted in North America including the United States [20,[32][33][34]36], Mexico [39], and the Caribbean [37].…”

“…In terms of outcomes, 23 studies evaluated associations between exposure of maternal adherence to the MD and offspring health outcomes: Including newborn anthropometrics and risk of preterm birth (n = 10) [23,28,31,[35][36][37][38]42,44,46]; risk of atopic diseases (n = 7) [24][25][26][27]29,32,39]; and the development of cardiometabolic disorder risk factors (n = 6) [20,21,30,34,40,41]. Three studies assessed maternal adherence to the MD in relation to maternal health outcomes: Including the risk of GDM (n = 1) [45] and levels of homeostasis model assessment of insulin resistance and adiponectin (n = 2) [33,43].…”

“…[48] but with additional food components (i.e., potatoes, pasta, rice, and fast food) included at the discretion of the study group [25,26]. Others used the MDS-2006 (n = 2) [23,38]; a modified version of the Mediterranean diet quality index in children and adolescents (KIDMED) index (n = 2) [42,46]; as well as Khoury's criteria (n = 2) [31,35] based on principles established in a randomized controlled trial on pregnant women [51]. Only one study used the alternative MD (aMed)-another variation of the MDS-2003 [59] adapted in a US cohort-in their main analysis [36].…”

Associations between Maternal Cadmium Exposure with Risk of Preterm Birth and Low Birth Weight: Effect of Mediterranean Diet Adherence on Affected Prenatal Outcomes

“…The Mediterranean diet pattern which is characterized by a high intake of iron, selenium, and antioxidants can be easily studied and translated to public health guidelines. Maternal adherence to a Mediterranean diet during pregnancy has been found to be associated with a reduced risk of gestational diabetes [22], normal birth weight [23][24][25][26] and longer gestational age [26,27], as well as favorable behavioral patterns [28], and other positive child outcomes [26]. Although there is an abundance of evidence suggesting multiple health benefits from adhering to a Mediterranean diet pattern [29][30][31][32][33], the potential role of this diet in mitigating the effects of prenatal cadmium exposure and birth outcomes has not yet been described.…”