Summary:
Pregnancy involves substantial physiological changes that increase nutritional demands and highlight the importance of maternal diet. At the same time, conditions such as gestational diabetes, preeclampsia, and excessive weight gain during pregnancy are becoming more common, largely reflecting rising obesity rates and lifestyle changes. These complications contribute to poorer outcomes for both mother and baby, making prevention a key public health priority. The Mediterranean diet is a dietary pattern characterised by high intake of plant-based foods, moderate consumption of fish and dairy, and low intake of red and processed meats, with olive oil as the primary fat source. This pattern is rich in bioactive compounds, including polyphenols, which have anti-inflammatory and antioxidant effects and may improve metabolic processes such as insulin sensitivity and glucose regulation. Previous research has linked this diet to improved maternal health outcomes, particularly a reduced risk of gestational diabetes. This study is a cross-sectional analysis that examined the relationship between adherence to the Mediterranean diet and adverse pregnancy outcomes in 1,511 women. Diet quality was measured using a validated adherence score, and statistical models were used to assess associations with outcomes including overall complications, cesarean delivery, and stillbirth. This study found that higher adherence to the Mediterranean diet was associated with a lower likelihood of adverse pregnancy outcomes. There were also trends suggesting reduced risk of cesarean delivery and stillbirth, although these associations were less certain. Analysis of individual dietary components indicated that moderate dairy intake was associated with fewer adverse outcomes, while higher fruit intake was linked to a lower likelihood of cesarean delivery. Overall, this study suggests that greater adherence to a Mediterranean-style dietary pattern during pregnancy may be associated with improved maternal outcomes. However, as this study is observational, the findings reflect associations rather than causal relationships.
Abstract:
Background/Objectives: Pregnancy is a critical period during which lifestyle factors, including diet, can affect maternal and fetal outcomes. The Mediterranean Diet (MD) may offer advantages, but evidence on its impact on adverse pregnancy outcomes is limited. We evaluated the association between an MD and adverse pregnancy outcomes, cesarean delivery, and stillbirth outcomes in a large sample of hospitalized women in Italy. Methods: A cross-sectional analysis of retrospectively assessed dietary exposure was conducted using data from 1511 pregnant women recruited within the multi-center PLATONE project. Adherence to the MD was assessed through the nine-item MEDI-LITE. Multivariable logistic regression was used to evaluate the relationship between MD and adverse pregnancy outcomes. Results: High, average, and poor adherence to the MD were reported by 30.8%, 45.3%, and 23.9% of participants, respectively. In a multivariable adjusted analysis, each one-unit increase in the MEDI-LITE adherence was associated with a lower likelihood of adverse pregnancy outcomes (OR = 0.94; 95%CI: 0.88–0.99), while downward trends were also observed for cesarean delivery (OR = 0.96; 0.90–1.01) and stillbirth (OR = 0.94; 0.83–1.06). Among specific MEDI-LITE components, moderate intake of dairy products was associated with reduced adverse pregnancy outcomes, while moderate-to-high fruit consumption was linked to lowered cesarean odds. Conclusions: Maternal adherence to an MD was associated with lower odds of adverse pregnancy outcomes. Given the observational design and because MEDI-LITE is a validated adherence score rather than a tool to test causal effects on pregnancy outcomes, these findings should be interpreted as associations and do not allow causal inference.
Article Publication Date: 26/02/2026
DOI: 10.3390/nu18050769
