Summary:
Maternal nutrition during pregnancy plays a key role in fetal development and long-term health outcomes in offspring. Both inadequate and excessive intake can disrupt normal development and increase risks such as low birth weight, preterm birth, and later chronic diseases including obesity, type 2 diabetes, and cardiovascular disease. Diet quality appears more important than individual nutrients, with balanced, minimally processed diets associated with better pregnancy and birth outcomes. In contrast, Western-style diets high in sugar, saturated fat, and ultra-processed foods are linked to increased neonatal adiposity, impaired fetal growth, and higher cardiometabolic risk in offspring. Maternal nutrition also influences fetal development through biological mechanisms such as epigenetic regulation, where diet alters gene expression and long-term control of metabolism, immunity, and brain development. Key nutrients in these pathways include folate, omega-3 fatty acids, iodine, iron, and vitamin B12, while deficiencies are associated with poorer growth and neurodevelopmental outcomes. This narrative review synthesises evidence from observational, systematic, and experimental studies, reporting that both undernutrition and overnutrition can alter placental structure and function, including nutrient transport and hormonal signalling. These changes help explain variations in fetal growth and birth weight. The review also highlights that maternal diet influences the gut microbiome and immune development, shaping both early and long-term disease risk. Overall, the review concludes that maternal nutrition is a major determinant of pregnancy and lifelong child health. Balanced, nutrient-dense diets support optimal fetal development, while poor dietary patterns increase the risk of metabolic, immune, and neurodevelopmental disorders.
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Abstract:
Over recent decades, a substantial body of research has expanded our understanding of how early-life conditions influence long-term health. These observations led to the formulation of the Barker Hypothesis, which postulates that adverse nutritional exposures during fetal life can induce persistent physiological and metabolic adaptations, thereby increasing susceptibility to chronic diseases later in life. This narrative review aims to provide a comprehensive overview of current recommendations for adequate maternal nutrition during pregnancy, with particular emphasis on key nutrients and specific dietary patterns. In addition, the effects of maternal diet on placental function and fetal growth are examined. A literature search was conducted in the following electronic databases: MEDLINE (via PubMed), Scopus, Web of Science, Embase, and the Cochrane Library. Manuscripts published between 2005 and 2025 were considered. The impact of prenatal nutritional exposures on immune development, neurodevelopment, metabolic regulation, and gut microbiota is also discussed, highlighting how these mechanisms may contribute to an increased long-term risk of non-communicable diseases, including obesity, metabolic syndrome, and neuropsychiatric disorders. Maternal nutrition during pregnancy plays a crucial role in shaping infants’ and children’s health, particularly regarding the development of non-communicable diseases. Therefore, ensuring adequate nutritional intake during this critical period—both quantitatively and qualitatively—is essential to optimize health outcomes for the newborn and to promote long-term well-being throughout childhood and beyond.
Article Publication Date: 27/04/2026
DOI: 10.3390/nu18091375
