How a Mediterranean Diet Can Impact Pregnancy Outcomes

A Mediterranean diet — rich in vegetables, legumes, fruits, and nuts but low in saturated fats and processed meats — has been linked to favorable outcomes across many patient populations, including patients with chronic disease. It is thought that stricter adherence to this diet is linked with lower chronic disease risk and a longer lifespan. Considering the importance of nutrition during pregnancy, researchers in a study published in JAMA Network Open hoped to determine how a Mediterranean diet can impact pregnancy outcomes, specifically adverse pregnancy outcomes.

This publication, emphasizing the result of many others, notes that the United States has a significantly higher pregnancy-related mortality rate than other developed countries. The CDC notes that, in 2020, there were 861 reported pregnancy-related deaths, an increase from the previous year. Additional data from the CDC notes that approximately 80% of these deaths are preventable.

Researchers in JAMA hoped to determine whether a Mediterranean diet can help reduce the risk of adverse pregnancy outcomes (APOs). They gathered data from the Nulliparous Pregnancy Outcomes Study and used data on 7,798 patients of varying racial, ethnic, and geographic profiles.

Patients were given an Alternative Mediterranean Diet (aMed) score, in which a score of 0–3 is low, 4–5 is moderate, and 6–9 is high. APOs were defined as having one or more complications, including pre-eclampsia, eclampsia, gestational hypertension, gestational diabetes, preterm birth, low birth weight considering gestational age, or stillbirth.

The average aMed score of the participants was 4.3. Roughly 30.6% of participants had a high aMed score, while 31.2% and 38.2% had moderate and low aMed scores, respectively. Researchers determined that a high aMed score was associated with a 21% lower rate of any APO than a low aMed score. Specifically, those with a low aMed score were 28% more likely to develop preeclampsia or eclampsia and 37% more likely to have gestational diabetes.

These trends were consistent across all racial and ethnic groups. Additionally, variations in pre-pregnancy BMI had no notable differences in outcome. However, women older than 34 showed stronger inverse relationships between aMed scores and APO risk.

Researchers in the publication concluded that “greater adherence to a Mediterranean diet pattern is associated with lower risk of APOs, with evidence of a dose-response association. Intervention studies are needed to assess whether dietary modification around the time of conception can reduce the risk of APOs and their downstream associations with future development of cardiovascular disease risk factors and overt disease.”