TOPLINE:

Higher adherence to Mediterranean diet (MD) during pregnancy was associated with lower odds of adverse pregnancy outcomes, particularly with moderate dairy intake and moderate-to-high fruit consumption.

METHODOLOGY:

• Researchers conducted an observational cross-sectional analysis to determine whether maternal adherence to the MD is associated with adverse pregnancy outcomes.
• They included 1511 pregnant women (mean age, 33.1 years) from four obstetric units in Italy who were admitted to the hospital for at least 24 hours for childbirth and/or complications between 2019 and 2023.
• Adherence to the MD was assessed during the first days of the hospital stay using the validated nine-item MEDI-LITE questionnaire evaluating data on the intake of fruit, vegetables, cereals, legumes, fish, meat, milk and dairy products, alcohol, and olive oil (score range, 0-18; higher scores indicating greater adherence).
• MEDI-LITE scores were categorised into three tertiles of adherence: poor adherence (0-9 points), average adherence (10-11 points), and high adherence (12-17 points).
• Outcomes assessed were adverse pregnancy outcomes (pregnancy, delivery, and foetal complications), mode of delivery (vaginal vs caesarean), and stillbirth, identified from electronic hospital records using standard diagnostic codes.

TAKEAWAY:

• Overall, 361 (23.9%) women reported poor adherence to the MD, 685 (45.3%) reported average adherence, and 465 (30.8%) reported high adherence.
• After multivariable adjustments, each one‑point increase in the MEDI‑LITE score was associated with lower odds of adverse pregnancy outcomes (odds ratio, 0.94; 95% CI, 0.88-0.99). Associations with caesarean delivery and stillbirth were in the same direction but were not statistically significant.
• A moderate intake of milk and dairy products (1-1.5 portions per day) was linked to 42% lower odds of developing the risk for adverse pregnancy outcomes.
• A moderate-to-high intake of fruit (at least one serving per day) was associated with a lower likelihood of caesarean delivery and stillbirth (P for trend < .05 for both).

IN PRACTICE:

"Our findings align with a growing body of evidence supporting the protective role of the MD in reducing the risk of adverse pregnancy outcomes," the authors wrote.

SOURCE:

This study was led by Simona Esposito, Research Unit of Epidemiology and Prevention, IRCCS Neuromed, Isernia, Italy. It was published online on February 26, 2026, in Nutrients.

LIMITATIONS:

The observational cross-sectional nature of the study may have introduced residual confounding and restricted causal inference. Data on diet were self-reported, which may have introduced recall and social desirability bias. The relatively small number of specific events, particularly stillbirths, limited power to analyse individual complications and draw definitive conclusions.

DISCLOSURES:

This study did not receive any external funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.