The relationship between adherence to the Mediterranean dietary pattern during early pregnancy and behavioral, mood and cognitive development in children under 1 year of age: a prospective cohort study

ABSTRACT

Purpose

To investigate the potential relationship between diet quality, represented by the Mediterranean diet score, during early pregnancy and behavioral, mood, and cognitive development in children under 1 year of age in a prospective cohort study in Iran.

Methods

658 Iranian pregnant women and their infants participated in this prospective birth cohort study. The Mediterranean diet score was calculated by using data from a food frequency questionnaire during the first trimester of pregnancy. We assessed the children’s development using the Ages and Stages Questionnaire (ASQ) at 6-month age. We used Cox proportional hazard model to calculate the hazard ratio (HR) and 95% confidence interval (CI) of ASQ domains across categories of the Mediterranean diet score.

Results

The mean age of the mothers was 28.8 ± 5.08 years old, and the average follow-up duration was 90 weeks. The mean BMI of the mothers before pregnancy was 25.1 ± 4.43 kg/m². In the multivariable-adjusted model, those infants whose mothers were in the second (HR: 0.44; 95% CI: 0.19, 1.04; P = 0.06) and third (HR: 0.39; 95% CI: 0.17, 0.89; P = 0.03) tertiles of the Mediterranean diet score had a lower risk of communication impairment compared to those who were at the first tertile. There was no association between maternal adherence to the Mediterranean diet during early pregnancy and other domains of the ASQ.

Conclusions

Greater adherence to the Mediterranean dietary pattern during the first trimester of pregnancy may be favorably associated with communication abilities at 6-month aged infants. More large-scale cohort studies are needed to confirm our findings.

KEYWORDS:

• Dietary pattern
• pregnancy
• cognitive development
• infancy
• Mediterranean diet
• age and stage questionnaire
• diet

Acknowledgments

We thank all those who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data described in the manuscript, code book, and analytic code will be made available upon request.

Additional information

Funding

This work was supported by the Semnan University of Medical Sciences under Grant number 1923.

Notes on contributors

Bahareh Jabbarzadeh Ganjeh

Bahareh Jabbarzadeh Ganjeh, an M.Sc student of nutrition, writes on nutrition research. Among her recent papers are Jabbarzadeh-Ganjeh, B., Jayedi, A. and Shab-Bidar, S., 2022. The effects of olive oil consumption on blood lipids: a systematic review and dose-response meta-analysis of randomized controlled trials. British Journal of Nutrition, pp.1–25. Mirrafiei, A., Jabbarzadeh, B., Hosseini, Y., Djafarian, K. and Shab-Bidar, S., 2022. No association between dietary magnesium intake and body composition among Iranian adults: a cross-sectional study. BMC nutrition, 8(1), p. 39.

Amin Mirrafiei

Amin Mirrafiei, an M.Sc student of nutrition, writes on nutrition research. Among his recent papers are Mirrafiei, A. and Shab-Bidar, S., Traditional Dietary Patterns in the Elderly: Iranian Aspect. In Ancient and Traditional Foods, Plants, Herbs and Spices used in the Middle East (pp. 71–81). CRC Press. Mirrafiei, A., Hasanzadeh, M., Sheikhhossein, F., Majdi¹, M., Djafarian, K. and Shab-Bidar, S., 2023. Association of main meal quality index with the odds of metabolic syndrome in Iranian adults: a cross-sectional study. BMC nutrition, 9(1), pp. 1–11.

Ahmad Jayedi

Ahmad Jayedi, a PhD candidate in nutrition, writes on nutrition research. Among his recent papers are Jayedi, A., Neyestanak, M.S., Qorbani, M., Abbasi-Ghahremanloo, A., Djafarian, K. and Shab-Bidar, S., 2023. Comparison of habitual and meal-specific dietary patterns identified by latent class analysis and confirmatory factor analysis in adults: a cross-sectional study. Nutrition, p. 112185. Jayedi, A., Daneshvar, M., Jibril, A.T., Sluyter, J.D., Waterhouse, M., Romero, B.D., Neale, R.E., Manson, J.E. and Shab-Bidar, S., 2023. Serum 25 (OH) D concentration, vitamin D supplementation, and risk of cardiovascular disease and mortality in patients with type 2 diabetes or prediabetes: a systematic review and dose-response meta-analysis. The American Journal of Clinical Nutrition.

Majid Mirmohammadkhani

Majid Mirmohammadkhani, a professor of epidemiology, writes on epidemiology. Among his recent papers are Keshtmandi, H., Mirmohammadkhani, M. and Rahmanian, M., 2023. Adjuvant Treatment with Oral Dydrogesterone in the Prevention of Preterm Labor: A Randomized, Double-Blinded, Placebo-Controlled Trial. Reproductive Sciences, pp. 1–9. Ghahremanfard, F., Jandaghi, E., Ghobad, R., Mirmohammadkhani, M. and Sarabi, M., 2023. Anti-TPO antibody and thyroid hormone levels in Iranian female breast cancer patients and their association with prognostic factors: A case-control study. European Journal of Translational Myology, 33(1).

Alireza Emadi

Alireza Emadi, an M.Sc of information technology, writes on health sciences. Among his recent papers are Jayedi, A., Zeraattalab-Motlagh, S., Moosavi, H., Mirmohammadkhani, M., Emadi, A. and Shab-Bidar, S., 2023. Association of plant-based dietary patterns in the first trimester of pregnancy with gestational weight gain: results from a prospective birth cohort. European Journal of Clinical Nutrition, pp. 1–8. Emadi, A., Halakoo, S., Delkhoush, C.T. and Ehsani, F., 2023. The Effects of Neuromodulators on Spasticity, Balance, and Gait in Patients with MS: A Systematic Review and Meta-Analysis Study. European Neurology, 86(2), pp. 144–154.

Farzaneh Ehsani

Farzaneh Ehsani, an M.Sc of psychology.

Sakineh Shab-Bidar

Sakineh Shab-Bidar, an associate professor of nutrition, writes on nutrition research. Among her recent works are Martami, F., Togha, M., Qorbani, M., Shahamati, D., Salami, Z. and Shab-Bidar, S., 2023. Association of dietary patterns with migraine: A matched case-control study. Current Journal of Neurology, pp. 87–95. Shahinfar, H., Payandeh, N., Torabynasab, K., Shahavandi, M., Mohammadpour, S., Babaei, N., Ebaditabar, M., Djafarian, K. and Shab-Bidar, S., 2023. The combined association of dietary inflammatory index and resting metabolic rate on cardiorespiratory fitness in adults. Journal of Health, Population and Nutrition, 42(1), p. 68. Omrani, M., Hosseinzadeh, M., Shab Bidar, S., Mirzaei, M., Teymoori, F., Nadjarzadeh, A., Firouzabadi, F.D. and Rahideh, S.T., 2023. Insulinaemic potential of diet and lifestyle and risk of type 2 diabetes in the Iranian adults: result from Yazd health study. BMC Endocrine Disorders, 23(1), pp. 1–10.