Published date: Mar 10 2025

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 23, Issue No. 1

Pages: 67 - 78

DOI: 10.18502/ijrm.v23i1.18189

Shahab-Aldin AkbarianDepartment of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd

Amin Salehi-AbargoueiDepartment of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd

Sara JambarsangDepartment of Biostatistics and Epidemiology, School of Public Health, Research Center of Prevention and Epidemiology of Non-Communicable Disease, Shahid Sadoughi University of Medical Sciences, Yazd

Habib NikukarMedical Nanotechnology and Tissue Engineering Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd

Azadeh NadjarzadehAzadnajarzadeh@ssu.ac.irDepartment of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd

Background: Abnormal gestational weight gain (GWG) can carry risks for both the mother and the baby. Diet imbalances are the determining factor in the weight gain of pregnant women.

Objective: This study aimed to assess the relationship between nutritional patterns and the weight of pregnant mothers living in Yazd, Iran from 2021–2022.

Materials and Methods: In this cohort study, data from 1497 pregnant women aged 18–45 yr with singleton pregnancy who completed the food frequency questionnaire in the Yazd Birth Cohort Study were extracted. This data included demographic variables, GWG (difference between initial weight at 13–15 wk and 1 wk before the expected delivery date), and food intake information before the 13th wk of pregnancy. The women were categorized into 3 groups based on GWG: inadequate, normal, and excessive. Dietary patterns were extracted from the food frequency questionnaire using principal component analysis, and multinomial logistic regression was used to evaluate the relationship between dietary patterns and GWG categories.

Results: According to the frequency of food consumption, 3 dietary patterns were obtained: the traditional pattern (cabbage vegetables, fruits, and dried fruits), the unhealthy pattern (processed meats and sweetened drinks), and the vegetable/fruit/olive pattern. The analysis results showed that pregnant women who followed the fruit/vegetable/olive pattern had a lower chance of insufficient weight gain during pregnancy (OR: 0.66, 95% CI: 0.45–0.98).

Conclusion: Consuming various fruits and vegetables can help regulate GWG in the population of pregnant women lived in Yazd, Iran. Diet can be considered one of the most effective and safe interventions.

Keywords: Pregnancy, Dietary patterns, Gestational weight gain

[1] Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: A systematic review and meta-analysis. JAMA 2017; 317: 2207–2225.

[2] Darling AM, Wang D, Perumal N, Liu E, Wang M, Ahmed T, et al. Risk factors for inadequate and excessive gestational weight gain in 25 low-and middle-income countries: An individual-level participant meta-analysis. PLoS Med 2023; 20: e1004236.

[3] Champion ML, Harper LM. Gestational weight gain: Update on outcomes and interventions. Curr Diab Rep 2020; 20: 11.

[4] Li M, Zhang C-Y, Yue C-Y. Effects of pre-pregnancy BMI and gestational weight gain on adverse pregnancy outcomes and complications of GDM. J Obstet Gynaecol 2022; 42: 630–635.

[5] Cano-Ibáñez N, Martínez-Galiano JM, Luque-Fernández MA, Martín-Peláez S, Bueno-Cavanillas A, Delgado-Rodríguez M. Maternal dietary patterns during pregnancy and their association with gestational weight gain and nutrient adequacy. Int J Environ Res Public Health 2020; 17: 79–88.

[6] Gilmore LA, Klempel-Donchenko M, Redman LM. Pregnancy as a window to future health: Excessive gestational weight gain and obesity. Semin Perinatol 2015; 39: 296–303.

[7] Guan P, Tang F, Sun G, Ren W. Effect of maternal weight gain according to the Institute of Medicine recommendations on pregnancy outcomes in a Chinese population. J Int Med Res 2019; 47: 4397–4412.

[8] Tebbani F, Oulamara H, Agli A. [Factors associated with low maternal weight gain during pregnancy]. Rev Epidemiol Sante Publique 2019; 67: 253–260. (in French)

[9] Campos CAS, Malta MB, Neves PAR, Lourenço BH, Castro MC, Cardoso MA. Gestational weight gain, nutritional status and blood pressure in pregnant women. Rev Saude Publica 2019; 53: 57–61.

[10] Tovar A, Kaar JL, McCurdy K, Field AE, Dabelea D, Vadiveloo M. Maternal vegetable intake during and after pregnancy. BMC Pregnancy Childbirth 2019; 19: 26–37.

[11] Lai JS, Soh SE, Loy SL, Colega M, Kramer MS, Chan JKY, et al. Macronutrient composition and food groups associated with gestational weight gain: The GUSTO study. Eur J Nutr 2019; 58: 1081–1094.

[12] Gernand AD, Schulze KJ, Stewart CP, West Jr KP, Christian P. Micronutrient deficiencies in pregnancy worldwide: Health effects and prevention. Nat Rev Endocrinol 2016; 12: 274–289.

[13] Cano-Ibáñez N, Martínez-Galiano JM, Amezcua-Prieto C, Olmedo-Requena R, Bueno-Cavanillas A, Delgado-Rodríguez M. Maternal dietary diversity and risk of small for gestational age newborn: Findings from a case-control study. Clin Nutr 2020; 39: 1943–1950.

[14] Martínez-González MÁ, Martín-Calvo N. The major European dietary patterns and metabolic syndrome. Rev Endocr Metab Disord 2013; 14: 265–271.

[15] Plante AS, Lemieux S, Labrecque M, Morisset AS. Relationship between psychosocial factors, dietary intake and gestational weight gain: A narrative review. J Obstet Gynaecol Can 2019; 41: 495–504.

[16] Itani L, Radwan H, Hashim M, Hasan H, Obaid RS, Ghazal HA, et al. Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: Results from the MISC cohort. Nutr J 2020; 19: 36.

[17] Saldiva SRDM, De Arruda Neta AdCP, Teixeira JA, Peres SV, Marchioni DML, Carvalho MA, et al. Dietary pattern influences gestational weight gain: Results from the ProcriAr cohort study-São Paulo, Brazil. Nutrients 2022; 14: 4428.

[18] Sharifi SF, Javadi M, Barikani A. Reliability and validity of short food frequency questionnaire among pregnant females. Biotechnol Health Sci 2016; 3: 432–451.

[19] Tielemans MJ, Garcia AH, Santos AP, Bramer WM, Luksa N, Luvizotto MJ, et al. Macronutrient composition and gestational weight gain: A systematic review. Am J Clin Nutr 2016; 103: 83–99.

[20] Schulz Ch-A, Oluwagbemigun K, Nöthlings U. Advances in dietary pattern analysis in nutritional epidemiology. Eur J Nutr 2021; 21: 4115–4130.

[21] Tielemans MJ, Erler NS, Leermakers ET, Van den Broek M, Jaddoe VW, Steegers EA, et al. A priori and a posteriori dietary patterns during pregnancy and gestational weight gain: The generation R study. Nutrients 2015; 7: 9383–9399.

[22] Guilloty NI, Soto R, Anzalota L, Rosario Z, Cordero JF, Palacios C. Diet, pre-pregnancy BMI, and gestational weight gain in Puerto Rican women. Matern Child Health J 2015; 19: 2453–2461.

[23] Maugeri A, Barchitta M, Favara G, La Rosa MC, La Mastra C, Magnano San Lio R, et al. Maternal dietary patterns are associated with pre-pregnancy body mass index and gestational weight gain: Results from the “mamma & bambino” cohort. Nutrients 2019; 11: 1308.

[24] Wrottesley SV, Pisa PT, Norris SA. The influence of maternal dietary patterns on body mass index and gestational weight gain in urban black South African women. Nutrients 2017; 9: 732.

[25] Ferreira LB, Lobo CV, Miranda AEdS, Carvalho BdC, Santos LCd. Dietary patterns during pregnancy and gestational weight gain: A systematic review. Rev Bras Ginecol Obstet 2022; 44: 540–547.

[26] Shin D, Lee KW, Song WO. Pre-pregnancy weight status is associated with diet quality and nutritional biomarkers during pregnancy. Nutrients 2016; 8: 162.

[27] Hillesund ER, Bere E, Haugen M, Øverby NC. Development of a New Nordic Diet score and its association with gestational weight gain and fetal growth-a study performed in the Norwegian Mother and Child Cohort Study (MoBa). Public Health Nutr 2014; 17: 1909–1918.

[28] Zhang S, Zhang C, Guo J, Li B, Li W, Liu J, et al. Higher sweet beverage consumption was associated with increased gestational weight gain and birth weight: A Chinese cohort study. Nutr Res 2024; 132: 15–26.

[29] Angali KA, Shahri P, Borazjani F. Maternal dietary pattern in early pregnancy is associated with gestational weight gain and hyperglycemia: A cohort study in South West of Iran. Diabetes Metab Syndr 2020; 14: 1711–1717.

[30] Tayyem R, Allehdan SS, Al-Awwad NJ, Alatrash RM, Mahfouz IA, Alasali F. Food group intake of pregnant jordanian women based on the three pregnancy trimesters. Prev Nutr Food Sci 2020; 25: 346.

[31] Zhou M, Peng X, Yi H, Tang S, You H. Determinants of excessive gestational weight gain: A systematic review and meta-analysis. Arch Public Health 2022; 80: 129.

[32] Jideani AI, Silungwe H, Takalani T, Omolola AO, Udeh HO, Anyasi TA. Antioxidant-rich natural fruit and vegetable products and human health. Int J Food Propert 2021; 24: 41–67.

[33] Wei X, He J-R, Lin Y, Lu M, Zhou Q, Li S, et al. The influence of maternal dietary patterns on gestational weight gain: A large prospective cohort study in China. Nutrition 2019; 59: 90–95.