From mother’s plate to newborn’s health: dietary patterns and pregnancy outcomes—a cohort study

Abstract

Abstract Background Maternal nutrition during pregnancy significantly influences both maternal and neonatal health outcomes, yet distinct dietary patterns and their impacts remain underexplored. The objective of this study was to identify dietary patterns during pregnancy and to investigate associations between these patterns and pregnancy outcomes. Methods We analyzed data from 1404 pregnant women in the LIFE Child cohort (Germany, 2011–2025) who completed a Food Frequency Questionnaire. To identify food groups and dietary patterns, hierarchical clustering was applied. Linear and logistic models were used to examine how these dietary patterns are associated with maternal parameters such as BMI, socioeconomic status, and age, as well as infant birth outcomes including gestational age, birth weight, and birth length. Results Four distinct dietary patterns were identified: mixed-diet, traditional bread-based, high-ultra-processed foods (high-UPF), and vegetable-rich. Significant differences in maternal characteristics were observed across these dietary patterns. Women adhering to the high-UPF pattern had the highest pre-pregnancy BMI and highest gestational weight gain, whereas women following the vegetable-rich pattern had the lowest pre-pregnancy BMI. Regarding neonatal outcomes, infants born to mothers in the vegetable-rich pattern had a significantly higher gestational age at birth and greater birth length compared with selected other dietary patterns. Furthermore, mothers adhering to the high-UPF pattern had the lowest proportion of infants born appropriate for gestational age; however, these differences were not statistically significant. Conclusion Maternal dietary patterns during pregnancy were associated with maternal characteristics and selected neonatal outcomes, supporting the critical importance of early nutritional information in pregnancy care.