Perinatal depression is a common disorder that can manifest during pregnancy and the postpartum period, severely affecting both the mother and the baby. Dietary factors have been associated with an increased risk of perinatal depression. We analyzed the association between adherence to certain dietary patterns before and during pregnancy and postpartum and perinatal depression. A scoping review of the available literature was conducted reporting the main findings following the PRISMA 2020 statement. The search strategy was last reproduced in December 2024 in MEDLINE, Web of Science and Scopus databases. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale and the Revised Cochrane risk-of-bias tool for randomized trials. The protocol has been published on OSF (https://doi.org/10.17605/OSF.IO/AV8TP). 11 studies (6 cohort studies, 4 cross-sectional studies, and 1 randomized clinical trial) conducted in various countries were included in the mapping review. These studies evaluated the dietary intake of the participants at different times during the perinatal period and identified several dietary patterns. 9/11 studies showed a significant inverse association between adherence to the Mediterranean Diet or healthy patterns, characterized by high intake of vegetables, fruits, fish and seafood and perinatal depression. In contrast, 4/11 studies showed that adherence to Western dietary patterns and the consumption of ultra-processed foods was associated with higher risk of perinatal depression. Adherence to healthy dietary patterns may be negatively associated with perinatal depression. Conversely, Western diet and the intake of ultra-processed and pro-inflammatory foods are directly associated with a higher risk of perinatal depression.

This review aimed to summarise the nutrition education programs and interventions that have sought to improve maternal health outcomes. Pregnancy is often considered a “teachable moment” when mothers may be motivated to adopt positive behavioural changes, including improving their nutrition habits. Pregnancy nutrition education is the provision of information and guidance on optimal nutritional practices that aim to support a healthy pregnancy. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched (Medline, Embase, CINAHL, Global Health, Scopus, PsycARTICLES, SocINDEX, Academic Search Complete) for studies reporting on nutrition education programs and interventions with pregnant women. Studies were included based on PICOS criteria, with no limitations on time and study design. Data were extracted and thematically analysed to identify the scope of diet, nutrition knowledge, and maternal outcomes included. This review includes 169 studies, which included various maternal outcomes, gestational weight gain; gestational diabetes mellitus, hypertensive disorders of pregnancy, and anaemia; dietary outcomes; nutritional status; and nutritional knowledge, attitudes, and/or behaviours. Significant positive results were observed for many health and dietary outcomes, with the exception of prevention of gestational diabetes and hypertensive disorders of pregnancy. A range of strategies have been used to deliver nutrition education. This inconsistency makes it challenging to summarize the key components of effective nutrition education and highlights the need for targeted approaches tailored to specific maternal outcomes.

The Healthy Eating Index (HEI) is widely used to assess diet quality, but certain contexts (e.g., pregnancy) may benefit from tailored versions. We evaluated whether the HEI’s current approach of assigning approximately equal weights to all components to compute the total score is appropriate when studying diet quality around conception. Data were from a U.S. prospective cohort of individuals who had not delivered a previous pregnancy past 20 weeks’ gestation (2010–2013, n=7882). Usual dietary intake around conception was estimated from food frequency questionnaires. Select adverse pregnancy outcomes (gestational diabetes, preeclampsia, preterm delivery, and small-for-gestational age birth) were abstracted from the medical record. We regressed each outcome on the 13 HEI-2015 component scores using SuperLearner, an ensemble machine learning method that combines predictions from multiple algorithms and avoids relying on parametric assumptions that characterize standard regression. We assessed the relative importance of each component using two permutation-based metrics: change in negative log likelihood (global influence) and absolute difference in the predicted probabilities (individual-level influence). Six of the 13 components (Greens and Beans, Saturated Fats, Total Protein Foods, Seafood and Plant Proteins, Fatty Acids, and Added Sugars) were important according to at least one metric for at least two of the four outcomes. In contrast, the Refined Grains component was not appreciably important for any outcome. These findings suggest that equal weighting of the HEI components may not be appropriate when evaluating diet quality for studies of pregnancy.

The aim is to examine the relationship between factors thought to potentially influence weight gain, such as sustainable nutrition (SN) behavior and plate clearing tendency (PCT) during pregnancy, and gestational weight gain (GWG). This cross-sectional correlational study was conducted on 340 women in the last trimester of pregnancy. Study data were collected through face-to-face interviews using a questionnaire form between October-December 2024. PCT is lower among younger women, those with low income and those with insufficient GWG (p<0.05). SN behaviors are higher in those who are older, have higher education levels, lower income and moderate physical activity (p<0.05). A negative correlation was found between food preference, a component of SN behaviors, and GWG (p<0.05). In the binary logistic regression model, higher pre-pregnancy BMI significantly increased the likelihood of excessive GWG (OR=1.49, 95% CI:1.332–1.665, p<0.001), whereas high physical activity was found to be protective against excessive GWG (OR=0.214, 95% CI:0.061–0.747, p=0.016). It was determined that pre-pregnancy BMI was higher and physical activity was lower in those with excessive GWG, in addition, food preference, one of the factors of SN behavior, affected weight gain. Food preference can be considered as a factor that may affect GWG.

Fe-deficiency anaemia is common during pregnancy and can lead to serious health consequences for mothers and babies. Antenatal Fe supplementation is associated with lower anaemia prevalence and improved pregnancy outcomes, and the WHO recommends daily oral Fe (30–60 mg) with folic acid (0·4 mg) during pregnancy. However, data on uptake and adherence in many low- and middle-income countries remain fragmented and outdated. We conducted a secondary analysis of Demographic and Health Surveys from sixty-nine low- and middle-income countries to assess uptake and adherence to Fe-containing supplements and explore associations with socio-demographic characteristics and antenatal care (ANC). Overall, 86 % of respondents reported receiving Fe supplements during pregnancy. Among these women, 46·1 % consumed ninety or more supplements, 23·3 % consumed 120 or more, and only 7·1 % consumed 180 or more. Higher education, wealth, and media access were strongly associated with increased odds of initiating supplementation (OR: 1·32; 95 % CI: 1·25, 1·38; OR: 1·29; 95 % CI: 1·20, 1·38; OR: 1·15; 95 % CI: 1·05, 1·26, respectively) and adhering to the regimen (OR: 1·16; 95 % CI: 1·12, 1·21; OR: 1·21; 95 % CI: 1·13, 1·30; OR: 1·14; 95 % CI: 1·08, 1·20, respectively). Early ANC attendance was also associated with higher supplement consumption. Country-specific ANC guidelines are needed to provide clear guidance on the timing and frequency of ANC attendance and supplementation.

Providing physiologic support to a brain-dead pregnant decedent poses complex ethical, legal, and clinical challenges. Understanding these considerations is necessary to navigate complex discussion and provide appropriate medical care. We use a theoretical case to examine these considerations and outline a path forward.

Gestational weight gain (GWG) can be defined as the total weight gained throughout pregnancy and is required for healthy fetal growth; however, gaining excessive weight during pregnancy has been linked with several adverse effects. This review aims to consider the evidence on weight management during pregnancy, with a focus on the key challenges surrounding GWG and the practical considerations related to assessing weight changes. It is estimated that nearly 50% of women gain excessive weight during pregnancy; nevertheless, this can be difficult to quantify due to the lack of global consensus on recommended GWG guidelines. Currently, there are no GWG guidelines in the UK and Ireland, as reiterated in the recent National Institute for Health and Care Excellence guidelines, due to the lack of evidence about what the optimal total weight change in pregnancy should be. This is further complicated by the conflicting results of interventions aimed at preventing excessive GWG and their resultant inconsistent effects on adverse pregnancy outcomes. Accurate calculation of GWG requires measurement of pre-pregnancy weight and weight prior to the onset of labour. However, several practical considerations are associated with obtaining these weights, as in practice, estimated or self-recalled weights are often used as an alternate, thereby introducing variability into the measurement of GWG and the potential for inaccuracies in analysis. These limitations highlight the need for a more uniform approach in assessing GWG. The WHO is in the process of developing global GWG standards, and this could potentially establish a uniform gold standard for assessing GWG and reintroduce routine weighing.

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical records. Predictors of fasting were identified using Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression with 5-fold cross-validation, followed by Poisson regression with robust standard errors. Among 1087 women with available data, 581 (53·4 %; 95 % CI 50·4 %, 56·4 %) reported fasting during pregnancy (19·5 % in the first trimester, 25·1 % in the second and 10·1 % in the third). Women who fasted had significantly lower levels of ferritin (P = 0·048), vitamin B12 (P = 0·001), erythrocytes folate (P < 0·001), 25-hydroxyvitamin D (P = 0·002) and vitamin D binding protein (P = 0·011), but higher parathyroid hormone (P = 0·011). Predictive models based on sociodemographic and clinical factors showed limited predictive ability. This study indicates that fasting during pregnancy is a common practice among women in Kuwait and is associated with lower levels of key nutrients such as vitamin D, RBC folate and vitamin B12. Fasting during pregnancy appears to be driven more by personal, religious and cultural influences than by identifiable clinical or sociodemographic characteristics.

This study examined the impact of maternal undernutrition during gestation and/or lactation on neonatal immune indices. From day 10 of gestation to term, pregnant rats received either ad libitum (AdLib) feeding or 50% food restriction (FR). After birth, pups were either nursed by their own dams or cross-fostered, resulting in three groups (n = 6 per group): a control group with AdLib feeding throughout (AdLib/AdLib), a group with FR only during gestation (FR/AdLib), and a group with FR during both gestation and lactation (FR/FR). At day of life 1 and at three weeks of age, spleen and thymus weights, as well as basal and lipopolysaccharide (LPS)-stimulated TNF levels and white blood cell indices, were measured in male offspring. At day of life 1, immunological indices were similar among groups. By three weeks, monocyte percentage was significantly decreased in FR/FR compared with AdLib/AdLib (1.6 ± 0.5% vs. 3.1 ± 0.4%). Relative spleen weight (adjusted for body weight) was also significantly lower in FR/FR compared with both AdLib/AdLib and FR/AdLib. Following LPS administration, TNF-α levels were reduced in FR/FR compared with FR/AdLib and AdLib/AdLib (206 ± 28 vs. 511 ± 91 and 484 ± 59 pg/ml, respectively; P < 0.05). Moreover, in FR/FR offspring, monocyte (5.4 ± 1.1% vs. 2.0 ± 0.6% and 2.0 ± 0.7%) and neutrophil (50.6 ± 5.5% vs. 17.2 ± 2.4% and 20.0 ± 4.2%) percentages were significantly increased, while lymphocyte percentage (43.2 ± 5.9% vs. 80.0 ± 2.4% and 77.2 ± 4.4%) was decreased compared with FR/AdLib and AdLib/AdLib. These findings suggest that undernutrition during both prenatal and postnatal periods can attenuate neonatal immunity by decreasing basal monocyte counts and impairing cytokine responses.

The planetary health diet (PHD) is a mostly plant-based diet that aims to optimise human health while minimising the environmental impact of food production. Limited data exist on whether the PHD fulfils key nutritional requirements during pregnancy. This research aimed to examine the PHD in early pregnancy and how it aligns with daily nutrient intake and European Food Safety Authority (EFSA) dietary guidelines. Pregnant women (n 678) from two Irish cohorts (ROLO and MicrobeMom) were analysed, and PHD index (PHDI) scores were assigned based on data from 3-d food diaries. Women were dichotomised by the median score to create a ‘High PHDI’ (> 88·99) and a ‘Low PHDI’ group (≤ 88·99). Differences in nutrient intakes and adherence to dietary guidelines between ‘High’ and ‘Low’ PHDI groups were explored. Compared with those with a ‘Low’ score, those with a ‘High’ PHDI score reported higher intakes of dietary fibre (g/d) (17·32 (13·39, 21·08) v. 21·74 (18·28, 25·88), P < 0·001), Fe (mg/d) (10·48 (8·48, 12·82) v. 12·06 (9·48, 14·60), P < 0·001), folate (µg dietary folate equivalent per d) (250·73 (193·88, 312·45) v. 279·57 (219·43, 356·81), P < 0·001) and Ca (mg/d) (837·75 (695·36, 1056·72) v. 956·57 (751·84, 1155·03), P < 0·001). A greater proportion of women in the ‘High PHDI’ group met EFSA recommendations for dietary fibre intake (10·3 % v. 28·9 %, P < 0·001). The PHD may support maternal nutritional adequacy in pregnancy while promoting environmental sustainability. Our findings provide valuable insights that can inform future dietary recommendations for pregnancy, contributing to both maternal health and planetary well-being.