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Association between maternal dietary diversity during pregnancy and birth outcomes: evidence from a systematic review and meta-analysis

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Tareke, Amare Abera, Melak, Edom Getnet, Mengistu, Bezawit Ketsela, Hussen, Jafar, Molla, Asressie·2024·BMC Nutrition
DOI 10.1186/s40795-024-00960-9PMC PMC11566373
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Abstract

Maternal nutrition is a key factor influencing birth and offspring health outcomes in later life. Dietary diversity (DD) is a proxy for the macro/micronutrient adequacy of an individual’s diet. There is inadequate comprehensive evidence regarding maternal nutrition during pregnancy, measured through DD and birth outcomes. This study aimed to provide extensive evidence on maternal DD during pregnancy and birth outcomes. A comprehensive search was performed using PubMed, HINARI, and Google Scholar databases up to January 17, 2024. Studies conducted among pregnant mothers and measuring maternal DD with an evaluation of birth outcomes (low birth weight, small for gestational age, preterm birth), in the global context without design restriction were included. The Newcastle Ottawa Scale and the Cochrane Risk of Bias tool were used to assess the risk of bias. The results are summarized in a table, and odds ratios were pooled where possible. Between-study heterogeneity was evaluated using I 2 statistics. Potential publication bias was assessed using a funnel plot and Egger’s regression test. To explore the robustness, a leave-one-out sensitivity analysis was conducted. Thirty-three studies were used to synthesize narrative evidence (low birth weight: 31, preterm birth: 9, and small for gestational age: 4). In contrast, 24 records for low birth weight, eight for preterm birth, and four for small for gestational age were used to pool the results quantitatively. Of the 31 studies, 17 reported a positive association between maternal DD and infant birth weight, 13 studies reported a neutral association (not statistically significant), and one study reported a negative association. Overall, inadequate DD increased the risk of low birth weight OR = 1.71, 95% CI; (1.24–2.18), with I 2 of 68.7%. No significant association was observed between maternal DD and preterm birth. Inadequate DD was significantly associated with small for gestational age (OR = 1.32, 95% CI; 1.15–1.49, and I 2 = 0.0%). Inadequate maternal DD is associated with an increased risk of low birth weight and small for gestational age but not preterm birth, underscoring the importance of promoting adequate DD during pregnancy. To address these issues, it is essential to implement and expand nutritional programs targeted at pregnant women, especially in low-resource settings, to ensure they receive diverse and adequate diets. Further research is needed to address the current limitations and to explore the long-term implications of maternal nutrition on child health. The study was prospectively registered on PROSPERO (registration number CRD42024513197). No funding was received for this study.

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  • Limited dietary diversity during pregnancy is correlated with negative birth outcomes and metabolic vulnerability.

    “There has been a correlation between limited dietary diversity during pregnancy and negative birth outcomes and metabolic vulnerability (8).”

    From Maternal nutritional status and the risk of metabolic syndrome in pregnancy: implications for public health nutrition (2026) · cites this paper as [8]

    The Discussion reports that inadequate maternal dietary diversity is associated with increased odds of low birth weight and small for gestational age, but not preterm birth. The Introduction discusses maternal nutrition and fetal metabolic programming more broadly; it does not establish a correlation between limited dietary diversity and metabolic vulnerability. Page numbers were not available in our copy. (LLM, conf=0.87)

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Cited by

Sorted by citations

Authors
Tareke, A. A., Melak, E. G., Mengistu, B. K., Hussen, J., & Molla, A.
Affiliations
Wollo University (ET)
Corresponding author
Tareke, Amare Abera
ORCID
Venue
BMC Nutrition
Publisher
Springer Science and Business Media LLC
Published
2024-11-14
Volume
10
Issue
1
Pages
151-151
ISSN
2055-0928 (ISSN-L)
DOI
10.1186/s40795-024-00960-9
PMC
PMC11566373
OpenAlex
W4404351168
Cited by
18
References
1
Citations by year
2026: 12 · 2025: 6
FWCI
1.06
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Nutrition (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
dietary diversity, maternal nutrition, pregnancy, birth outcomes, low birth weight, small for gestational age, preterm birth, micronutrient adequacy, maternal diet, infant health, resource-limited settings, maternal morbidity, maternal mortality risk factors, maternal health financing, maternal health policy

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