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

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/m(2). 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.