Sharma Sukshma, Esposito Simona, Di Castelnuovo Augusto, Gialluisi Alessandro, De Domenico Paola, de Gaetano Giovanni, Bonaccio Marialaura, Iacoviello Licia
Research Unit of Epidemiology and Prevention, IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
Department of Medicine and Surgery, LUM University, 70010 Casamassima, BA, Italy.
Nutrients. 2025 May 20;17(10):1723. doi: 10.3390/nu17101723.
BACKGROUND/OBJECTIVES: There is limited evidence on the association between maternal Mediterranean diet (MD) adherence and risks of preeclampsia, gestational diabetes mellitus (GDM), and excessive gestational weight gain (eGWG), and hence a systematic review of observational studies and randomized controlled trials was conducted.
A total of 30,930 articles from the Scopus, EMBASE, PubMed, MEDLINE, and Google Scholar databases were identified, published between January 2000 and April 2025. The National Institutes of Health Quality Assessment Tool and the Cochrane Risk of Bias Tool 2.0 were used to assess the quality of seven studies (one each were case-control and cross-sectional, three were RCTs, and two were prospective cohort studies).
Overall, the studies examined the risks of preeclampsia (four studies), GDM (five studies), and eGWG (three studies). Only one prospective cohort study out of four reported that MD adherence was associated with lower risk of preeclampsia (OR 0.78; 95% CI: 0.64 to 0.96 for highest vs. lowest tertile). MD adherence was associated with decreased risk of GDM in the intervention groups in four studies (two RCTs (OR: 0.75, 95% CI 0.57 to 0.98 and OR: 0.72, 95% CI 0.50 to 0.97) and one each of cross-sectional (OR: 2.32; 95% CI 2.13 to 2.57 for a 1-point decrease in the dietary score) and case-control studies (high Vs. low MD adherence: OR: 0.20, 95% CI 0.50 to 0.70)). MD adherence was associated with decreased risk of eGWG in two studies: one RCT (RR: 0.91, 95% CI 0.86 to 0.96 for a 1-point increment in the MD score) and one cross-sectional study (OR: 1.78; 95% CI 1.51 to 2.02 for a 1-point decrease in the MD score).
Findings indicated the protective associations between MD adherence and GDM and eGWG risks but not for preeclampsia.
背景/目的：关于孕妇遵循地中海饮食（MD）与先兆子痫、妊娠期糖尿病（GDM）和孕期体重过度增加（eGWG）风险之间的关联，证据有限，因此对观察性研究和随机对照试验进行了系统综述。
共检索了Scopus、EMBASE、PubMed、MEDLINE和谷歌学术数据库中2000年1月至2025年4月发表的30930篇文章。使用美国国立卫生研究院质量评估工具和Cochrane偏倚风险工具2.0对七项研究的质量进行评估（一项病例对照研究、一项横断面研究、三项随机对照试验和两项前瞻性队列研究）。
总体而言，这些研究考察了先兆子痫（四项研究）、GDM（五项研究）和eGWG（三项研究）的风险。四项研究中只有一项前瞻性队列研究报告称，遵循MD与先兆子痫风险较低相关（最高三分位数与最低三分位数相比，OR为0.78；95%CI：0.64至0.96）。在四项研究的干预组中，遵循MD与GDM风险降低相关（两项随机对照试验（OR分别为0.75，95%CI为0.57至0.98；OR为0.72，95%CI为0.50至0.97）、一项横断面研究（饮食评分每降低1分，OR为2.32；95%CI为2.13至2.57）和一项病例对照研究（高MD依从性与低MD依从性相比：OR为0.20，95%CI为0.50至0.70））。在两项研究中，遵循MD与eGWG风险降低相关：一项随机对照试验（MD评分每增加1分，RR为0.91，95%CI为0.86至0.96）和一项横断面研究（MD评分每降低1分，OR为1.78；95%CI为1.51至2.02）。
研究结果表明，遵循MD与GDM和eGWG风险之间存在保护性关联，但与先兆子痫无关。
