: Maternal dietary behaviors, including meal frequency patterns, may influence fetal growth. This study examined the associations between maternal meal frequency patterns during pregnancy-categorized as structured, moderately irregular, or highly irregular-and neonatal anthropometric outcomes, including weight, length, head, chest, and abdominal circumferences, and Apgar score. A secondary objective was to assess whether maternal education and household income modify these associations. : This cross-sectional study included 1025 mother-newborn pairs from a socioeconomically diverse Romanian cohort. Maternal meal frequency patterns were classified based on self-reported weekly consumption. Neonatal anthropometric outcomes were obtained from medical records. Multivariable linear regression models, adjusted for maternal and neonatal characteristics, assessed the associations between meal frequency patterns and birth outcomes. Interaction terms evaluated effect modification by maternal education and income. : Structured maternal meal frequency patterns were associated with a slight but significant reduction in neonatal length compared to highly irregular patterns (β = -0.36 cm; 95% CI: -0.68 to -0.04; = 0.02). A borderline inverse association with birth weight was also observed (β = -63.82 g; 95% CI: -128.87 to 1.23; = 0.05). No significant differences were found for other anthropometric indicators or Apgar score. Maternal education modified the association between moderately irregular patterns and chest circumference (β = 0.15 cm; 95% CI: 0.04 to 0.25; = 0.003), while household income modified the association with abdominal circumference (β = 0.14 cm; 95% CI: 0.02 to 0.26; = 0.02). : Maternal meal frequency patterns were modestly associated with neonatal length, while socioeconomic factors modified specific anthropometric outcomes. These findings highlight the importance of considering social context in prenatal nutritional recommendations.