Children of expectant mothers who consumed a Mediterranean diet or engaged in a mindfulness-based stress reduction (MBSR) program, demonstrated better neurodevelopmental outcomes at age 2, according to study findings published in JAMA Network Open.
Improving Mothers for a Better Prenatal Care Trial Barcelona (IMPACT BCN; ClinicalTrials.gov Identifier: NCT03166332) randomized clinical trial and reported on the impact of a prenatal Mediterranean diet or MBSR program on child neurodevelopment.
The researchers identified and included a total of 1221 expectant mothers with pregnancies between 19- and 23-weeks’ gestation with a heightened risk for delivering small for gestational age (SGA) newborns. Following exclusions and dropouts, the researchers assessed 626 expectant mothers and their children.
The researchers randomly assigned participants to 3 cohorts in a 1:1:1 ratio. Participants in the Mediterranean diet group attended monthly educational sessions and received a free provision of extra virgin olive oil and nuts, whereas those in the stress reduction group underwent an 8-week MBSR program designed specifically for pregnancy. Participants in the usual care group received standard pregnancy care according to institutional protocols.
Among the children, 46.8% (293) identified as female and 53.2% (333) identified as male. The mean (SD) age of participants was 24.8 (2.9) months.
The researchers evaluated child neurodevelopment using the Bayley-III assessment domains (cognitive, language, motor, social-emotional, and adaptive) at the corrected postnatal age of 24 months.
Compared with children of mothers in the usual care cohort, those of mothers in the Mediterranean diet group exhibited notably superior scores in the cognitive domain (mean [SD], 123.6 [17.8] vs 118.6 [18.3]; β, 5.02; 95% CI, 1.52-8.53; P =.005) and the social-emotional domain (mean [SD], 108.6 [22.0] vs 103.4 [18.5]; β, 5.15; 95% CI, 1.18-9.12; P =.01).
Similarly, compared with children of mothers in the usual care cohort, those of mothers in the stress reduction group demonstrated significantly higher scores in the social-emotional domain (mean [SD], 108.2 [24.0] vs 103.4 [18.5]; β, 4.75; 95% CI, 0.54-8.85; P =.02).
In the Mediterranean diet group, children of mothers with greater consumption of docosahexaenoic acid demonstrated enhanced language scores, whereas those of mothers with increased consumption of trans fatty acids demonstrated reduced social-emotional and language scores.
In the MBSR group, enhanced maternal well-being corresponded to children with higher scores in the Bayley-III language, social-emotional, and adaptive behavior domains.
The researchers also identified a significant positive association between maternal 24-hour urinary cortisone/cortisol levels and child language domain scores and a nonsignificant positive association between cortisone/cortisol levels and child cognitive domain scores.
Study limitations included the small sample size and lack of generalizability to the general pregnancy population because of the trial’s focus on pregnancies at high risk for SGA.
“In this prespecified analysis of a randomized clinical trial, treating pregnant women at high risk for SGA with structured interventions based on Mediterranean diet or stress reduction significantly improved child neurodevelopment at age 2 years as assessed by Bayley-III,” the researchers concluded. “These results need replication in further randomized clinical trials as well as assessment in additional patient populations.”Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Crovetto F, Nakaki A, Arranz A, et al. Effect of a mediterranean diet or mindfulness-based stress reduction during pregnancy on child neurodevelopment: a prespecified analysis of the IMPACT BCN randomized clinical trial. JAMA Netw Open. August 22, 2023. doi:10.1001/jamanetworkopen.2023.30255