{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:01:29Z","timestamp":1787029289088,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2014NextGeneration","award":["Project PE_00000019"],"award-info":[{"award-number":["Project PE_00000019"]}]},{"award":["Project PE_00000019"],"award-info":[{"award-number":["Project PE_00000019"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004505","name":"University of Catania","doi-asserted-by":"crossref","award":["CUP E63C22002080006"],"award-info":[{"award-number":["CUP E63C22002080006"]}],"id":[{"id":"10.13039\/501100004505","id-type":"DOI","asserted-by":"crossref"}]},{"award":["CUP E63C22002080006"],"award-info":[{"award-number":["CUP E63C22002080006"]}],"id":[{"id":"https:\/\/ror.org\/03a64bh57","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004008","name":"Istituto Superiore di Sanit\u00e0","doi-asserted-by":"crossref","award":["I83C22001830006"],"award-info":[{"award-number":["I83C22001830006"]}],"id":[{"id":"10.13039\/501100004008","id-type":"DOI","asserted-by":"crossref"}]},{"award":["I83C22001830006"],"award-info":[{"award-number":["I83C22001830006"]}],"id":[{"id":"https:\/\/ror.org\/02hssy432","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Maternal diet during pregnancy may influence neonatal outcomes, but dietary behaviours are socially patterned and were measured differently across cohorts. We therefore evaluated whether cohort-specific, partially harmonized maternal dietary patterns were associated with adverse birth outcomes after accounting for maternal and socioeconomic characteristics in two Italian birth cohorts. Methods: We analyzed 3234 mother\u2013infant dyads from Piccolipi\u00f9 (2011\u20132015) and 1564 from MAMI-MED (2020\u2013ongoing). Maternal diet was captured by cohort-specific food questionnaires and grouped into food categories. Principal component analysis identified dietary patterns; pattern scores were categorized into tertiles and combined into five joint-adherence profiles. Logistic regression estimated odds ratios (OR) for preterm birth (PTB, &lt;37 weeks), low birth weight (LBW, \u22642500 g), macrosomia (\u22654000 g), and small\/large for gestational age (SGA\/LGA), with progressive adjustment for maternal age, pre-pregnancy body mass index (BMI), education, employment, and (Piccolipi\u00f9) income. Results: Two comparable patterns emerged in both cohorts: Western (processed foods, fried items, snacks\/sweets, sugar-sweetened beverages) and Prudent (fruit, vegetables, fish, whole grains\/yogurt). Western adherence was more common among younger women and those with disadvantage, whereas Prudent adherence tracked higher education, employment and income. After full adjustment, dietary profiles were not consistently associated with PTB, SGA or LGA in either cohort. In Piccolipi\u00f9, preferential Prudent adherence was associated with lower odds of LBW (OR 0.49; 95% CI 0.24\u20130.92) and higher odds of macrosomia (OR 1.56; 95% CI 1.06\u20132.30). Across cohorts, higher pre-pregnancy BMI predicted macrosomia\/LGA, while lower education increased the probability of PTB and LBW. Conclusions: Across two Italian birth cohorts, maternal dietary patterns were socially stratified, whereas pre-pregnancy BMI and maternal education were more consistently associated with birth outcomes than dietary-pattern adherence per se.<\/jats:p>","DOI":"10.3390\/nu18071065","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:32:47Z","timestamp":1774611167000},"page":"1065","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maternal Dietary Patterns, Socioeconomic Conditions, and Birth Outcomes in the MAMI-MED and Piccolipi\u00f9 Italian Birth Cohorts"],"prefix":"10.3390","volume":"18","author":[{"given":"Giuliana","family":"Favara","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6349-1351","authenticated-orcid":false,"given":"Letizia","family":"Leccese","sequence":"additional","affiliation":[{"name":"Centre for Behavioural Science and Mental Health, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-5003","authenticated-orcid":false,"given":"Martina","family":"Barchitta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2081-0161","authenticated-orcid":false,"given":"Francesca","family":"Candelora","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Department of Medical Sciences and CPO-Piemonte, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1850-3015","authenticated-orcid":false,"given":"Martina","family":"Culasso","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, ASL Roma 1, Lazio Regional Health Service, 00154 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0864-2801","authenticated-orcid":false,"given":"Carla","family":"Ettore","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, 95124 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Ettore","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, 95124 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Galvani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, 95124 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-6666","authenticated-orcid":false,"given":"Vieri","family":"Lastrucci","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"La Mastra","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clara","family":"La Rosa","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2023-2135","authenticated-orcid":false,"given":"Roberta","family":"Magnano San Lio","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2655-8574","authenticated-orcid":false,"given":"Andrea","family":"Maugeri","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6464-2211","authenticated-orcid":false,"given":"Paola","family":"Pani","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health\u2014IRCCS \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1805-6240","authenticated-orcid":false,"given":"Lorenza","family":"Nistic\u00f2","sequence":"additional","affiliation":[{"name":"Centre for Behavioural Science and Mental Health, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2627-1282","authenticated-orcid":false,"given":"Sonia","family":"Brescianini","sequence":"additional","affiliation":[{"name":"Centre for Behavioural Science and Mental Health, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4405-8162","authenticated-orcid":false,"given":"Antonella","family":"Agodi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1055\/s-0029-1237424","article-title":"Developmental origins of health and disease: Brief history of 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