Methods:

Our analysis was conducted using a prebirth observational cohort of 1079 mother–offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-h dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores of⩽ 57 and> 57, with low scores representing poorer diet quality. Neonatal% FM was assessed within 72 h after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal% FM, FM, and fat-free mass (FFM) while adjusting for prepregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex and gestational age.

Results:

Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, sd: 13.6). An HEI-2010 score of⩽ 57 was significantly associated with higher neonatal% FM (β= 0.58, 95% confidence interval (CI) 0.07–1.1, P< 0.05) and FM (β= 20.74; 95% CI 1.49–40.0; P< 0.05) but no difference in FFM.

Conclusions:

Poor diet quality during pregnancy increases neonatal adiposity independent of maternal prepregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.