Maternal diet quality during pregnancy and child cognition and behavior in a US cohort.

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Maternal intake of several nutrients during pregnancy is linked to offspring cognition. The relationship between maternal dietary patterns and offspring cognition is less established.


To examine associations of maternal diet quality during pregnancy with child cognition and behavior.


Among 1580 mother-child pairs in Project Viva, a prospective pre-birth cohort, we assessed maternal diet during pregnancy using food frequency questionnaires and evaluated diet quality using modified versions of the Mediterranean Diet Score (MDS-P) and Alternate Healthy Eating Index (AHEI-P). Child cognitive and behavioral outcomes were assessed using standardized tests and questionnaires at infancy, early and mid-childhood. We conducted multivariable linear regression analyses.


Mothers were predominantly white, college-educated, and non-smokers. After adjustment for child age and sex and maternal sociodemographic and lifestyle characteristics, maternal high (6-9) vs. low (0-3) MDS-P during pregnancy was associated with higher child Kaufman Brief Intelligence Test (KBIT-II) nonverbal (mean difference for first trimester = 4.54; 95%CI: 1.53, 7.56) and verbal scores (3.78; 95%CI: 1.37, 6.19), and lower Behavioral Rating Inventory of Executive Function (BRIEF) Metacognition Index (-1.76; 95%CI: -3.25, -0.27), indicating better intelligence and fewer metacognition problems in mid-childhood. Maternal Q4 vs. Q1 AHEI-P during pregnancy was associated with higher Wide Range Assessment of Visual Motor Abilities matching scores in early childhood (mean difference for first trimester = 2.79; 95%CI: 0.55, 5.04), higher KBIT-II verbal scores (2.59; 95%CI: 0.13, 5.04) and lower BRIEF Global Executive Composite scores in mid-childhood (-1.61; 95%CI: -3.20, -0.01), indicating better visual spatial skills, verbal intelligence and executive function.


Maternal intake of a better quality diet during pregnancy was associated with better visual spatial skills in the offspring at early childhood, and better intelligence and executive function in the offspring at mid-childhood.

Am J Clin Nutr
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Maternal diet quality during pregnancy and child cognition and behavior in a US cohort.
Mahmassani HA, Switkowski KM, Scott TM, Johnson EJ, Rifas-Shiman SL, Oken E, Jacques PF