Nutrition that aligns with guidelines during pregnancy may be associated with better infant growth outcomes,

Expectant mothers who maintain a diet that meets USDA dietary guidelines during pregnancy may be more likely to have infants with healthy birthweights, steadier growth patterns, and potentially a reduced risk of obesity later in childhood, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

The research, involving more than 2,800 mother-child pairs across eight ECHO Cohort Study Sites, suggests that following a healthy prenatal diet in line with the USDA Dietary Guidelines for Americans could have long-term positive effects on infant growth up to 24 months.

This study found that eating a healthy diet during pregnancy was linked with a lower chance of extremely rapid infant growth,” said Assiamira Ferrara, MD, PhD, of Kaiser Permanente Northern California Division of Research. Dr. Ferrara noted that rapid growth from birth to 24 months is a strong predictor of obesity later in life.

The study used two dietary measures—the Healthy Eating Index (HEI) and the Empirical Dietary Inflammatory Pattern (EDIP)—to look at maternal eating patterns. The HEI measures overall diet quality. The EDIP score measures how likely a diet is to cause inflammation in the body. Diets with high EDIP scores have been linked to increased levels of inflammation.

Key findings from the research showed that:

• Higher HEI scores, reflecting healthier diets, were associated with a 12% reduced chance of infants being born large for gestational age (LGA), alongside lower rates of rapid growth up to 6 and 24 months.
• Lower EDIP scores, indicating diets with reduced inflammatory potential, were associated with a 24% higher chance of LGA and had mixed effects on growth: slower from birth to 6 months but faster growth between birth and 12 months. This association was less clear and warrants further study.

To assess rapid growth, the study relied on a measurement called the weight-for-length z-score (WLZ) a tool used to track an infant's growth. It compares a baby’s weight to its length and tells you how far a baby's weight is from the average weight of babies of the same length. Rapid growth was defined as a significant increase in WLZ scores from birth to 6, 12, or 24 months. Babies whose WLZ scores jumped more than expected moved to a higher percentile on the growth chart, meaning they weighed more relative to their peers of the same length.

“The findings support a role for a balanced prenatal diet that aligns with the USDA Dietary Guidelines in promoting healthy birthweights and balanced growth through early childhood,” said Monique Hedderson, PhD, of Kaiser Permanente Northern California Division of Research. “This suggests the need for programs to help improve pregnant people’s access to healthy food and interventions to support healthy eating during pregnancy.”

Researchers said that the findings represent an opportunity for an early obesity prevention strategy. More research is needed to learn how low-inflammatory diets during pregnancy might benefit fetal and infant growth.