TABLE 7.

Perinatal outcomes.

References	Objective	Outcomes	Conclusion
Assaf-Balut et al. (18)	The women of the intervention group attended two group sessions where they were instructed to improve the consumption of EVOO and nuts and they received 10 L of EVOO and 2 kg of pistachios in each session. The control group received basic dietary guidelines and was told to limit all types of fat intake (including < 3 servings/week of walnuts and < 40 ml/day of EVOO). To assess lifestyle and diet, the semi-quantitative Diabetes Nutrition and Complications Trial (DNCT) questionnaires and the MEDAS questionnaires were used, which were administered on 3 different visits. Blood pressure, height, weight, gestational weight gain, and BMI were assessed and recorded at all three visits.	There was a linear association between high, moderate, and low adherence and a lower risk of GD (OR = 0.35, 95% CI [0.18, 0.67], p = 0.002), UTIs (OR = 0.19, 95% CI [0.07, 0.52], p = 0.001), prematurity (OR = 0.30, 95% CI [0.13, 0.72], p = 0.007) and low-weight newborns (OR = 0.36, 95% CI [0.17, 0.77], p = 0.009).	High adherence to the six predefined dietary targets at the end of the first trimester is associated with a reduction in the risk of GD, UTIS, prematurity, and low birth-weight infants.
Chatzi et al. (21)	Mothers reported their diet from the time of their last menstrual period using a validated semiquantitative FFQ. The overall dietary pattern was examined using the Trichopoulou score. In addition, weight, height, abdominal perimeter, thickness of subscapular skin folds and triceps, systolic and diastolic blood pressure, and lipid, leptin, and adiponectin levels of children were measured	High maternal adherence to MD was associated with a lower BMI score in the offspring of 0.14 units (95% CI [–0.15, –0.13]), abdominal perimeter at 0.39 cm (95% CI [–0.64, –0.14]), and the sum of the skinfold thickness by 0.63 mm (95% CI [–0.98, –0.28]). The authors also observed lower systolic (–1.03 mmHg, 95% CI [–1.65, –0.42]) and diastolic blood pressure (–0.57 mmHg, 95% CI [–0.98, –0.16]) in childhood.	Increased adherence to MD during pregnancy may protect against excess cardiometabolic risk in childhood.
Assaf-Balut et al. (29)	The women of the intervention group attended two group sessions where they were instructed to improve the consumption of EVOO and nuts and they received 10 L of EVOO and 2 kg of pistachios in each session. The control group received basic dietary guidelines and was told to limit all types of fat intake (including < 3 servings/week of walnuts and < 40 ml/day of EVOO). To assess lifestyle and diet, the semi-quantitative Diabetes Nutrition and Complications Trial (DNCT) questionnaires and the MEDAS questionnaires were used, which were administered on 3 different visits. Blood pressure, height, weight, gestational weight gain, and BMI were assessed and recorded at all three visits.	The relative risk of GD was 0.75 (95% CI [0.57, 0.98], p = 0.039). Rates of insulin-treated GD were also significantly reduced: (OR = 0.43, 95% CI [0.24, 0.78], p = 0.006); prematurity (OR = 0.29, 95% CI [0.11, 0.77], p = 0.013); gestational weight gain at 24–28 and 36–38 weeks of gestation (p = 0.022 and p = 0.037, respectively); emergency Cesarean section (OR = 0.30, 95% CI [0.14, 0.63], p = 0.001); perineal trauma (OR = 0.21, 95% CI [0.12, 0.36], p = 0.001); UTIs (OR = 0.41, 95% CI [0.26, 0.64], p = 0.001); and low-weight newborns and macrsomia (OR = 0.21, 95% CI [0.08, 0.54], p = 0.001) and (OR = 0.19, 95% CI [0.07, 0.57], p = 0.003), respectively).	Early nutritional intervention with supplemented MD reduces the incidence of GD and improves several maternal and neonatal outcomes.
Martínez-Galiano et al. (30)	A paired case study (children with low birth weight) and controls (normal weight children) was conducted. For the dietary evaluation, an FFQ was used for the previous year’s intake, while three indices were used to evaluate adherence to MD: Predimed, Trichopoulou, and Pangiotakos.	Adherence to MD and daily intake of 5 g of EVOO was associated with a lower risk of low birth weight (OR = 0.59, 95% CI [0.38, 0.98]).	Adherence to MD and EVOO intake is associated with a reduced risk of underweight newborns.
Melero et al. (31)	Prospective analysis of the prevention study of GD of St. Carlos [18, 28]. After delivery, a follow-up was carried out for 2 years, in which both the control group and the intervention group received the same recommendations, and the same questionnaires were used for dietary evaluation.	Adherence to MD enriched with EVOO and pistachios during pregnancy was associated with children of mothers with pregestational BMI < 25 kg/m2 and normal glucose tolerance (NGT) having a lower risk (OR (95% CI) of severe events requiring hospitalization due to bronchiolitis or asthma (OR = 0.75, CI [0.58, 0.98] and (OR = 0.77, CI [0.59, 0.99], respectively) or other diseases requiring antibiotic or corticosteroid treatment (OR = 0.80, CI [0.65, 0.98] and (OR = 0.73, CI [0.59, 0.90], respectively) (all ps < 0.05).	A nutritional intervention based on MD during pregnancy is associated with a reduction in childhood hospital admissions, especially in women with pregestational BMI < 25 kg/m2 and normal glucose tolerance.
Cánovas-Conesa et al. (32)	A case study (children with gastroschisis) and controls (healthy children) was conducted. At the time of diagnosis, each case completed a validated FFQ of the diet consumed during pregnancy.	A maternal diet rich in oleic acid (OR = 0.79, 95% CI [0.65, 0.97]) and plant products (OR = 0.70, 95% CI [0.48, 1.00]) was associated with preventing the risk of vascular occlusion of the omphalomesenteric arteries, decreasing the risk of gastroschisis.	A maternal diet rich in oleic acid and plant products can prevent vascular risk of the omphalomesenteric arteries, reducing the risk of gastroschisis.
Steenweg-de Graaff et al. (33)	Nutritional intake for the last 3 months at the beginning of pregnancy was assessed using a modified version of an FFQ. In addition, mothers were asked to complete the Child Behavior Checklist for Young Children (CBCL), which serves to measure the degree of problematic behavior of children.	MD was negatively associated (OR = 0.90, 95% CI [0.83, 0.97], p = 0.006) and the traditional Dutch diet was positively associated with child externalizing problems (OR = 1.11, 95% CI [1.03, 1.21], p = 0.011). No diet was associated with internalizing problems.	Both low adherence to MD and high adherence to the traditional Dutch diet during pregnancy are associated with an increased risk of externalizing problems in the child.