Table 1.
Summary of included studies characteristics.
| Author, Year Country |
Study Design | Age (Years) | GW (Range or Mean) |
Sample n = | Exposure | Outcome | Main Results |
|---|---|---|---|---|---|---|---|
| Abbasi et al., 2019 Iran [37] |
Case-control | case: 24 ± 8 control: 26 ± 6 |
>20 weeks | case: 170 control: 340 |
WDP (red and processed meat, fried potatoes, pickles, sweets, pizza) | Risk of preeclampsia | The Western dietary pattern associated with preeclampsia: OR: 5.99; 95% CI: 3.414, 10.53; p < 0.001) |
| Alves-Santos et al., 2019 Brazil [54] |
Prospective Cohort | 26.7 ± 5.5 | 5–13 weeks | 193 | Fast foods and candies (fast food and snacks; cakes, cookies, or crackers; and candies or desserts) | LGA Birth Length (BL) |
Fast food and candies dietary pattern associated with LGA newborn: OR: 4.38; 95% CI: 1.32, 14.48 Fast food and candies dietary pattern associated with the newborn with BL > 90th percentile: OR: 4.81; 95% CI: 1.77, 13.07 |
| Amezcua-Prieto et al., 2019 Spain [21] |
Case-control | NR | NR | 518 | Industrial sweets | SGA | Intake of industrial sweets associated with odds of having an SGA newborn (OR: 2.70; 95% CI: 1.42, 5.13). |
| Ancira-Moreno et al., 2020 Mexico [53] |
Prospective Cohort | 25.08 ± 5.8 | 2nd and 3rd trimester | 660 | Mixed dietary patterns (sugary drinks, juices and sodas, red and processed meat, cereals) |
LBW | The mixed dietary pattern associated risk LBW infant: (OR: 1.58; 95% CI: 0.63, 3.44) |
| Angali, Shahri, Borazjani, 2020, Iran [42] | Prospective Cohort | ≥18 years | <13 weeks | 488 | “High fat - fast food” pattern (refined cereal, processed meat and high-fat dairy and juices) | GWG and hyperglycemia |
High fat-fast food patterns associated with higher GWG (β: 0.029; 95% CI: 0.012, 0.049). |
| Asadi et al., 2019 Iran [38] |
Case-control | case: 29 ± 5.17 control: 27.5 ± 4.92 |
24–28 weeks | case: 130 control: 148 |
WDP (SSB, refined grain products, fast foods, salty snacks, sweets and biscuit, mayonnaise) | GDM | The prudent dietary pattern associated with GDM risk: (OR: 0.88; 95% CI: 0.44, 0.99) |
| Barbosa et al., 2021 Brazil [52] |
Prospective Cohort | >14 | 22–25 weeks | 2750 | Soft drinks | Gestational Hypertension (GH) | Soft drink consumption > 7 times per week associated with GH: (RR: 1.45; 95% CI: 1.16, 1.82; p = 0.001) |
| Bärebring et al., 2016 Sweden [84] |
Prospective Cohort | 32.1 (IQR: 30.8–35.3) |
35.9 weeks (IQR: 35.1–36.4) | 95 | Snacks pattern (sweets, cakes, biscuits, potato chips, popcorn) | GWG | Snacks pattern associated with excessive GWG (OR: 1.018; 95% CI: 1.004, 1.032). |
| Baskin et al., 2015 Australia [88] |
Prospective Cohort | 30.55 ± 4.24 | 16 weeks | 167 | Unhealthy dietary patterns (sweets and desserts, refined grains, high- energy drinks, fast foods, hot chips, high-fat dairy, fruit juice and red meats) | Depressive symptoms | An unhealthy diet at T2 is associated with depressive symptoms: β: 0.19; 95% CI=0.04, 0.34; p < 0.05 |
| Borgen et al., 2012 Norway [75] |
Prospective Cohort | >18 years | 15 weeks | 32,933 | SSB | Preeclampsia | Sugar-sweetened beverages associated with increased risk of preeclampsia: OR: 1.27; 95% CI: 1.05, 1.54 |
| Brantsæter et al., 2009 Norway [76] |
Prospective Cohort | >18 | 20.7 weeks (SD ± 3.7) |
23,423 | Dietary patterns (Processed meat products, white bread, French fries, salty snacks, and sugar-sweetened drinks) |
Risk of preeclampsia |
Processed food patterns are associated with increased risk of developing preeclampsia (OR: 1.21; 95% CI: 1.03, 1.42). |
| Chen et al., 2009 USA [56] |
Prospective Cohort | 24–44 | NR | 13,475 | SSB | Risk of gestational diabetes mellitus (GDM) | Intake of sugar-sweetened cola associated with risk of GDM (RR: 1.22; 95% Cl: 1.01, 1.47). |
| Chen et al., 2020 China [35] |
Case-control | case: 28 ± 1.3 control: 28 ± 1.5 |
>22 weeks | case: 1290 control: 1290 |
High-salt pattern (pickled vegetables, processed and cooked meat, fish and shrimp, bacon and salted fish, bean sauce) | Hypertensive disorder during pregnancy |
High-salt pattern diets associated with higher systolic blood pressure: (r: 0.110; p < 0.05) |
| Coelho et al., 2015 Brazil [63] |
Prospective Cohort | 24.7 ± 6.1 | ≥22 weeks | 1298 | Snack dietary patterns (sandwich cookies, salty snacks, chocolate, and chocolate drink) |
Birth weight | Snack dietary patterns positively associated with birth weight: (β: 56.64; p = 0.04) in pregnant adolescents. |
| Dale et al., 2019 Norway [79] |
Prospective Cohort | ≥18 | 16-18 weeks | 88,514 | SSB | CHD | 25–70 mL/day sucrose-sweetened soft beverages associated with non-severe CHD (RR:1.30; 95% CI: 1.07, 1.58) and (RR: 1.27; 95% CI: 1.06, 1.52) for ≥70 mL/day. |
| Dominguez et al., 2014 Spain [74] |
Prospective Cohort | >18 | NR | 3048 | Fast food | GDM | Fast food consumption associated with GDM risk: (OR: 1.86; 95% CI: 1.13, 3.06) |
| Donazar-Ezcurra et al., 2017 Spain [71] |
Prospective Cohort | >18 | NR | 3455 | WDP (red meat, high-fat processed meats, potatoes, commercial bakery products, whole dairy products, fast foods, sauces, pre-cooked foods, eggs, soft drinks and sweets, chocolates) |
GDM | The Western dietary pattern associated with GDM incidence: (OR: 1.56; 95% CI: 1.00, 2.43; p = 0.05) |
| Donazar-Ezcurra et al., 2017 Spain [72] |
Prospective Cohort | >18 | NR | 3396 | Soft drinks | GDM | Sugar-sweetened soft drinks (SSSD) associated with GDM: (OR: 2.06; 95% CI: 1.28, 3.34; p: 0.004) |
| Englund-Ögge et al., 2014 Norway [85] |
Prospective Cohort | <20 to ≥40 | 15 weeks | 66,000 | WDP (salty snacks, chocolates and sweets, French fries, cakes, white bread, ketchup, dairy desserts, SSB, mayonnaise, processed meat, waffles, pancakes, cookies) | Preterm delivery | Western diet pattern associated with risk of preterm delivery (Hazard Ratio: 1.02; 95% CI: 0.92, 1.13). |
| Englund-Ögge et al., 2019 Norway [68] |
Prospective Cohort | >18 years | 15 weeks | 65,904 | WDP (salty snacks, chocolate and sweets, cakes, French fries, white bread, ketchup, SSB, processed meat products, and pasta) | LGA | The prudent pattern associated with decreased LGA risk: (OR: 0.84; 95% CI: 0.75, 0.94) The traditional group associated with increased LGA risk: (OR: 1.12; 95% CI: 1.02, 1.24) |
| Ferreira et al., 2022 Brazil [89] |
Cross-sectional | 28 (IQR 19–45) | NR | 260 | Dietary patterns (sweets, snacks and cookies) |
GWG | Women with greater adherence to “Pattern 2” (sweets, snacks, and cookies) during pregnancy were less likely to have inadequate GWG (OR: 0.14; 95% CI = 0.03, 0.60) |
| Garay et al., 2019 United Kingdom [80] |
Cross-sectional | 18–45 years | NR | 303 | WDP (cakes/biscuits/ice cream, chips/crisps, processed meat, takeout, chocolate, soft drinks) |
CBWC | Health-conscious dietary pattern associated with increased CBWC (OR: 4.75; 95% CI: 1.17, 8.33; p = 0.010) “Western Diet” associated with increased CBWC (β: −2.64; 95% CI: −5.87, 0.59; p = 0.109) |
| Gomes et al., 2020 Brazil [18] |
Prospective Cohort | ≥18 years | All trimesters | 259 | UPF energy (cookies, sweets, SSB, reconstituted meats, crackers, packaged chips, frozen dinners, ultra-processed breads) | GWG | Energy percentage derived from UPF associated with average weekly GWG (β: 4.17; 95% CI 0.55, 7.79). |
| Grieger, et al., 2014 Australia [22] |
Cross-sectional | >18 | 13 weeks | 309 | Dietary patterns (high-fat/sugar/takeaway: takeaway foods, potato chips, refined grains, and added sugar) |
Preterm delivery | High-fat/sugar/takeaway pattern associated with preterm birth: (OR: 1.54; 95% CI: 1.10, 2.15; p = 0.011) |
| Grundt et al., 2016 Norway [73] |
Prospective Cohort | >18 | 15 weeks | 50,280 | SSC | BW | Each 100 mL intake of SSC associated with: 7.8 g decrease in BW (95% CI: −10.3, 5.3); decreased risk of BW > 4.5 kg (OR: 0.94; 95% CI: 0.90, 0.97) and increased risk of BW < 2.5 kg (OR: 1.05; 95% CI: 0.99, 1.10). |
| Günther et al., 2019 Germany [66] |
Prospective Cohort | 30.3 ± 4.4 | <12 weeks | 1995 | Fast foods | LGA | Fast food consumption associated with LGA: (OR 3.14; 95% CI: 1.26,7.84; p = 0.014) |
| Hajianfar et al., 2018 Iran [39] |
Prospective Cohort | 20–40 | 8–16 weeks | 812 | WDP (processed meats, fruits juice, citrus, nuts, desserts and sweets, potato, legumes, coffee, egg, pizza, high fat dairy, and soft drinks) |
Preeclampsia Hypertension |
The Western dietary pattern is associated with: Preeclampsia: (OR: 2.08; 95% CI: 1,4.36, p = 0.02) High systolic blood pressure: (OR: 0.13; 95% CI: 0.04, 0.42; p = 0.002) |
| Hajianfar et al., 2018 Iran [40] |
Prospective Cohort | 29.4 ± 4.85 | 8–16 weeks | 812 | WDP (processed meats, fruits juice, citrus, nuts, desserts and sweets, potato, legumes, coffee, egg, pizza, high fat dairy, and soft drinks) |
LBW | Western dietary pattern (top quartile) associated with LBW infant: (OR: 5.51; 95% CI: 1.82, 16.66; p = 0.001) |
| Hirko et al., 2020 USA [58] |
Prospective Cohort | mean: 27 | mean: 13.4 weeks | 327 | Dietary patterns (added sugar: soda, fruit-flavored drinks with sugar, pastries—donuts, sweet rolls, Danish, and cookies, cake, pie, or brownies) |
GWG | Higher added sugar intake associated with excessive GWG (OR: 0.91; 95% CI: 0.84, 0.99) |
| Ikem et al., 2019 Denmark [20] |
Prospective Cohort | 25–30 | 12 weeks | 55,139 | WDP (potatoes, French fries, bread white, pork, beef veal, meat mixed, meat cold and dressing sauce) | Gestational hypertension Preeclampsia |
Western diet associated with GH: (OR: 1.18; 95% CI: 1.05, 1.33) Preeclampsia: (OR: 1.40; 95% CI: 1.11, 1.76): |
| Itani et al., 2020 United Arab Emirates [36] |
Prospective Cohort | 19–40 | 27–42 weeks | 242 | WDP (sweets, sweetened beverages, added sugars, fast food, eggs, and offal) | GWG | The Western pattern is associated with excessive gestational weight gain (OR: 4.04; 95% CI: 1.07, 15.24)The western pattern is associated with gestational weight gain rate (OR: 4.38; 95% CI: 1.28, 15.03) |
| Ker et al., 2021 Taiwan [46] |
Prospective Cohort | 33.9 ± 4.6 | All trimesters | 196 | SSB | Postpartum depression | SSB intake associated with increased EPDS scores: (β: 0.25; 95% CI: 0.04, 0.45) during the first and second trimesters |
| Lamyian et al., 2017 Iran [19] |
Prospective Cohort | 18–45 years | ≤6 weeks | 1026 | Fast food | GDM | Fast food consumption (≥175 g/week) associated with GDM risk: (OR: 2.12; 95% CI: 1.12, 5.43; p-trend: 0.03 |
| Liu et al., 2021 China [47] |
Cross-sectional | 26.88 ± 4.62 | All trimesters | 7934 | Dietary patterns (snacks pattern: beverages, sweetmeat, fast-food, dairy and eggs) |
Macrossomia SGA |
Snacks pattern associated with: risk of macrosomia: (OR: 1.265; 95% CI: 1.000, 1.602) SGA: (OR: 1.260; 95% CI: 1.056, 1.505). |
| Loy, Marhazlina; Jan 2013 Malaysia [43] | Cross-sectional | 29.7 ± 4.8 | 33.66 ± 3.95 weeks | 108 | Dietary patterns (confectioneries: cake, cookies, chocolate, candy, sweetened condensed milk) |
LBW | Confectioneries food intake associated with lower birth weight: (β: −1.999; p = 0.013) |
| Marí-Sanchiz et al., 2017 Spain [69] | Prospective Cohort | >18 | NR | 3298 | UPF (Processed meat) |
GDM | Processed meat consumption associated with GDM: (OR: 2.01; 95% CI: 1.26, 3.21; p-trend 0.003) |
| Marquez, 2012 USA [64] |
Cross-sectional | 18–49 | ≥37 weeks | 290 | SSB | GWG | A high intake of regular soda is associated with an increased risk of Excessive GWG (OR: 1.41; 95% CI: 0.60, 3.31). |
| Martin et al., 2016 Sweden [59] |
Prospective Cohort | 16–47 | 39 ± 2 weeks | 389 | Dietary patterns (latent class 3: white bread, red and processed meats, fried chicken, French fries, and vitamin C–rich drinks) |
BMI-for-age at birth | Association between the latent class 3 diet (processed food) and BMI-for-age z-score at birth:(β: −0.41; 95% CI: −0.79, −0.03). |
| Martin et al., 2015 USA [55] |
Prospective Cohort | NR | 24–29 weeks | 3941 | Dietary patterns (hamburgers or cheeseburgers, white potatoes, fried chicken, beans, corn, spaghetti dishes, cheese dishes, processed meats, biscuits, and ice cream) |
Preterm birth | Diet characterized by ultra-processed food associated with preterm birth: (OR: 1.53; 95% CI: 1.02, 2.30) |
| Maugeri et al., 2019 Italy [67] |
Prospective Cohort | 15–50 (Mean: 37) |
4–20 weeks (Mean: 16) |
232 | WDP (high intake of red meat, fries, dipping sauces, salty snacks and alcoholic drinks) | GWG | Western dietary patterns associated with GWG: (β: 1.217; Standard Error: 0.487; p = 0.013) |
| Mikeš et al., 2021 Czech Republic [86] |
Prospective Cohort | 25 ± 5 | 32 weeks | 4320 | Unhealthy Dietary pattern: (pizza, fish products, processed meat, sausages, smoked meat, hamburgers, and confectionary foods, sugary drinks, cakes, chocolate and sweets). |
Birth Weight Birth Length |
A 1-unit increase in the unhealthy pattern score was associated with a mean birth weight reduction of −23.8 g (95% CI: −44.4, −3.3; p = 0.023); a mean birth length reduction of −0.10 cm (95% CI: −0.19, −0.01; p = 0.040). |
| Mitku et al., 2020 South Africa [50] |
Prospective Cohort | <25 to >30 | 1st and 2nd trimesters |
687 | Junk food (sweets, muffins, chips, mixed salad, fruit juice, fizzy soft drinks, vetkoek, coffee creamer, cooking oil, hamburgers, cooked vegetables, cereals rice, margarine) |
Birth Weight | Junk food intake is associated with an increase in birth weight (p < 0.001). |
| Nascimento et al., 2016 Brazil [62] |
Prospective Cohort | 26.2 ± 5.8 | 26.4 weeks (SD ± 0.8) | 841 | WDP (white bread, savory, sweet, chocolate, cookies, soft drinks, pasta, fried food, pizza, chicken, canned food) |
GDM | Association between GDM incidence and dietary patterns (RR: 0.78; 95%CI: 0.43, 1.43) |
| Nicolì et al., 2021 Italy [78] |
Prospective Cohort | 35.75 ± 5.53 | NR | 376 | Soft drink | GDM | Non-nutritive-sweetened soft drink consumption associated with GDM (OR: 1.766; 95% CI: 1.089, 2.863; p = 0.021) |
| Okubo et al., 2012 Japan [44] |
Prospective Cohort | ≥18 | All trimesters | 803 | Dietary patterns (wheat products pattern: bread, confectioneries, fruit and vegetable juice, and soft drinks) |
SGA birth | Wheat products pattern associated with SGA infant: (OR: 5.2; 95% CI: 1.1, 24.4) |
| Rasmussen et al., 2014 Denmark [83] |
Prospective Cohort | 21–39 | 2nd trimester | 69,305 | WDP (French fries, white bread, meat mixed, margarine, dressing sauce, chocolate milk, soft drink, cakes, chocolate, candy, sweet spread, dessert dairy) | Preterm Birth | Western diet associated with preterm delivery (OR: 1.30; 95% CI: 1.13, 1.49) |
| Rodrigues, Azeredo, Silva, 2020, Brazil [65] | Cross-sectional | 24.9 ± 6.5 | 39.4 weeks (SD ± 1.2) |
99 | Processed meat | LBW | Maternal consumption of sausages associated with LBW: (OR: 1.46; 95% CI: 1.02, 2.10) |
| Rohatgi et al., 2017 USA [4] |
Prospective Cohort | 27.2 ± 5.1 | 32–37 weeks | 45 | UPF energy intake | GWG | Each 1% increase in UPF energy intake associated with increase in GWG: (β: 1.33; 95% CI: 0.3, 2.4; p = 0.016) |
| Schmidt et al., 2020 Denmark [70] |
Prospective Cohort | NR | 12 weeks | 66,387 | Soft drinks | CHD | High intake of sugar-sweetened carbonated beverages (≥4 servings) associated with CHD: (OR: 2.41; 95% CI: 1.26, 4.64; p-trend = 0.03.) |
| Sedaghat et al., 2017 Iran [41] |
Case-control | case: 29.64 ± 4.52 control: 29.76 ± 4.26 |
case: 29.39 ± 4.74 weeks control: 31.19 ± 3.53 weeks |
case: 122 control: 266 |
WDP (sweet snacks, mayonnaise, SSB, salty snacks, solid fats, high-fat dairy, red and processed meat, and tea and coffee) | GDM | Western dietary patterns associated with GDM risk: (OR: 1.68; 95% CI: 1.04, 2.27) |
| Tamada et al., 2021 Japan [48] |
Prospective Cohort | 30.7 years (SD ± 5.1) | 14.4 weeks (SD ± 5.6) | 94,062 | Ready-made meals (pre-packed foods, instant noodles, soup) | Stillbirth Preterm Birth LBW |
Ready-made meals associated with stillbirth: (OR: 2.632; 95% CI: 1.507, 4.597; q = 0.007); Preterm birth: (OR: 0.993; 95% CI: 0.887, 1.125) LBW: (OR: 0.961; 95% CI: 0.875, 10.56) |
| Teixeira et al., 2020 Brazil [60] |
Prospective Cohort | mean: 25.9 | 10–11 weeks | 299 | Dietary patterns (processed meats, sandwiches and snacks, sandwich sauces, desserts and sweets, soft drinks) |
SGA | Dietary pattern with snacks, sandwiches, sweets, and soft drinks associated with the risk to deliver SGA babies: (RR: 1.92; 95% CI: 1.08, 3.39) |
| Tielemans et al., 2015 Netherlands [81] |
Prospective Cohort | 31.6 (IQR ± 4.3) | 13.4 weeks (IQR: 12.2–15.5) |
3374 | Dietary patterns (margarine—solid and liquid, sugar and confectionary, cakes, chocolate, candy, snacks) |
GWG | Margarine, sugar, and snacks pattern are associated with a higher prevalence of excessive GWG: (OR: 1.45; 95% CI: 1.06, 1.99) |
| Uusitalo et al., 2009 Finland [77] |
Prospective Cohort | 29.2 ± 5.2 | 10 weeks | 3360 | Dietary patterns (fast food: sweets, fast food, snacks, chocolate, fried potatoes, soft drinks, high-fat pastry, cream, fruit juices, white bread, processed meat, sausage) |
GWG | Fast food patterns associated with weight gain rate: (β: 0.010; SE: 0.003; p = 0.004) |
| Wen et al., 2013 Australia [87] |
Prospective Cohort | >16 | 24–34 weeks | 368 | Junk food diet (soft drinks, processed meat, meals, chips or French fries) |
LGA | Junk food diet versus without a junk food diet associated with a newborn LGA: (OR: 0.36; 95% CI: 0.14, 0.91; p = 0.03) |
| Wrottesley, Pisa & Norris, 2017; South Africa [51] | Prospective Cohort | ≥18 | All trimesters | 538 | WDP (white bread, cheese and cottage cheese, red meat, processed meat, roast potatoes and chips, sweets, chocolate, soft drinks, miscellaneous) | GWG | Western dietary pattern associated with excessive GWG (OR: 1.07; 95% CI: 0.78, 1.45; p = 0.682) |
| Yong et al., 2021 Malaysia [49] |
Prospective Cohort | 30.01 ±4.48 | 1st trimester | 452 | Beverages (carbonated and juices) |
GDM | Higher fruit juice intake associated with GDM (OR: 0.92; 95% CI: 0.89, 0.98). |
| Zareei et al., 2019 Iran [45] |
Cross-sectional | 28.96 ± 5.85 | NR | 82 | Dietary patterns (unhealthy dietary patterns: mayonnaise, fries, red meat, soft drinks, pizza, snacks, sweets and dessert, refined cereal, hydrogenated oils, high-fat dairy products, sugar, processed meat, broth.) |
Preeclampsia | The unhealthy dietary pattern associated with preeclampsia (OR: 1.381; 95% CI: 0.462, 4.126, p = 0.564) |
| Zhang et al., 2006 USA [57] |
Prospective Cohort | >18 | NR | 13,110 | WDP (red and processed meat, refined grain products, sweets, French fries and pizza) | GDM | Western pattern score associated with GDM risk (RR: 1.63; 95% CI: 1.20, 2.21; p = 0.001); Red meat associated with GDM risk: (RR: 1.61; 95% CI: 1.25, 2.07) Processed meat associated with GDM risk: (RR: 1.64; 95% CI: 1.13, 2.38) |
| Zhu et al., 2017 Denmark [82] |
Prospective Cohort | >18 | 25 weeks | 918 | Soft drinks | Birth weight | Daily soft drinks consumption associated with offspring risk of LGA: (RR: 1.57; 95% CI: 1.05, 2.35) |
| Zuccolotto et al., 2019 Brazil [61] |
Cross-sectional | 27.6 ± 5.4 | 24–39 weeks | 785 | Snack dietary patterns (breads; butter and margarine; Processed meat, sweets, chocolate milk and cappuccino) |
GDM | Dietary patterns associated with GDM risk: (OR: 1.01; 95% CI: 0.63, 1.63) |
BMI: body mass index; BW: birth weight; CBWC: customized birthweight centiles; CI: confidence interval; CHD: congenital heart defects; EPDS: Edinburgh Postpartum Depression Scores; GDM: gestational diabetes mellitus; GWG: gestational weight gain; IQR: interquartile range; LBW: low birth weight; LGA: large for gestational age; NR: not reported; OR: odds ratio; RR: relative risk; SD: standard deviation; SGA: small for gestational age; SSB: sugar-sweetened Beverage; SSC: sugar-sweetened carbonated beverages; UPF: ultra-processed food; WDP: Western dietary pattern.