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To evaluate the effect of low trans fatty acids (TFAs) dietary patterns during pregnancy on the risk of low birth weight (LBW). All pregnant women who received prenatal care with gestational age &lt;8 weeks in this study took place in Tehran from December 2014 to August 2016. Women in the intervention group received dietary patterns with TFAs content of &lt; 1%; those in the control group had dietary intake without any change in TFAs content. Dietary intakes were assessed by 3 non-consecutive 24-hour recalls in three trimesters. Hazard ratio (HR) was calculated using Cox proportional‐hazards models. Incidence and HR (95% CI) for LBW based on multivariable adjusted models were calculated. Of the 800 women ( n  = 407 in control and  n  = 393 in intervention groups), 108 (13.5%) women were diagnosed with LBW. The incidence of LBW in the intervention group was 12% and in the control group was 19%. After multivariable adjustment for confounders, the HR for incident LBW in the intervention group was 0.65 (0.44–0.96). Kaplan-Meier plot showed a significant difference between the two groups in the incidence of LBW. Intake of low TFAs dietary patterns during pregnancy reduced the risk of LBW.IMPACT STATEMENTWhat is already known on this subject?  Maternal nutrition affects foetal development, and one important dietary determinant of foetal growth may be trans fatty acids (TFAs). It is generally advised to avoid high-fat dairy products that are the main sources of TFAs during pregnancy; however, there is limited data on the effects of a diet of LBW.What do the results of this study add?  Intake of low TFAs dietary patterns during pregnancy reduced the risk of LBW. In this study, the risk of LBW in the intervention group decreased by about 50%.What are the implications of these findings for clinical practice and/or further research?  The results of this study could give physicians and other health care providers the hint that Management of maternal nutrition with focussed on TFAs content should be included in routine prenatal care, to facilitate interventions and guidance regarding maternal nutrition. What is already known on this subject?  Maternal nutrition affects foetal development, and one important dietary determinant of foetal growth may be trans fatty acids (TFAs). It is generally advised to avoid high-fat dairy products that are the main sources of TFAs during pregnancy; however, there is limited data on the effects of a diet of LBW. What do the results of this study add?  Intake of low TFAs dietary patterns during pregnancy reduced the risk of LBW. In this study, the risk of LBW in the intervention group decreased by about 50%. What are the implications of these findings for clinical practice and/or further research?  The results of this study could give physicians and other health care providers the hint that Management of maternal nutrition with focussed on TFAs content should be included in routine prenatal care, to facilitate interventions and guidance regarding maternal nutrition.

Does trans fatty acid affect low birth weight? A randomised controlled trial