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The present study investigated the association of maternal dietary patterns with pre-pregnancy body mass index (BMI) and total gestational weight gain (GWG), using data of 232 women from the “Mamma & Bambino” cohort. Dietary patterns were derived by a food frequency questionnaire and principal component analysis. Self-reported pre-pregnancy BMI and GWG were calculated according to the World Health Organization and Institute of Medicine guidelines, respectively. The adherence to the “Western” dietary pattern—characterized by high intake of red meat, fries, dipping sauces, salty snacks and alcoholic drinks—was associated with increased GWG (β = 1.217; standard error [SE] = 0.487;  p  = 0.013), especially among obese women (β = 7.363; SE = 1.808;  p  = 0.005). In contrast, the adherence to the “prudent” dietary pattern—characterized by high intake of boiled potatoes, cooked vegetables, legumes, pizza and soup—was associated with reduced pre-pregnancy BMI (β = −0.631; SE = 0.318;  p -trend = 0.038). Interestingly, the adherence to this pattern was positively associated with GWG among underweight (β = 4.127; SE = 1.722;  p  = 0.048), and negatively among overweight and obese individuals (β = −4.209; SE = 1.635;  p  = 0.016 and β = −7.356; SE = 2.304;  p  = 0.031, respectively). Our findings point out that the promotion of a healthy diet might represent a potential preventive strategy against inadequate weight gain, even during the periconceptional period.

Maternal Dietary Patterns Are Associated with Pre-Pregnancy Body Mass Index and Gestational Weight Gain: Results from the “Mamma & Bambino” Cohort