The relationship between maternal dietary behaviors and pregnancy outcomes among postpartum women in Iran: a cross-sectional study

Abstract Background Maternal dietary behaviors play a critical role in determining pregnancy outcomes. Poor nutrition may increase the risk of complications such as gestational diabetes mellitus (GDM), preeclampsia, preterm birth, and low birth weight (LBW). This study aimed to investigate the associations between maternal dietary behaviors and pregnancy outcomes among postpartum women attending healthcare centers in Saveh, Iran in 2024. Methods This cross-sectional study included 404 postpartum women who were selected via two-stage cluster random sampling. Data were collected using a validated 21-item dietary behavior questionnaire, a demographic questionnaire, and a pregnancy outcome checklist. The dietary behaviors were categorized as unhealthy (0–33.3), suboptimal (33.4–66.6), and healthy (> 66.6). Outcomes including GDM, preeclampsia, macrosomia, LBW, preterm birth, and small for gestational age (SGA), were assessed on days 3–5 postpartum. Statistical analyses, including one-way ANOVA, the chi-square test, Pearson’s correlation, and logistic regression modeling, were performed via SPSS 19 (p < 0.05). Results The participants had a mean age of 28.6 ± 5.6 years. Dietary behaviors were distributed as follows: unhealthy (28.5%), suboptimal (40.8%), and healthy (30.7%). Among women with healthy dietary behaviors, 39.5% experienced adverse pregnancy outcomes, whereas among those with unhealthy dietary behaviors, 76.5% experienced adverse pregnancy outcomes. A significant correlation was found between dietary behavior and pregnancy outcomes (p < 0.001). Healthier dietary behaviors were associated with a 3% reduction in the odds of adverse outcomes (OR, 0.97; 95% CI, [0.96–0.98], p < 0.001). Conclusion Poor maternal dietary behavior is associated with negative pregnancy outcomes. Improving nutritional education and integrating dietary counseling into prenatal care could promote maternal and neonatal health outcomes.