Supplementary Material for: Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction during pregnancy on fetal brain development detected by neurosonography. A secondary analysis of a Randomized Clinical Trial (IMPACT BCN).

Introduction: We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12months old.
Methods: This was a secondary analysis of a randomized clinical trial (2017-2020) including 1,221 singleton pregnancies at high-risk for small-for-gestational age. Participants were randomized into three groups at 19-23 weeks’ gestation: Mediterranean diet intervention, stress reduction program or usual care. A detailed neurosonography was performed on 881 participants at mean(SD) 33.4(1.1) weeks’ gestation. Neurosonographic measurements were done offline. ASQ was performed on 276 infants at one year of corrected age.
Results: Biparietal diameter were similar among study groups. Mediterranean diet group fetuses had deeper insula [26.80(1.68) vs. 26.63(1.75), mm, p=0.02] and longer corpus callosum [42.98 (2.44) vs. 42.62(2.27), mm, p=0.04], with lower rate of suboptimal score infants in ASQ problem-solving domain (6.2% vs. 16.3%, p=0.03); Stress reduction group fetuses had deeper insula [26.90(1.75) vs. 26.63(1.75), mm, p=0.04] and lower rates of suboptimal score infants in ASQ fine motor domain (4.3% vs. 12.8%, p=0.04), compared to usual care group fetuses.
Conclusion: Maternal structured intervention during pregnancy of the trial has the potential to modify offspring’s neurodevelopment.