Factors Associated with Dietary Behaviour During Pregnancy: An Insight from the SaperePer Cohort

Background: Diet during pregnancy plays a crucial role in promoting healthy dietary behaviours and positive maternal and child health outcomes. However, evidence regarding the factors associated with healthy dietary behaviours among pregnant women is limited. The SaperePer study aims to assess the dietary behaviours of pregnant women and identify the sociodemographic, lifestyle, and health-related factors that influence their choices. Methods: This cross-sectional analysis included 1254 pregnant women recruited from two Northern Italian centres (Turin and Cuneo). Dietary behaviour was assessed using a questionnaire, which generated a diet-related scores. Associations between these scores and participants’ characteristics were investigated using multivariable regression models. Results: Overall, participants reported relatively favourable dietary habits and a low prevalence of risky behaviours. Higher socioeconomic position was found to be one of the strongest contributing factors to dietary behaviour (medium vs. low β (95% CI) = 1.18 (0.93, 1.42); high vs. low β (95% CI) = 1.57 (1.10, 2.04), both p < 0.001). Higher dietary behaviour scores were positively associated with older maternal age, moderate physical activity, and better perceived physical and psychological health, whereas smoking and alcohol consumption were associated with lower scores. Conclusions: Dietary behaviour during pregnancy appears to be shaped by a complex interplay of socioeconomic, behavioural, and health-related factors rather than by nutritional knowledge alone. These findings highlight the need for tailored interventions that address the social and contextual features of dietary behaviour to encourage healthier habits during pregnancy.