1. Introduction
depression, anxiety
COVID-19 INFECTION, EARLY PREGNANCY
Prenatal health is important for both mother and child. Additionally, the offspring’s development is affected by the mother’s diet. The aim of this study was to assess whether a Clinical Decision Support System (CDSS) can improve adherence to the Mediterranean diet in early pregnancy and whether this change is accompanied by changes in nutritional status and psychological parameters. We designed a three month randomised controlled clinical trial which was applied to 40 healthy pregnant women (20 in the CDSS and 20 in the control group). Medical history, biochemical, anthropometric measurements, dietary, and a psychological distress assessment were applied before and at the end of the intervention. Pregnant women in the CDSS group experienced a greater increase in adherence to the Mediterranean diet, as assessed via MedDietScore, in the first trimester of their pregnancy compared to women in the control group (The maternal diet during pregnancy has been linked to the health of both the mother and her offspring [Studies have established that MD promotes maternal health during pregnancy and child health after delivery [Clinical Decision Support Systems (CDSS) date back to the 1970s [Within this scope, we have developed a CDSS to enable individuals to follow diet and lifestyle instructions from home, avoiding visits to the healthcare setting, with the intention of minimizing the risk of COVID-19 infection. The present CDSS was developed by our research team in 2016, and ever since, it has been applied in clinical practice to assist dieticians in the nutritional care process, such as nutritional screening and monitoring. The CDSS allows patients to visit their personal dietary regimen at any time and to record and monitor their own progress, e.g., goals of body weight, physical activity, and consumption of fruits, vegetables, and legumes, via a login password [In the present study, we hypothesised that the incorporation of CDSS into dietary practices ameliorates nutritional status and reduces health-related anxiety and depression among pregnant women. Therefore, we aimed to investigate whether:(a) MD adherence increases in healthy pregnant women with the support of CDSS compared to controls who receive standard guidelines for pregnancy;(b) Pregnant women intervened by CDSS have an improved nutritional status in terms of anthropometry, dietary intake of nutrients, and biochemical profile, as well as a better psychological state (depression and anxiety) than pregnant controls.To our knowledge, this is the first study to investigate the effectiveness of CDSS in improving MD adherence among pregnant women.