Identifying Inadequate Maternal Nutrition in Pregnancies Affected by Fetal Heart Defects: A Feasibility Pilot Study Using Photo-Based Diet Quality Assessment

Etiologies of congenital heart disease (CHD) are multifactorial. The role of maternal nutrition and environmental factors among these CHD etiologies remain insufficiently understood. This pilot study evaluated the potential association between maternal diet quality, nutrient intake, and food security to fetal CHD in a cohort of 100 pregnant individuals, including 20 with CHD-affected pregnancies identified in a fetal cardiology clinic at an urban tertiary care hospital. A Diet Quality Photo Navigation (DQPN) tool assessed dietary quality and nutrient intake, while a survey collected data on demographics, health history, and food security. Comparison tests assessed for differences between CHD- and non-CHD-affected pregnancies. CHD-affected pregnancies demonstrated descriptively lower Healthy Eating Index scores, reduced prenatal multivitamin use, and lower intake of iron, manganese, fiber, and vitamin C. The non-CHD group demonstrated a significantly higher consumption of healthier snacks (<i>p</i> = 0.03), plant-based meat alternatives (<i>p</i> = 0.05), and unsweetened beverages (<i>p</i> = 0.05), while descriptively showing greater fruit and vegetable intake as compared to the CHD-affected group. No statistically significant differences in food security or socioeconomic indicators were identified. These findings demonstrate the feasibility of applying a DQPN tool in fetal health research and describe maternal dietary patterns that may inform the design of future hypothesis-driven studies. Continued investigation into maternal diet quality is critical to understand its potential role in mitigating CHD risk through targeted nutritional interventions.