To determine the effect of a maternal vegan diet on pregnancy outcome.
This is a prospective observational study. Women with a singleton pregnancy who maintained the same diet prior to, and throughout current pregnancy were enrolled. Stratification was performed according to diet type: vegans, lacto–ovo–vegetarians, fish-eaters, and omnivores.
Overall, 273 women were enrolled, of them, 112 omnivores, 37 fish-eaters, 64 lacto–ovo–vegetarians, and 60 vegans. The vegan diet was significantly associated with an increased risk of small-for-gestational-age newborns compared only to an omnivore diet (RR = 5.9, 95% CI, 1.2–21.8). The incidence of preterm birth was similar in all groups. Vegans had lower birthweight compared to lacto–ovo–vegetarians (3015 ± 420 g vs. 3285 ± 482 g, P = 0.004), and to omnivores (3328 ± 495 g, P < 0.001), but not to fish-eaters. Vegans also had a lower mean gestational weight gain compared only to omnivores (11.6 ± 4.2 kg vs. 14.3 ± 4.6 kg, P = 0.001).
The vegan diet is associated with an increased risk for small-for-gestational-age newborns and lower birthweight.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Get just this article for as long as you need it
Prices may be subject to local taxes which are calculated during checkout
Key TJ, Appleby PN, Rosell MS. Health effects of vegetarian and vegan diets. Proc Nutr Soc. 2006;65:35–41.
Gilsing AMJ, Crowe FL, Lloyd-Wright Z, Sanders TAB, Appleby PN, Allen NE, et al. Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study. Eur J Clin Nutr. 2010;64:933–9.
Majchrzak D, Singer I, Männer M, Rust P, Genser D, Wagner KH, et al. B-vitamin status and concentrations of homocysteine in Austrian omnivores, vegetarians and vegans. Ann Nutr Metab. 2007;50:485–91.
Elorinne AL, Alfthan G, Erlund I, Kivimäki H, Paju A, Salminen I, et al. Food and nutrient intake and nutritional status of Finnish vegans and non-vegetarians. PLoS ONE. 2016;11:1–14.
Winston CJ. Health effeets of vegan diets 1-3. Am J Clin Nutr. 2009;89:1627–33.
Leung AM, LaMar A, He X, Braverman LE, Pearce EN. Iodine status and thyroid function of Boston-area vegetarians and vegans. J Clin Endocrinol Metab. 2011;96:1303–7.
Sebastiani G, Barbero AH, Borrás-Novel C, Casanova MA, Aldecoa-Bilbao V, Andreu-Fernández V, et al. The effects of vegetarian and vegan diet during pregnancy on the health of mothers and offspring. Nutrients. 2019;11:1–29.
Pawlak R. To vegan or not to vegan when pregnant, lactating or feeding young children. Eur J Clin Nutr. 2017;71:1259–62.
Ganpule A, Yajnik CS, Fall CHD, Rao S, Fisher DJ, Kanade A, et al. Bone mass in Indian children—relationships to maternal nutritional status and diet during pregnancy: the Pune maternal nutrition study. J Clin Endocrinol Metab. 2006;91:2994–3001.
Adaikalakoteswari A, Vatish M, Lawson A, Wood C, Sivakumar K, McTernan PG, et al. Low maternal vitamin B12 status is associated with lower cord blood HDL cholesterol in white caucasians living in the UK. Nutrients. 2015;7:2401–14.
Piccoli GB, Clari R, Vigotti FN, Leone F, Attini R, Cabiddu G, et al. Vegan-vegetarian diets in pregnancy: danger or panacea? A systematic narrative review. BJOG Int J Obstet Gynaecol. 2015;122:623–33.
Pistollato F, Sumalla Cano S, Elio I, Masias Vergara M, Giampieri F, Battino M. Plant-based and plant-rich diet patterns during gestation: beneficial effects and possible shortcomings. Adv Nutr. 2015;6:581–91.
Ferrara P, Sandullo F, Di Ruscio F, Franceschini G, Peronti B, Blasi V, et al. The impact of lacto-ovo-/lacto-vegetarian and vegan diets during pregnancy on the birth anthropometric parameters of the newborn. J Matern Neonatal Med. 2019;0:1–7.
Zulyniak MA, De Souza RJ, Shaikh M, Desai D, Lefebvre DL, Gupta M, et al. Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance. BMJ Open. 2017;7:1–9.
Tan C, Zhao Y, Wang S. Is a vegetarian diet safe to follow during pregnancy? A systematic review and meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2019;59:2586–96.
Avnon T, Anbar R, Lavie I, Ben-Mayor Bashi T, Paz Dubinsky E, Shaham S, et al. Does vegan diet influence umbilical cord vitamin B12, folate, and ferritin levels? Arch Gynecol Obstet. 2020;301:1417–22.
Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018;131;e49–64.
Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 202: Gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133:e1–25.
Dollberg S, Haklai Z, Mimouni FB, Gorfein I, Gordon E-S. Birth weight standards in the live-born population in Israel. Isr Med Assoc J. 2005;7:311–4.
Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. J Am Med Assoc. 1998;280:1690.
Rosell M, Appleby P, Spencer E, Key T. Weight gain over 5 years in 21 966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford. Int J Obes. 2006;30:1389–96.
Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. J Am Med Assoc. 2017;317:2207–25.
Viswanathan M, Siega-Riz AM, Moos MK, Deierlein A, Mumford S, Knaack J, et al. Outcomes of maternal weight gain. Evid Rep. Technol Assess. 2008;168:1–22.
Carter JP, Furman T, Hutcheson HR. Preeclampsia and reproductive performance in a community of vegans. South Med J. 1987;80:692–7.
Gabbe SG, Graves CR. Management of diabetes mellitus complicating pregnancy. Obstet Gynecol. 2003;102:857–68.
Jali MV, Desai BR, Gowda S, Kambar S, Jali SM. A hospital based study of prevalence of gestational diabetes mellitus in an urban population of India. Eur Rev Med Pharm Sci. 2011;15:1306–10.
No funding was received.
Conflict of interest
The authors declare that they have no conflict of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Avnon, T., Paz Dubinsky, E., Lavie, I. et al. The impact of a vegan diet on pregnancy outcomes. J Perinatol 41, 1129–1133 (2021). https://doi.org/10.1038/s41372-020-00804-x