Interventions to Optimize Dietary Patterns in Black Pregnant Individuals: An Integrative Review

Black pregnant individuals bear an inequitable burden of maternal morbidity and mortality in many high income countries (HICs). Adverse social determinants of health and health-related factors, including dietary patterns, influence these disproportional rates. Dietary patterns are highly individualized and are associated with health and pregnancy outcomes in distinctive ways across to races and ethnic groups. While nutrition interventions are effective in improving dietary patterns in pregnant individuals, trial participants are predominantly non-Hispanic White. The objective of this integrative review is to identify and evaluate research exploring interventions to optimize dietary patterns in Black pregnant individuals in HICs.

Electronic searches were conducted in October, 2023 and June, 2025 and reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement. Eligibility was determined based on select criteria specific to the study participants, setting, methodological approach, intervention, and publication type. Final articles were critically appraised using the Joanna Briggs Institute and Consolidated Standards of Reporting Trials tools. Data extraction and synthesis of eligible articles was conducted as outlined by Whittemore and Knafl.

Fourteen articles from ten studies were included in the final review and were overall favorably appraised. Half of these studies enrolled Black or African American pregnant women exclusively. Interventions included nutrition education, behavioral counseling, and nutritious food delivery and were delivered in a variety of settings and modalities. Measurement and analysis of dietary assessments were inconsistently reported, and change in diet quality was the primary outcome for only three articles. Only one intervention was effective in improving participants' dietary intake.

Results from this integrative review illustrate the paucity of research on interventions to optimize dietary patterns in Black pregnant individuals in (HICs). Future nutrition intervention studies are needed among Black pregnant individuals, that include comprehensive reporting of participant demographics, social determinants of health, and dietary patterns. This will allow better understanding of the relationship between these factors and pregnancy and health outcomes for Black pregnant individuals.