**5. Conclusions**

These limitations notwithstanding, this study contributes to the growing literature on the effects of toxic exposures during pregnancy and adds information on the potential role of diet in preventing adverse birth outcomes. Although our study did not support that maternal adherence to a Mediterranean diet pattern may mitigate exposure, it is possible that other dietary patterns may in fact help mitigate the association between elevated prenatal cadmium exposure and lower birth weights. Future research should focus on finding dietary patterns that can mitigate prenatal cadmium risk and that can be easily translatable into public health recommendations.

**Supplementary Materials:** The following are available online at http://www.mdpi.com/2305-6304/8/4/90/s1, Table S1: Regression coe fficients and 95% confidence intervals for the association/relationship between, cadmium exposure (log cd) and birth weight; Table S2: Odds ratio and 95% confidence intervals for the association/relationship between cadmium exposure (log cd) and preterm birth; Table S3: Regression coe fficients and 95% confidence intervals for the association/relationship between, cadmium exposure (high/low) and (1) Apgar score, (2) Ponderal index.

**Author Contributions:** Conceptualization, C.H. and S.G.-N.; methodology and analysis, C.H., K.N, S.G.-N.; writing—original draft preparation, S.G.-N. and C.H.; writing—review and editing, S.G.-N., K.N., J.S.H., R.L.M., H.G.S., C.H.; funding acquisition, C.H. All authors have read and agreed to the published version of the manuscript. **Funding:** This research was funded by gran<sup>t</sup> R24ES028531, R01MD011746 andP30ES025128, and supported in part by the division of intramural research at NIH, National Institute of Environmental Health Sciences.

**Acknowledgments:** The authors thank participants of the NEST study and Cheyenne Bradford for her help with the literature review.

**Conflicts of Interest:** The authors declare no conflict of interest.
