818 Diet quality predicts hypertensive disorders of pregnancy in hawaii cohort

Abstract

Data are mixed on whether diet quality in early gestation is associated with adverse pregnancy outcomes. This study aims to see if there is a correlation with diet quality and the development of hypertensive disorders of pregnancy (HDP) in Hawaii. In a longitudinal cohort study, diet quality was measured via a Food Frequency Questionnaire during each trimester in 56 healthy women. Three diet quality indices were assigned – The Healthy Eating Index (HEI), The Alternate Mediterranean Diet score (aMED), and the Dietary approaches to Stop Hypertension (DASH) score. Mean aggregate scores were compared among those who did and did not develop hypertensive disorders of pregnancy. Logistic Regression models were used or confounding demographic covariates (age, parity, BMI, ethnicity). Generalized Estimating equations were also used to see if a longitudinal change in diet quality was associated with HDP. There was a high incidence of HDP in this cohort, with 12 participants (21%) developing the condition. There was no change of diet quality scores over time from 1st to 3rd trimester. Aggregate mean diet quality scores were higher in the unaffected group versus those who developed HDP. Logistic regression models showed that all three scores were significantly associated with development of HDP, with the DASH diet score having the greatest effect, and the best fit modeling. Age and nulliparity were also independently associated with this disorder. Every point higher of DASH diet score portended a 3% less chance of developing HDP. The components of the DASH Score that contributed the most difference between the two groups were consumption of whole grains, dairy, and legumes or nuts. Diet quality can help predict risk of HDP and may be a modifiable risk factor to target. The DASH diet score may be most predictive of this condition. Further studies in a larger cohort may further identify the mechanism by which nutritional components contribute to this risk.View Large Image Figure ViewerDownload Hi-res image Download (PPT)