93. The P4 study: Micronutrient intake in women 6 months after hypertensive versus normotensive pregnancy

Abstract

Introduction Hypertensive disorders and poor dietary quality are associated with increased long-term risk of cardiovascular and metabolic disease. Energy intake patterns after hypertensive (HP) versus normotensive pregnancy (NP) may provide insight into these risk associations and their mechanisms. Objective/hypothesis Assess diet quality as measured by micronutrient and macronutrient intake six months after NP versus HP (either preeclampsia or gestational hypertension). Methods Prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatrics) study. Women were studied 6 months after NP versus HP. Energy intake (EI) was measured using a self-reported, three-day food diary and FoodWorksTM to calculate macronutrient and micronutrient intake. Results 74 women (60 NP, 14 HP) had complete, analysable 3-day food diaries 6 months postpartum. Maternal age (32 NP, 31 HP) was similar, however less (4/14; 29%) of the HP group were still breastfeeding (50/60; 83% of NP, p 0.001). Mean BMI was higher postpartum in HP (29 ± 8 versus 24 ± 4, p =0.02). Total average EI was 17% lower in HP (7909kJ versus 9534kJ NP, p = 0.02). Macronutrient intake (carbohydrate, fat and protein) was similar between groups. However, intake of several important micronutrients was significantly lower after HP, even allowing for the lower total EI, including Vitamin A (43% lower), riboflavin (36% lower), magnesium (34%), calcium (29%), iodine (29%) and phosphorus (24%). Women breastfeeding at 6 months (both after NP and HP, n=54) had higher carbohydrate and fat (but not protein) intake compared to women not breastfeeding (n=20), and also increased intake of Vitamin A, riboflavin, magnesium and iron. However, breastfeeding women also had higher EI, with their increased macronutrient and micronutrient intake approximately in proportion to their overall EI versus women not breastfeeding. Discussion Six months postpartum, women with previous HP have significantly lower reported micronutrient intake compared to NP, possibly reflecting poorer diet quality.