Abstract P214: Adherence to Dietary Recommendations of the AHA 2020 Goals and Risk of Preeclampsia Among Danish Women

Abstract

Objective: Because the role of diet in preeclampsia is unclear, we examined the association between adherence to the American Heart Association’s (AHA) 2020 dietary recommendations and risk of preeclampsia. Methods: We followed 66,161 singleton pregnancies from 62,310 women participating in the Danish National Birth Cohort. Diet was assessed around gestation week 20 with a semi-quantitative food frequency questionnaire (FFQ). Adherence to the AHA dietary recommendations was calculated by a score, which addressed 5 dietary components: fruits and vegetables, fish, whole grains, sodium and sugar-sweetened beverages. Preeclampsia was ascertained by linkage to the Danish National Patient Registry. We estimated relative risks [RR] and 95% confidence intervals [95% CI] of preeclampsia according to increasing quintiles of adherence to the AHA recommendations using logistic regression models with generalized estimating equations to account for repeated pregnancies per woman while adjusting for energy intake, age, BMI, parity, smoking status, socio-economic status, height, region, education, and vitamin C and E intakes. Results: We identified 1,319 (2%) cases of preeclampsia, including 307 (0.5%) cases of severe preeclampsia. The AHA score ranged from 4 to 49 points with a maximum possible score of 50 points. Stronger adherence to the AHA score was inversely associated with the risk of preeclampsia. The adjusted RR [95%CI] among women categorized with the highest AHA score compared to women in the lowest score category was 0.81 (95%CI 0.68, 0.96). When each component of the score was separately examined, the association with risk of preeclampsia was largely driven by sodium. Specifically, women with the highest sodium intake (median 3,729 mg/day [range: 3611, 3922]) had 20% (95%CI 2, 43%) higher risk of developing preeclampsia compared to women with the lowest sodium intake (median 2,602 mg/day [range 2,435, 2,710]). When sodium intake was excluded from the AHA score, greater adherence to AHA recommendations was no longer related to risk of PE (RR 0.87, 95%CI 0.60, 1.28). Conclusions: Higher adherence to the AHA 2020 dietary recommendations during pregnancy was associated with a lower risk of preeclampsia. Although diet sodium tends to be underestimated when measured by FFQ, we found that sodium intake was related to risk of preeclampsia.