Abstract
Maternal diet is an important potential factor associated with the risk of preeclampsia. However, it is unclear whether adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet can reduce the development of preeclampsia. To examine the potential association, we conducted a hospital-based case-control study at the First Affiliated Hospital of Zhengzhou University, China. A total of 449 cases with preeclampsia and 449 controls were studied. Dietary information was collected using a validated food frequency questionnaire (FFQ). DASH scores were calculated according to nutrients/food emphasised or minimised in the DASH diet. The calculated DASH scores ranged from 11 to 38 for all of the participants, and the DASH scores of the cases were significantly lower than those of the controls (23.48 ± 4.58 vs 24.51 ± 4.51; p = 0.001). Participants in the fourth quartile of the DASH score were 45% less likely to have preeclampsia than those in the first quartile in the crude model (Q4 vs Q1, odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.38, 0.80; ptrend = 0.001). The relationship remained significant in the model adjusted for multiple confounders, especially for major risk factors of preeclampsia (OR: 0.53; 95% CI: 0.36, 0.78; ptrend = 0.001). Our findings suggest an inverse relationship between adherence to a DASH-style diet and the odds of preeclampsia. Further larger-scale cohort studies or randomised controlled trials are warranted to confirm these relationships.
Highlights
Preeclampsia is a pregnancy-specific complication that occurs after 20 weeks of gestation and is characterised by hypertension, proteinuria and oedema, with or without multiple organ damage[1]
We adjusted for confounders using the three models mentioned above (except for the confounder of gestational diabetes mellitus (GDM)), and found that adherence to the Dietary Approaches to Stop Hypertension (DASH) diet was still inversely associated with the odds of preeclampsia. This case-control study demonstrated an inverse association between adherence to a DASH-style diet and the odds of preeclampsia. This significant inverse relationship remained in the model adjusted for multiple confounders, especially for major risk factors of preeclampsia including pre-pregnancy body mass index (BMI) and nulliparity
To the best of our knowledge, this is the first case-control study to explore the association between adherence to a DASH-style diet and the odds of preeclampsia in a Chinese population
Summary
Preeclampsia is a pregnancy-specific complication that occurs after 20 weeks of gestation and is characterised by hypertension, proteinuria and oedema, with or without multiple organ damage[1]. It is a major cause of foetal and maternal morbidity and mortality worldwide, and affects 2–8% of all pregnancies[2]. Studies have shown that diets rich in vegetables and fruits or various nutrients such as vitamin D, calcium and zinc are associated with lower levels of oxidative stress and inflammation[6,7], which are both recognised pathogenic factors for preeclampsia[8]. Recent studies have used factor analysis to explore the relationship between dietary patterns and the risk of preeclampsia[10,11,12]. Considering that the DASH diet was previously found to be associated with a decreased risk of GDM19, we performed a sensitivity analysis to exclude the influence of GDM on the results
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