Association of Above-Average Healthy Eating Index and Pregnancy Outcomes [ID: 1375493

Abstract

INTRODUCTION: Nutritional health plays an important role in the intrauterine environment's effect on the developmental origins of disease. The Healthy Eating Index (HEI), a measure of dietary quality scaled 0–100 with 100 being ideal, has been shown to be poor on average in Americans. In a prospective cohort study of healthy pregnant individuals with a singleton gestation, we assessed dietary quality and its association with pregnancy outcomes. METHODS: Individuals completed their first study visit at a mean gestational age of 15 weeks, and three, 24-hour dietary recalls were obtained. Participants were dichotomized by HEI scores as above and at or below the U.S. average (>58 and ≤58). We assessed outcomes including gestational diabetes (GDM), hypertensive disorders of pregnancy (HDP), and large for gestational age (LGA >90th percentile). Statistical analysis was completed using two-sample t tests and Fisher's exact tests (P=.05). The study was IRB approved. RESULTS: Of the 67 participants included in the analysis, 45 (67%) had above average and 22 (33%) had below average HEI scores. The incidence of HDP was significantly lower among individuals with higher dietary quality (22.8% versus 4.4%, P=.03). Although the rates of GDM were not different between the two groups (15.6% versus 9.1%, P=.71), the proportion of LGA infants trended lower in those with higher HEI (4% versus 22%, P=.19). CONCLUSION: Our data suggest that higher dietary quality may lead to improved pregnancy outcomes and support the potential role of the HEI for further exploring these relationships in future research.