Dietary risk factors for hypertensive disorders of pregnancy

Abstract

Poor diet quality, as assessed by the US Department of Agriculture’s Health Eating Index (HEI), has previously been linked with hypertensive disorders of pregnancy (HDP). We assessed specific dietary components contributing to this increased risk of HDP. This is a nested case control study in a cohort of 450 study participants with singleton pregnancies who completed the NIH Dietary Health Questionnaire II (DHQ-II) in the third trimester or within 3 months of delivery from 2017-2020. Patients with fetal anomalies, pregnancies conceived by in-vitro fertilization, and deliveries at an outside hospital were excluded. Cases were patients diagnosed with HDP and controls were patients without HDP. Cases were matched to controls by BMI class in a 1:2 ratio. The primary exposures of interest were HEI score components and other DHQ-II dietary components including minerals, caffeine, and water. These dietary components were compared between cases and controls using univariate analyses. 150 patients with HDP were matched to 300 controls without HDP. Baseline demographics were similar between groups, including BMI. Patients with HDP were less likely to have high quality diets (HEI≥70) than controls (7.3% v 15.7%, P=0.02). HDP was associated with significantly higher dairy, saturated fat, and sodium intake compared to controls. Other HEI components such as protein, vegetable, added sugar, and fatty acid uptake were similar between groups (Figure). Caffeine, water, and mineral consumption was similar between groups (Table). Patients with HDP are more likely to have consumed a diet higher in sodium, dairy, and saturated fats. Antenatal diet modification in patients at high risk of HDP should be further studied.View Large Image Figure ViewerDownload Hi-res image Download (PPT)