O30. Diet and preeclampsia: A prospective multicentre unmatched case control study in Ethiopia

Abstract

Background Preeclampsia is one of the most commonly encountered hypertensive disorders of pregnancy that accounts for 20–80% of maternal mortality in developing countries, including Ethiopia. For many years diet have been suggested to play a role in preeclampsia. However, the hypotheses have been diverse and often revealed inconsistent results across studies, and this has not been studied in Ethiopia Objectives The objective of this study was to determine the effect of dietary habits on the incidence of preeclampsia Bahir Dar, Ethiopia Methods A prospective multicentre unmatched case- control study was conducted among 453 (151 cases and 302 controls) pregnant women attending antepartum or intrapartum care in public health facilities of Bahir Dar City Administration. Interviewer administered face to face interview, measurement of mid-arm circumference (MUAC) and document review were conducted using a standardized and pretested questionnaire. Data entry and cleaning was done by Epi.info version 3.5.3.The data were transported to SPSS version 20 for analysis. Both bivariate and multivariate logistic regression analyses were applied. Backward stepwise unconditional logistic regression analysis was employed to determine the putative association of predictive variables with the outcome variable and to control for the effect of confounding variables. A P -value 0.05 was considered to declare statistically significant throughout the study. Result For every 1-cm increase of MUAC, there was an increase in the incidence rate of preeclampsia by a factor of 1.35 ( AOR = 1.35, 95%CI:1.21, 1.51). A higher incidence of preeclampsia was found in women who reported to have consumed coffee daily during pregnancy ( AOR = 1.78, 95%CI: 1.20, 3.05). Similarly for women who had anemia during the first trimester the incidence of preeclampsia 2.5 times higher than their counterparts ( AOR = 2.47, 95%CI: 1.12,7.61). This study also revealed consumption of fruit or vegetables at least three times a week during pregnancy to be protective against preeclampsia ( AOR = 0.51, 95%CI: 0.29, 0.91; AOR = 0.46, 95%CI: 0.24, 0.90, respectively). In addition compliance with IFA during pregnancy has shown a significant independent effect on the prevention of preeclampsia in this study ( AOR = 0.16, 95%CI: 0.08, 0.29) Conclusion and recommendation Adequate vegetable and fruit consumption and compliance to folate intake during pregnancy are independent protective factors of preeclampsia. On the other hand, higher mid upper arm circumference, anemia and daily coffee intake during pregnancy are risk factors for the development of preeclampsia. Audience specific education and promotion for the use of the protective factors identified in this study should be strengthened. The risk factors identified can be used for prediction and early diagnoses of preeclampsia allowing timely interventions to be performed to minimize deaths associated with severe preeclampsia/eclampsia.