Abstract 073: A Mediterranean Diet Pattern Is Associated With Lower Risk Of Adverse Pregnancy Outcomes In US Women: Results From The NuMoM2b Cohort

Abstract

Introduction: Adverse pregnancy outcomes (APOs) are associated with an increased risk of developing cardiovascular disease (CVD). While the Mediterranean diet pattern has been inversely related to CVD outcomes, its association with APOs in US women has not been previously evaluated. Hypothesis: Adherence to a Mediterranean diet pattern during the periconception period is associated with lower risk of APOs. Methods: Racially and ethnically diverse women (n=8075, mean age: 27±6y) from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) cohort were enrolled across 8 US medical centers from 2010-13. An Alternate Mediterranean Diet (aMed) score was computed from data on habitual diet in the 3 months around conception, assessed using a semi-quantitative food frequency questionnaire in the first trimester. APOs were prospectively ascertained and defined as developing 1 or more of the following: gestational hypertension, preeclampsia/eclampsia, gestational diabetes, preterm delivery, small for gestational age, or stillbirth. Multivariable logistic regression was used to examine associations of the aMed score and its components with any APO and individual APOs. Results: Women in the highest vs. lowest quintile of the aMed score had 21% lower odds of developing any APO, and 36% and 52% lower odds of preeclampsia/eclampsia and gestational diabetes, respectively; a linear trend across aMed score categories was detected (p-trend<0.05) ( Figure ). When aMed score components were examined separately, higher intakes of vegetables, fruits, legumes, and fish and lower intakes of red meat were related to up to 26% lower odds of APOs. Conclusions: Greater adherence to a Mediterranean diet pattern is related to lower risk of APOs, with evidence of a dose-response relationship, highlighting the potential of this diet pattern in CVD primordial prevention efforts in US women. Long-term studies are needed to assess whether dietary modification in the periconception period can reduce risk of APOs and future CVD.

American Heart Association EPI|Lifestyle Scientific Sessions: 2022 Meeting Highlights

“…Higher intakes of vegetables, fruits, legumes, and fish and a lower intake of red meat were associated with lower odds of adverse pregnancy outcomes. 73 …”

Maternal Preconception Omega-6, Omega-3, and Omega-6:Omega-3 Intake and Uterine Artery Indices in Mid-Gestation

“…Maternal nutritional status is an important component of health during pregnancy, with implications for both maternal and fetal outcomes [1][2][3] . Multiple, recent, large-scale analyses demonstrate that overall poor periconceptional diet quality is associated with adverse maternal and neonatal outcomes, including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, and intrauterine growth restriction while more favorable dietary patterns have been associated with improved pregnancy outcomes [4][5][6] .…”

“…[1][2][3] Multiple, recent, large-scale analyses demonstrate that overall poor periconceptional diet quality is associated with adverse maternal and neonatal outcomes, including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, and intrauterine growth restriction, whereas more favorable dietary patterns have been associated with improved pregnancy outcomes. [4][5][6] Intake of individual nutrients has also been shown to have differential effects on pregnancy outcomes. For example, periconceptional intake of omega-3 (ω-3) polyunsaturated fatty acids (PUFA) is associated with the risk of preterm birth, with the magnitude of effect varying by maternal body mass index (BMI) categories.…”

Identifying barriers, facilitators, and interventions to support healthy eating in pregnant women with or at risk for hypertensive disorders of pregnancy

“… 3 , 4 Some studies suggest that these diets are safe and are associated with lower diastolic BP and lower risk of HDP in pregnant women. 5 , 6 , 7 Additionally, dietary approaches have been shown to lower BP more in those with higher BP and have a more modest BP effect on those with lower-range BP, which may indicate that dietary intervention is a safer approach to control BP during pregnancy. 5 Despite the importance of a healthy diet for BP control and to limit gestational weight gain, only 6%–7% of pregnant women or women of childbearing age with hypertension adhere to the recommended DASH diet.…”