Effect of Maternal Nutrition and Dietary Habits on Preeclampsia: A Case-Control Study

Abstract

Introduction: 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 has been suggested to play a role in preeclampsia. However, the hypotheses have been diverse and often revealed inconsistent results across studies. Moreover, rarely were these hypotheses studied in Ethiopia. Therefore, this study aimed to explore whether the incidence of preeclampsia was related to nutrient or micronutrient deficiencies. Objectives: To describe the effect of nutrition and dietary habits on the incidence of preeclampsia. Methods: A facility based 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. Case-control incidence density sampling followed by 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 statistically significant at 95% confidence level throughout the study. Result: Those women having a MUAC value ≥ 25.6 cm were two times more likely than their counterparts to have preeclampsia (AOR = 2.49, 95% CI = 1.58, 3.94). Strikingly, higher odds of preeclampsia were found in women who reported to have taken coffee during pregnancy (AOR = 2.16, 95% CI = 1.32, 3.53). Similarly, those women who had anemia during the first trimester pregnancy were three times more likely than their counterparts to have incidence of M. Endeshaw et al. 1406 preeclampsia (AOR = 2.80, 95% CI = 1.09, 7.21). The result in this study also revealed that taking fruit or vegetables during pregnancy was found to be protective of preeclampsia (AOR = 0.37, 95% CI = 0.19, 0.73, AOR = 0.45, 95% CI = 0.22, 0.91) respectively. In addition, folate intake during pregnancy has shown a significant independent effect on the prevention of preeclampsia in this study (AOR = 0.19, 95% CI = 0.10, 0.37). Conclusion and Recommendation: Vegetable and fruit consumption and folate intake during pregnancy are independent protective factors of preeclampsia. On the other hand, higher mid upper arm circumference, anemia and coffee intake during pregnancy are risk factors for the development of preeclampsia.

Nutrition of Black Women During Pregnancy

“…Researchers have also found a correlation between increased vitamin C, fruit, and vegetable consumption and decreased occurrence of small for gestational age newborns (Rao et al, 2001; Mikkelsen, Osler, Orozova-Bekkevold, Knudsen, & Olsen, 2006; Jain, Wise, Yanamandra, Dhanireddy, & Bocchini, 2007; Ramon et al, 2009). Endeshaw and colleagues (2014) also found increased vegetable and fruit consumption to be protective against preeclampsia. Many women do not adequately eat fruits and vegetables despite the known benefits (Crozier et al, 2009; Krebs-Smith, Guenther, Subar, Kirkpatrick, & Dodd, 2010; Stallings, Gazmararian, Goodman, & Kleinbaum, 2015).…”

“…Currently, it is recommended that pregnant women obtain 1200–2500 mg/d of calcium and 600–1000 μg/d of folate (Institute of Medicine, 2005). Calcium supplementation and appropriate folate intake have protective effects against preeclampsia (Hofmeyr, Lawrie, Atallah, Duley, & Torloni, 2014; Endeshaw, Ambaw, Aragaw, & Ayalew, 2014). Previous research findings have linked the consumption of certain micronutrients to positive health outcomes.…”

“…It is recommended that pregnant women consume 15–100 μg/d (Institute of Medicine, 2005). Iron also has numerous benefits, preventing low birth weight as well as maternal anemia, which in turn has been linked to preeclampsia development (Peña Rosas et al, 2012; Endeshaw et al, 2014). Pregnant women should obtain 27 to 45 mg/d of iron (Institute of Medicine, 2005).…”

Low vitamin C intake increases risk of pre-eclampsia in high pesticide exposure area

“…(19) However, the results of our study differed from those of one study on pregnant or post partum women in Semarang and another study on pregnant women in Makassar, with and without pre-eclampsia, where it was found that low protein intake was a risk factor of preeclampsia in pregnancy. (7,20) Similarly, a study that was conducted in one Indian hospital found that low protein intake was a risk factor of preeclampsia. (21) Low protein intake contributes toward oxidative stress that subseaquently causes preeclampsia.…”

“…(6) According to a study conducted by Kartasurya (7) on 200 pregnant/post partum women (50 pre-eclampsia cases and 150 controls), in women with pre-pregnancy body mass index (BMI) scores of >23 kg/m 2 , the risk of pre-eclampsia was four and a half times greater than in women with pre-pregnancy BMI scores of <23 kg/m 2 . Lipids are involved in the generation of free radicals and polyunsaturated fatty acids (PUFA) tend to be oxidized by free radicals and reactive oxygen species (ROS).…”