Healthy dietary patterns and common pregnancy complications: a prospective and longitudinal study

Abstract

Background Adherence to alternate Healthy Eating Index (AHEI), alternate Mediterranean diet (AMED), and Dietary Approaches to Stop Hypertension (DASH) has been linked to lower risks of chronic diseases. However, their associations with common pregnancy complications are unclear. Objectives This study investigates the associations of AHEI, AMED, and DASH during periconception and pregnancy with common pregnancy complication risks. Methods The study included 1887 pregnant women from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies–Singletons. Women responded to an FFQ at 8–13 gestational weeks, and they performed a 24-h dietary recall at 16–22 and 24–29 wk. Gestational diabetes (GDM), gestational hypertension, preeclampsia, and preterm delivery were ascertained using medical records. Results Healthier diet indicated by higher AHEI, AMED, and DASH scores was generally related to lower risks of pregnancy complications. Significant inverse associations were observed between AHEI score reported at 16–22 wk and GDM risk [adjusted RR (95% CI), highest (Q4) vs. lowest quartile (Q1): 0.32 (0.16, 0.66), P-trend = 0.002]; DASH score reported at both 8–13 [adjusted RR (95% CI), Q4 vs. Q1: 0.45 (0.17, 1.17), P-trend = 0.04] and 16–22 wk [adjusted RR (95% CI), Q4 vs. Q1: 0.19 (0.05, 0.65), P-trend = 0.01] and gestational hypertension risk; AHEI score reported at 24–29 wk and preeclampsia risk [adjusted RR (95% CI), Q4 vs. Q1: 0.31 (0.11, 0.87), P-trend = 0.03]; AMED score reported at 8–13 wk [adjusted RR (95% CI), Q4 vs. Q1: 0.50 (0.25, 1.01), P-trend = 0.03] and DASH score reported at 24–29 wk [adjusted RR (95% CI), Q4 vs. Q1: 0.50, (0.26, 0.96), P-trend = 0.03] and preterm delivery risk. Conclusions Adherence to AHEI, AMED, or DASH during periconception and pregnancy was related to lower risks of GDM, gestational hypertension, preeclampsia, and preterm delivery. This study was registered at ClinicalTrials.gov as NCT00912132.

Quality Appraisal of Nutritional Guidelines to Prevent, Diagnose, and Treat Malnutrition in All Its Forms during Pregnancy

“…Systematic reviews have shown promising results in promoting adequate GWG and glycemic control by following nutrition and lifestyle recommendations during pregnancy [ 7 , 8 ]. In addition, observational studies have reported positive results in preventing hypertensive disorders, low birth weight, and preterm birth in women with better diet quality indices compared to women with lower dietary quality scores [ 9 , 10 , 11 ].…”

Association of a Mediterranean Diet Pattern With Adverse Pregnancy Outcomes Among US Women

“…Our findings add to the growing body of evidence demonstrating that the Mediterranean diet pattern may play an important role in preserving the health of women across the lifespan, including during pregnancy. 10,[12][13][14] Long-term intervention studies are needed to assess whether promoting a Mediterranean-style diet pattern around the time of conception and throughout pregnancy can prevent APOs or reduce their downstream associations with future CVD risk. This may be particularly useful to study in pregnant persons at high risk for APOs.…”

Adherence to the Mediterranean Diet in Pregnancy and Its Benefits on Maternal-Fetal Health: A Systematic Review of the Literature

“…Eating patterns before and during pregnancy characterized by a high intake of fruits, vegetables, legumes, whole grains, nuts, olive oil, and a low intake of red meat and processed meats have been associated with an increased risk of hypertension during pregnancy. Although the biological mechanisms by which MD plays a protective role are not precisely known, these findings could indicate that the consumption of unsaturated fatty acids and micronutrients as well as some bioactive compounds make this diet help prevent complications during pregnancy ( 44 ).…”

“…Due to the beneficial effects of the MD, some authors highlight the need to recover the MD pattern in the general population and, in particular, in pregnant women, to avoid overweight and obesity, problems during pregnancy, as well as to achieve an adequate weight gain, as all this is related to overweight and the increase in adiposity in the offspring ( 40 , 41 , 44 , 45 ).…”