Mediterranean diet linked to lower risk of pre-eclampsia

The results of a new study showed that pregnant women who adhered more to a Mediterranean-style diet had a lower risk of pre-eclampsia.

“As an observational study, it clearly has limitations to consider, but these findings are based on other evidence that the Mediterranean diet reduces cardiovascular risk and extends these findings to pregnancy because preeclampsia is a consequence of Cardiovascular,” Noel Mueller, Ph.D., said associate professor at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. theheart.org | Medscape Heart.

The study was published online April 20 in Journal of the American Heart Association.

The authors note that preeclampsia, which is characterized by a range of symptoms including high blood pressure, proteinuria, and terminal organ dysfunction, is a disorder that occurs in up to 5%-10% of all pregnant women worldwide and is more common. in black women. It is a major cause of maternal and fetal morbidity and increases the risk of long-term cardiovascular disease (CVD), including chronic hypertension, coronary artery disease, stroke, and heart failure.

Babies born to mothers with pre-eclampsia are also at increased risk of developing high blood pressure and other abnormal heart metabolic parameters.

They note that several studies have demonstrated the benefit of the Mediterranean diet – which is mainly characterized by a high intake of vegetables, fruits and unsaturated fats – in reducing the risk of cardiovascular disease in the non-pregnant population. The current study was conducted to see if benefits could also be seen in pregnant women in the form of a reduced risk of pre-eclampsia.

For the study, which used data from the Boston Birthing Cohort, maternal sociodemographic and nutritional data were obtained from 8,507 women via a food frequency questionnaire and interview within 24-72 hours of birth. The Mediterranean-style diet score was calculated from a food frequency questionnaire. Additional clinical information, including physician diagnoses for pre-existing conditions and pre-eclampsia, was extracted from medical records.

Of the women in the sample, 848 developed preeclampsia, of whom 47% were black, and 28% were Hispanic.

After multivariate adjustment, greater adherence to a Mediterranean-style diet was associated with lower odds of pre-eclampsia (adjusted odds ratio comparing 3 to 1, 0.78; 95% CI, 0.64–0.96).

A subgroup analysis of black women showed a similar benefit with an adjusted odds ratio comparing 3 to 1 of 0.74 (95% CI, 0.76–0.96).

In this racially and ethnically diverse group, women who adhered to a more Mediterranean-style diet during pregnancy had a 20% lower odds of developing pre-eclampsia, after adjusting for potential confounding factors. In addition to the evidence for the protective effect of pre-eclampsia, he concluded. The authors note that a Mediterranean-style diet against the odds of pre-eclampsia remained present in a subgroup analysis of black women.

Asked whether this would be sufficient evidence to recommend a Mediterranean diet for pregnant women, Mueller said that organizations issuing nutritional guidelines would likely require repeating these findings and possibly also a randomized trial in a diverse population before advocating such a diet.

“This is something we would like to do, but it will take time and money,” he added.

In the meantime, she’ll recommend a Mediterranean diet to her pregnant patients, said study lead author Anum Minhas, MD, Johns Hopkins University School of Medicine.

“The Mediterranean diet is a very healthy way to eat. I can’t see any downside to following such a diet during pregnancy, especially for high-risk women – those with obesity, high blood pressure or gestational diabetes, and there are potential benefits Other possible ones, such as weight loss and increased gestational diabetes.”

Mueller said he appreciates this pragmatic approach. “Sometimes there can be reluctance to make recommendations from observational studies, but the alternative to recommending this diet is either to have no diet recommendations or to recommend an alternative diet,” he said. “The Mediterranean diet or the DASH diet, which is quite similar, has shown by far the greatest evidence of heart protection of any diet. They have been shown to reduce blood pressure and lipids and improve cardiovascular risk, and I think we can Now assuming that it will likely extend into pregnancy. I feel comfortable recommending this diet to pregnant women.”

But he added, “Having said that, a randomized trial is still needed during pregnancy. We think it works but until we get a randomized trial we won’t know for sure, we won’t know how much benefit we can get.”

Comment on the study for theheart.org | Medscape HeartJoAnn Manson, MD, chief of preventive medicine at Brigham and Women’s Hospital in Boston, noted that this type of observational study is important for generating hypotheses but cannot prove cause-and-effect relationships.

“The evidence is promising enough,” said Manson, who was not involved in this study. But, she added, going forward, a randomized trial would be needed in women at high risk of pre-eclampsia, starting from the start of pregnancy, if not sooner.

She noted, “In the meantime, several broad-based groups could benefit from looking at the diet evaluated before or during pregnancy to see if this dietary pattern is prospectively associated with a lower risk of pre-eclampsia.”

“With additional supporting data, given the diet’s safety and general cardiovascular benefits, it could become a key tool for preventing adverse pregnancy outcomes.”

The Boston Birth Cohort Study was supported in part by grants from the March of Dimes, the National Institutes of Health, and the Department of Health and Resource Services at the US Department of Health and Human Services. Authors She did not disclose any related financial relationships.

Jaha. Posted online April 20, 2022. Full text

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