Hypertensive disorders of pregnancy tied to fatty, salty diet

Women who adhere to a diet rich in sodium, dairy, and saturated fats are at increased risk of hypertensive disorders of pregnancy (HDP), according to a study presented at the 43rd Annual Pregnancy Meeting of the Society for Maternal Fetal Medicine (SMFM 2023).

“Patients with HDP are more likely to have consumed a diet higher in sodium, dairy, and saturated fats,” said the researchers, led by Dr Suzanne O’Nan, assistant professor at Washington University in St Louis, Missouri, US.

Poor diet quality, as defined by the Health Eating Index (HEI) of the US Department of Agriculture, has been shown to contribute to HDP in previous studies. In the current nested case-control study, O’Nan and her colleagues evaluated specific dietary components that contribute to a greater HDP risk.

Four hundred fifty women with singleton pregnancies who completed the National Institute of Health Dietary Health Questionnaire II (DHQ II) in the third trimester or within 3 months of delivery from 2017‒2020 were included in the analysis. Those with foetal anomalies, pregnancies conceived by in-vitro fertilization, and deliveries at an outside hospital were excluded.

Eligible women were grouped into cases (those diagnosed with HDP) and controls (those without HDP). O’Nan and her team matched the cases to controls by body mass index (BMI) class in a 1:2 ratio.

HEI score components and other DHQ-II dietary components including minerals, caffeine, and water were the primary exposures of interest. Using univariate analyses, the research team compared these dietary components between cases and controls.

Of the women, 150 had HDP and 300 had no HDP. The two cohorts had similar baseline demographics, including BMI. [SMFM 2023, abstract 616]

Fewer patients with HDP consumed high quality diets (HEI ≥70) relative to controls (7.3 percent vs 15.7 percent; p=0.02). The case group was also more likely to have significantly higher dairy, sodium, and saturated fat intake compared with the control group.

Other HEI components such as protein, vegetable, added sugar, and fatty acid uptake did not differ between cases and controls. Likewise, consumption of caffeine, water, and mineral was similar between the two groups.

“Antenatal diet modification in patients at high risk of HDP should be further studied,” the researchers said.

In an earlier cross-sectional study assessing the role of dietary factors in pregnancy-induced hypertension among women attending antenatal care services at a teaching hospital, HDP significantly correlated with higher salt intake, visible fat, and obesity. [J Family Med Prim Care 2021;10:3268-3272]

“The association of dietary factors with HDP could be explained by several factors, one being the high-calorie intake by women with known HDP and those without HDP. The imbalance between the energy intake and expenditure is a potential risk factor and leads to overweight or obesity,” the authors said.

Furthermore, a systematic review and meta-analysis showed that women who consume a diet higher in processed meat, salty snacks, and sweet drinks were more likely to develop complications such as pre-eclampsia. [BMC Med 2014;12:157]