Preeclampsia is a leading cause of maternal death in the United States, and its prevalence is rising in comparison to other developed countries. It can also have potentially fatal consequences for the baby. While the condition affects about 2%-6% of women in the United States, it affects Black women twice as much as other racial groups.
Researchers from the Smidt Heart Institute at Cedars-Sinai discovered that women who conceived while following the anti-inflammatory diet had a significantly lower risk of developing preeclampsia during pregnancy in a new study evaluating the Mediterranean diet and adverse pregnancy outcomes.
The study, which was published today in the peer-reviewed journal JAMA Network Open, also looked at the link between the Mediterranean diet and other negative pregnancy outcomes, such as gestational diabetes and hypertension, preterm birth, delivery of a small-for-gestational-age infant, and stillbirth.
“This multicenter, population-based study validates that a healthier eating pattern is associated with a lower risk of adverse pregnancy outcomes, the most exciting being a 28% lower risk for preeclampsia,” said Natalie Bello, MD, MPH, senior and corresponding author of the study and director of Hypertension Research at the Smidt Heart Institute. “Importantly, this link between the Mediterranean diet and a lower risk of adverse pregnancy outcomes was observed in a geographically, racially, and ethnically diverse population.”
These findings add to the growing body of evidence demonstrating that a Mediterranean-style diet may play an important role in preserving women’s health across the lifespan, including during pregnancy.Christine Albert
Bello also notes that researchers found the association was stronger in women who are traditionally considered to be of advanced maternal age, those 35 or older.
Preeclampsia is a dangerous blood pressure condition that develops during pregnancy and puts the mother’s heart under strain. If left untreated, the condition can lead to serious complications such as impaired kidney and liver function and a reduction in blood supply to the fetus. In addition to preeclampsia, women who adhered to a heart-healthy diet had a lower risk of gestational diabetes.
The research was conducted as part of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be, which enrolled 10,038 women between 2010 and 2013. The JAMA Network Open study included 7,798 of women who enrolled. During their first study visit in the first trimester, women who were pregnant with their first child were asked to complete a semi-quantitative food frequency questionnaire.
The questionnaire focused on the women’s eating habits during the three months prior to their visit and asked the participants to report their intake of common foods and beverages. Individuals’ responses were then categorized into the nine components of a Mediterranean diet – vegetables, fruits, nuts, whole grains, legumes, fish, monounsaturated-to-saturated fat ratio, red and processed meats, and alcohol – to calculate a Mediterranean diet score.
The data was compiled, analyzed, and studied by researchers and showed:
- Of the 7,798 women enrolled, 10% were 35 years old or older, 11% were non-Hispanic Black, 17% were Hispanic, and 4% were Asian.
- 20% of enrollees had obesity at the onset of their participation.
- A high Mediterranean diet score was related to 21% lower odds of having any adverse pregnancy outcome, as well as a 28% and 37% lower risk of having preeclampsia/eclampsia and gestational diabetes.
“We also examined the individual components of the Mediterranean diet and discovered that higher intakes of vegetables, legumes, and fish were associated with a lower associated risk of an adverse pregnancy outcome,” Bello explained.
According to Christine Albert, MD, MPH, chair of the Department of Cardiology, who was not involved in the study, these findings show that in US women, adopting a Mediterranean diet pattern may represent an important lifestyle approach for the prevention of adverse pregnancy outcomes, particularly in women of advanced maternal age.
Only three observational studies, each with a small number of participants, had previously investigated the link between adherence to this healthy diet pattern around the time of conception and the risk of developing preeclampsia.
“These findings add to the growing body of evidence demonstrating that a Mediterranean-style diet may play an important role in preserving women’s health across the lifespan, including during pregnancy,” Albert said.
Long-term studies, according to Bello, are needed to determine whether promoting a Mediterranean-style diet around the time of conception and throughout pregnancy can prevent negative pregnancy outcomes and lower future cardiovascular risk.