Abstract 021: Maternal Dietary Patterns During Late Pregnancy Are Linked To Hypertensive Disorders Of Pregnancy Among A Low-income Predominantly Hispanic/latina Pregnancy Cohort In Los Angeles
Authors: Luis E Maldonado, Claudia M Toledo-Corral, Genevieve Dunton, Shohreh Farzan, Carrie V Breton, Theresa M Bastain
Journal: Circulation (2022)

Introduction: Studies evaluating links between maternal dietary patterns during pregnancy and hypertensive disorders of pregnancy (HDPs) among disproportionately burdened populations such as Hispanics/Latinas are needed. Hypothesis: We hypothesize that maternal dietary patterns characterized by higher intakes of energy-dense, nutrient-poor foods will be adversely associated with HDPs. Methods: Women participating in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort—an ongoing, prospective pregnancy cohort of predominantly low-income Hispanic/Latina women in Los Angeles—orally completed up to two 24-hour dietary recalls using the Automated Self-Administered 24-hour Dietary Assessment Tool in the third trimester of pregnancy (N=464). HDPs were abstracted from maternal medical records and based on a physician diagnosis or having systolic or diastolic blood pressure measurements (≥140 mmHg and ≥90 mmHg, respectively) during ≥2 consecutive prenatal visits. Using multiple logistic regression, we evaluated links between having any HDP, gestational hypertension (GHTN), or pre-eclampsia during pregnancy and two dietary patterns previously identified using factor analysis in MADRES (Solid Fats, Refined Grains, and Cheese (SRC); Vegetables, Oils, and Fruit (VOF)), as well as with the Healthy Eating Index (HEI-2015), adjusting for maternal age, education, Hispanic/Latina ethnicity, chronic diabetes, parity, daily total energy intake, and other dietary patterns (only in SRC and VOF models). In separate models, we additionally tested dietary interactions with gestational diabetes. Results: The prevalence of any HDP, GHTN, and preeclampsia was 21.6%, 6.67%, and 12.1%, respectively. Comparing highest-to-lowest quartiles, the SRC dietary pattern was significantly associated with greater odds of having any HDP (OR=3.50, 95% CIs: 1.34, 9.10; P trend =0.010) and preeclampsia (OR=3.59, 95% CIs: 1.11, 11.62; P trend =0.058), while the VOF dietary pattern was associated with lower odds of preeclampsia (OR=0.33, 95% CIs: 0.12, 0.93; P trend =0.031). The associations of higher odds of HDP and preeclampsia with the SRC dietary pattern were more pronounced among those without gestational diabetes (P interactions =0.008 and 0.010, respectively). Findings for HEI-2015 were null. Conclusions: Among predominantly low-income Hispanic/Latina women, a diet characterized by higher intakes of solid fats, refined grains, and cheese during late pregnancy was associated with increased odds of preeclampsia and HDP, especially among women without gestational diabetes. Meanwhile, a diet characterized by higher intakes of vegetables, oils, and fruit during this period was associated with lower odds of preeclampsia. These results suggest that dietary counselling may be particularly important for pregnant women from high-risk populations.