Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition

Location: Hall D

Poster Board Number: 325

P13-067 - Dietary Patterns Before and During Pregnancy and Risk of Hypertensive Disorders of Pregnancy: A Systematic Review

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives: Hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia, are common maternal complications during pregnancy, with known short- and long-term health risks for both mother and child. However, the association between dietary patterns before and during pregnancy and these outcomes is not well understood. A systematic review to assess this relationship was conducted as part of the USDA-HHS Pregnancy and Birth to 24 Months Project.



Methods: Nine databases, including PubMed, Embase, Cochrane, and CINAHL were searched from January 1980 to January 2017 for peer-reviewed articles related to dietary patterns and pregnancy/birth outcomes. A priori inclusion/exclusion criteria were used to dual screen articles; relevant data were extracted and risk of bias was assessed for included articles. After qualitatively synthesizing the data, a conclusion statement was drafted, and the evidence was graded.

Results: Of the 9,103 studies identified, 8 were included for this review (from four cohorts and one RCT) with sample sizes ranging from 290 to 72,072. Five of the 8 studies showed an association between dietary patterns before and during pregnancy and reduced risk of HDP. The Mediterranean, New Nordic Diet, and other dietary patterns were beneficial. The current evidence is based on a small body of evidence with heterogeneity in study design and methodology, and minority and lower SES populations were underrepresented.




Conclusions:
Limited evidence in healthy Caucasian women with access to health care suggests that dietary patterns before and during pregnancy higher in vegetables, fruits, whole grains, nuts, legumes, fish, and vegetable oils and lower in red and processed meats and refined grains are associated with a reduced risk of HDP, including preeclampsia and gestational hypertension. Not all components of the assessed dietary patterns are associated with all hypertensive disorders. Evidence is insufficient to estimate the association between dietary patterns before and during preconception/pregnancy and risk of HDP in minority women and those of lower socioeconomic status. Further research is needed that reflects the diversity of the US population, uses consistent dietary patterns and methods, and has adequate statistical power to address this issue.




Funding Source:

Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA and the Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, US Department of Health and Human Services, Rockville, MD.

CoAuthors: Ramkripa Raghavan – Panum Group; Carol Dreibelbis – Panum Group; Yat Ping Wong – United States Department of Agriculture, Food and Nutrition Service; Barbara Abrams – University of California, Berkeley; Alison Gernand – The Pennsylvania State University; Kathleen Rasmussen – Division of Nutritional Sciences, Cornell University; Anna Maria Siega-Riz – University of Virginia School of Nursing; Jamie Stang – University of Minnesota School of Public Health; Kellie Casavale – United States Department of Health and Human Services, Office of Disease Prevention and Health Promotion ; Joanne Spahn – United States Department of Agriculture, Food and Nutrition Service; Eve Stoody – United States Department of Agriculture, Food and Nutrition Service

Brittany L. James

Panum Group
Alexandria, Virginia