Preeclampsia, characterized by a range of symptoms including hypertension, proteinuria, and end‐organ dysfunction, is a disorder that occurs in up to 5% to 10% of all pregnant women worldwide.1 It is a major cause of maternal and fetal morbidity and raises the risk for long‐term cardiovascular disease (CVD), including chronic hypertension, coronary artery disease, ischemic stroke, and heart failure. It is possible that the observed increased risk of CVD may be related to shared cardiometabolic risk factors, such as hypertension, diabetes, and obesity, between preeclampsia and CVD, although studies have suggested that the increased CVD risk conferred by preeclampsia exceeds that expected by cardiometabolic factors alone. Children born to mothers with preeclampsia have also shown to be at an elevated risk of having higher blood pressure and other abnormal cardiometabolic parameters including flow‐mediated dilation, which are markers of elevated CVD risk. Given these health hazards to both mothers and children, it is important to prevent development of preeclampsia.
Multiple studies have demonstrated a benefit of the Mediterranean diet, characterized primarily by high intake of vegetables, fruits, and healthy fats, in reducing CVD risk in the nonpregnant population, and it is hypothesized that adherence to a dietary pattern such as the Mediterranean diet may reduce the risk of preeclampsia.
On April 20, 2022 a new analysis based on the Boston Birth Cohort data was published in the Journal of the American Heart Association. For the study, maternal sociodemographic and dietary data were obtained from 8507 women via interview and food frequency questionnaire within 24-72 hours of giving birth. A Mediterranean-style diet score was calculated from the food frequency questionnaire. Additional clinical information, including physician diagnoses of preexisting conditions and preeclampsia, were extracted from medical records. Of 8507 women in the sample, 848 developed preeclampsia. 47% were Black, 28% were Hispanic, and the remaining were White/Other. After multivariable adjustment, the greatest adherence to a Mediterranean-style diet was associated with lower odds of developing preeclampsia (adjusted odds ratio comparing tertile 3 to tertile 1, 0.78; 95% CI, 0.64 - 0.96).
A subgroup analysis of Black women demonstrated a similar benefit with an adjusted odds ratio comparing tertile 3 to tertile 1 of 0.74 (95% CI, 0.76 - 0.96).
Despite this very promising data, the current study is cross sectional, which limits its ability to establish causality. There is still a need for a randomized trial of the Mediterranean diet in pregnancy.
Reference: https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022589
