TABLE 2.
Association of second trimester adherence to the dietary recommendations from the AHA 2020 Impact Strategic Goals (18) and the DASH (19) diet with risk of preeclampsia (n = 66,651 pregnancies), the Danish National Birth Cohort (1996–2002)1
| Relative risk (95% CI) of preeclampsia by quintiles of adherence | ||||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | P-trend | |
| AHA primary score | ||||||
| Median, (range) | 23 (4, 26) | 29 (27, 30) | 35 (31, 37) | 36 (35, 38) | 41 (39, 49) | — |
| n cases | 311 | 262 | 278 | 231 | 228 | — |
| n pregnancies | 14,258 | 11,911 | 14,000 | 12,937 | 13,545 | — |
| Age and energy2 | 1.00 | 1.02 (0.86, 1.19) | 0.92 (0.79, 1.09) | 0.83 (0.70, 0.98) | 0.79 (0.66, 0.94) | <0.01 |
| Multivariable3 | 1.00 | 1.08 (0.92, 1.27) | 1.01 (0.86, 1.18) | 0.92 (0.77, 1.10) | 0.90 (0.75, 1.08) | 0.13 |
| Multivariable vs. normotensive4 | 1.00 | 1.08 (0.92, 1.27) | 1.01 (0.85, 1.18) | 0.92 (0.78, 1.10) | 0.90 (0.75, 1.08) | 0.14 |
| Multivariable excluding HTN before pregnancy5 | 1.00 | 0.98 (0.83, 1.17) | 1.00 (0.85, 1.18) | 0.90 (0.75, 1.08) | 0.88 (0.73, 1.06) | 0.14 |
| AHA secondary score | ||||||
| Median, (range) | 35 (9, 39) | 43 (40, 46) | 49 (47, 51) | 54 (52, 57) | 62 (58, 79) | — |
| n cases | 271 | 289 | 218 | 268 | 254 | — |
| n pregnancies | 12,604 | 14,708 | 12,095 | 13,229 | 14,015 | — |
| Age and energy2 | 1.00 | 0.91 (0.78, 1.08) | 0.84 (0.70, 1.00) | 0.94 (0.80, 1.12) | 0.88 (0.74, 1.04) | 0.21 |
| Multivariable3 | 1.00 | 0.95 (0.81, 1.12) | 0.90 (0.75, 1.08) | 1.02 (0.86, 1.22) | 0.95 (0.79, 1.14) | 0.78 |
| Multivariable vs. normotensive4 | 1.00 | 0.95 (0.81, 1.12) | 0.90 (0.75, 1.08) | 1.02 (0.86, 1.21) | 0.95 (0.79, 1.14) | 0.77 |
| Multivariable excluding HTN before pregnancy5 | 1.00 | 0.94 (0.80, 1.12) | 0.95 (0.80, 1.13) | 1.00 (0.83, 1.20) | 0.96 (0.79, 1.15) | 0.82 |
| DASH score | ||||||
| Median, (range) | 19 (9, 20) | 22 (21, 22) | 24 (23, 25) | 26 (26, 27) | 29 (28, 39) | — |
| n cases | 310 | 246 | 281 | 232 | 241 | — |
| n pregnancies | 13,942 | 11,671 | 13,941 | 13,041 | 14,056 | — |
| Age and energy2 | 1.00 | 0.97 (0.81, 1.15) | 0.97 (0.84, 1.14) | 0.88 (0.73, 1.06) | 0.91 (0.77, 1.08) | 0.19 |
| Multivariable3 | 1.00 | 0.99 (0.83, 1.19) | 1.02 (0.87, 1.20) | 0.93 (0.77, 1.12) | 0.96 (0.80, 1.15) | 0.57 |
| Multivariable vs. normotensive4 | 1.00 | 0.99 (0.82, 1.18) | 1.02 (0.87, 1.20) | 0.93 (0.77, 1.12) | 0.96 (0.80, 1.15) | 0.56 |
| Multivariable excluding HTN before pregnancy5 | 1.00 | 1.02 (0.85, 1.23) | 1.03 (0.88, 1.22) | 0.97 (0.79, 1.17) | 0.99 (0.82, 1.20) | 0.83 |
1DASH, Dietary Approaches to Stop Hypertension; GHTN, gestational hypertension; HTN, hypertension; ICD-10, International Classification of Diseases, 10th revision; Q, quintile of adherence.
2Model adjusted for total energy intake and maternal age at pregnancy.
3Model adjusted for total energy intake, age, prepregnancy BMI, parity, smoking, concurrent gestational diabetes, height, Denmark demographic regions, education, vitamin C and vitamin E intake.
4Excluded 499 cases of GHTN (n = 65,152 pregnancies).
5Excluded 589 pregnancies with diagnosis of chronic hypertension before pregnancy (ICD-10: I10, I11, I12, I13, I15, I16).