TABLE 3.
Relative risk (95% CI) of hypertensive disorders of pregnancy by quartiles of AHEI, AMED, and DASH, NICHD Fetal Growth Studies–Singletons
| Dietary patterns | GW | Models | Total | Q1 | Q2 | Q3 | Q4 | P-trend |
|---|---|---|---|---|---|---|---|---|
| Gestational hypertension1 | ||||||||
| AHEI | 8–132 | Case/Obs. | 55/1505 | 25/374 | 13/375 | 12/374 | 5/382 | |
| Model 14 | 1.00 | 0.54 (0.28, 1.04) | 0.53 (0.27, 1.06) | 0.23 (0.09, 0.61) | 0.002 | |||
| Model 25 | 1.00 | 0.59 (0.30, 1.15) | 0.71 (0.35, 1.46) | 0.38 (0.14, 1.04) | 0.06 | |||
| A | Case/Obs. | 57/1682 | 18/416 | 15/419 | 14/413 | 10/434 | ||
| Model 14 | 1.00 | 0.87 (0.44, 1.70) | 0.85 (0.42, 1.70) | 0.61 (0.28, 1.34) | 0.23 | |||
| Model 25 | 1.00 | 0.91 (0.47, 1.79) | 0.91 (0.46, 1.82) | 0.77 (0.34, 1.72) | 0.54 | |||
| 24–293 | Case/Obs. | 58/1652 | 20/411 | 18/413 | 9/407 | 11/421 | ||
| Model 14 | 1.00 | 0.95 (0.51, 1.77) | 0.51 (0.23, 1.12) | 0.65 (0.30, 1.38) | 0.13 | |||
| Model 25 | 1.00 | 0.92 (0.49, 1.71) | 0.48 (0.21, 1.06) | 0.80 (0.36, 1.77) | 0.27 | |||
| AMED | 8–132 | Case/Obs. | 55/1505 | 18/333 | 26/580 | 5/273 | 6/319 | |
| Model 14 | 1.00 | 0.88 (0.49, 1.59) | 0.38 (0.14, 1.02) | 0.41 (0.16, 1.04) | 0.02 | |||
| Model 25 | 1.00 | 0.86 (0.47, 1.59) | 0.40 (0.14, 1.12) | 0.47 (0.18, 1.28) | 0.08 | |||
| 16–223 | Case/Obs. | 57/1682 | 18/447 | 19/419 | 11/380 | 9/436 | ||
| Model 14 | 1.00 | 1.15 (0.61, 2.17) | 0.76 (0.36, 1.59) | 0.56 (0.25, 1.26) | 0.11 | |||
| Model 25 | 1.00 | 1.13 (0.60, 2.10) | 0.81 (0.39, 1.70) | 0.71 (0.31, 1.61) | 0.32 | |||
| 24–293 | Case/Obs. | 58/1652 | 17/429 | 15/407 | 14/399 | 12/417 | ||
| Model 14 | 1.00 | 0.98 (0.49, 1.93) | 1.00 (0.49, 2.01) | 0.86 (0.41, 1.80) | 0.73 | |||
| Model 25 | 1.00 | 1.03 (0.52, 2.03) | 1.12 (0.55, 2.27) | 1.09 (0.51, 2.35) | 0.77 | |||
| DASH | 8–132 | Case/Obs. | 55/1505 | 22/333 | 22/478 | 5/358 | 6/336 | |
| Model 14 | 1.00 | 0.75 (0.42, 1.35) | 0.23 (0.09, 0.62) | 0.32 (0.13, 0.80) | 0.001 | |||
| Model 25 | 1.00 | 0.91 (0.51, 1.60) | 0.33 (0.12, 0.88) | 0.45 (0.17, 1.17) | 0.04 | |||
| 16–223 | Case/Obs. | 57/1682 | 21/378 | 18/501 | 15/399 | 3/404 | ||
| Model 14 | 1.00 | 0.67 (0.36, 1.24) | 0.72 (0.37, 1.39) | 0.15 (0.04, 0.49) | 0.002 | |||
| Model 25 | 1.00 | 0.82 (0.43, 1.56) | 0.79 (0.40, 1.58) | 0.19 (0.05, 0.65) | 0.01 | |||
| 24–293 | Case/Obs. | 58/1652 | 17/368 | 19/486 | 13/399 | 9/399 | ||
| Model 14 | 1.00 | 0.94 (0.49, 1.79) | 0.83 (0.40, 1.73) | 0.60 (0.26, 1.37) | 0.23 | |||
| Model 25 | 1.00 | 0.97 (0.50, 1.86) | 1.06 (0.49, 2.29) | 0.82 (0.34, 1.96) | 0.75 | |||
| Preeclampsia6 | ||||||||
| AHEI | 8–132 | Case/Obs. | 52/1502 | 16/365 | 16/378 | 13/375 | 7/384 | |
| Model 14 | 1.00 | 1.01 (0.51, 2.00) | 0.89 (0.43, 1.85) | 0.50 (0.20, 1.25) | 0.16 | |||
| Model 25 | 1.00 | 1.24 (0.61, 2.51) | 1.14 (0.53, 2.43) | 0.77 (0.30, 2.00) | 0.71 | |||
| 16–223 | Case/Obs. | 60/1685 | 20/418 | 15/419 | 21/420 | 4/428 | ||
| Model 14 | 1.00 | 0.79 (0.41, 1.53) | 1.16 (0.63, 2.12) | 0.23 (0.08, 0.69) | 0.03 | |||
| Model 25 | 1.00 | 0.83 (0.43, 1.60) | 1.22 (0.66, 2.24) | 0.26 (0.09, 0.78) | 0.07 | |||
| 24–293 | Case/Obs. | 55/1649 | 19/410 | 16/411 | 14/412 | 6/416 | ||
| Model 14 | 1.00 | 0.88 (0.46, 1.70) | 0.82 (0.41, 1.63) | 0.37 (0.14, 0.95) | 0.05 | |||
| Model 25 | 1.00 | 0.85 (0.44, 1.63) | 0.69 (0.34, 1.41) | 0.31 (0.11, 0.87) | 0.03 | |||
| AMED | 8–132 | Case/Obs. | 52/1502 | 13/328 | 23/577 | 9/277 | 7/320 | |
| Model 14 | 1.00 | 1.07 (0.55, 2.09) | 0.92 (0.40, 2.14) | 0.65 (0.26, 1.65) | 0.44 | |||
| Model 25 | 1.00 | 1.09 (0.54, 2.21) | 0.93 (0.38, 2.30) | 0.68 (0.25, 1.85) | 0.53 | |||
| 16–223 | Case/Obs. | 60/1685 | 25/454 | 7/407 | 15/384 | 13/440 | ||
| Model 14 | 1.00 | 0.33 (0.14, 0.75) | 0.77 (0.41, 1.45) | 0.63 (0.32, 1.22) | 0.31 | |||
| Model 25 | 1.00 | 0.30 (0.13, 0.69) | 0.77 (0.41, 1.45) | 0.67 (0.34, 1.32) | 0.43 | |||
| 24–293 | Case/Obs. | 55/1649 | 19/431 | 15/407 | 14/399 | 7/412 | ||
| Model 14 | 1.00 | 0.87 (0.45, 1.69) | 0.88 (0.45, 1.75) | 0.45 (0.19, 1.07) | 0.10 | |||
| Model 25 | 1.00 | 0.91 (0.47, 1.75) | 1.02 (0.51, 2.04) | 0.47 (0.18, 1.21) | 0.22 | |||
| DASH | 8–132 | Case/Obs. | 52/1502 | 15/326 | 16/472 | 14/367 | 7/337 | |
| Model 14 | 1.00 | 0.81 (0.40, 1.63) | 0.95 (0.46, 1.96) | 0.56 (0.22, 1.40) | 0.31 | |||
| Model 25 | 1.00 | 0.99 (0.49, 2.02) | 1.27 (0.59, 2.74) | 0.72 (0.28, 1.89) | 0.75 | |||
| 16–223 | Case/Obs. | 60/1685 | 21/378 | 18/501 | 6/390 | 15/416 | ||
| Model 14 | 1.00 | 0.70 (0.38, 1.30) | 0.32 (0.13, 0.79) | 0.79 (0.40, 1.56) | 0.26 | |||
| Model 25 | 1.00 | 0.77 (0.41, 1.45) | 0.33 (0.13, 0.83) | 0.94 (0.45, 1.96) | 0.50 | |||
| 24–293 | Case/Obs. | 55/1649 | 17/368 | 16/483 | 14/400 | 8/398 | ||
| Model 14 | 1.00 | 0.80 (0.40, 1.57) | 0.90 (0.44, 1.84) | 0.54 (0.23, 1.27) | 0.21 | |||
| Model 25 | 1.00 | 0.70 (0.35, 1.41) | 0.82 (0.39, 1.73) | 0.56 (0.23, 1.38) | 0.25 | |||
Models included all normotensive women (i.e., without preeclampsia or gestational hypertension) and women with gestational hypertension.
At this GW interval, AHEI, AMED, and DASH scores were estimated using self-reported diet in the past 3 months assessed by FFQ.
At this GW interval, AHEI, AMED, and DASH scores were estimated based on Automated Self-Administered 24-h dietary recall.
Log-binomial regression models adjusted for maternal age (y).
Log-binomial regression models adjusted for maternal age (y), race (non-Hispanic white, non-Hispanic black, Hispanic, Asian), education (<high school, high school, some college, Bachelor, Graduate), marriage/cohabiting (yes, no), nulliparity (yes, no), pre-pregnancy BMI (kg/m2), family history of diabetes (yes, no), light to vigorous physical activities (MET-h/wk), sleep durations (5–6, 7, 8–9, 10+ h/d), and total energy intake (kcal/d).
Models included all normotensive women (i.e., without preeclampsia or gestational hypertension) and women with preeclampsia.
AHEI, alternate Healthy Eating Index; AMED, alternate Mediterranean diet; DASH, Dietary Approaches to Stop Hypertension; GW, gestational week; NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Development.