Mediterranean-Style Diet and Risk of Preeclampsia by Race in the Boston Birth Cohort

Abstract

Background Preeclampsia is a major cause of maternal and fetal morbidity and mortality. Given its large public health burden, there is a need to identify modifiable factors that can be targeted for preeclampsia prevention. In this study, we examined whether a Mediterranean-style diet is protective for preeclampsia in a large cohort of racially and ethnically diverse, urban, low-income women. Methods and Results We used data from the Boston Birth Cohort. Maternal sociodemographic and dietary data were obtained via interview and food frequency questionnaire within 24 to 72 hours postpartum, respectively. Additional clinical information, including physician diagnoses of preexisting conditions and preeclampsia, were extracted from medical records. We derived a Mediterranean-style diet score from the food frequency questionnaire and performed logistic regression to examine the association of the Mediterranean-style diet score with preeclampsia. Of 8507 women in the sample, 848 developed preeclampsia. 47% were Black, 28% were Hispanic, and the remaining were White/Other. After multivariable adjustment, greatest adherence with MSD was associated with lower preeclampsia odds (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). Conclusions Self-report of higher adherence to a Mediterranean-style diet is associated with lower preeclampsia odds, and benefit of this diet is present among Black women as well.

Keywords: diet; preeclampsia; pregnancy.

Figure 1. Unadjusted associations of potential risk factors with preeclampsia.

Figure 2. Relationship between adjusted* odds of preeclampsia and Mediterranean‐style diet score.

*Variables included in the model: maternal age, race, education, marital status, smoking in pregnancy, parity, and prepregnancy obesity.

Figure 3. Adjusted* odds ratios of preeclampsia according to joint categories of Mediterranean‐style diet score and race.

*Variables included in the model: maternal age, education, marital status, smoking in pregnancy, parity, and prepregnancy obesity. MSDS indicates Mediterranean‐style diet score.