Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, United States.
Pregnancy Hypertens. 2019 Apr;16:131-138. doi: 10.1016/j.preghy.2019.04.001. Epub 2019 Apr 8.
Evidence on the potential roles that dietary patterns play in the risk of preeclampsia remains limited.
To examine the associations between dietary patterns during pregnancy and the risk of preeclampsia.
We analyzed data from a cluster randomized controlled trial among 987 healthy pregnant women in three rural counties in northwestern China. Maternal diet during the whole pregnancy was assessed using a 107-item food frequency questionnaire with proportion size administered before delivery. Principal component factor analysis with varimax rotation was used to identify common dietary patterns. Preeclampsia was diagnosed by trained clinicians and recorded in delivery records.
Nineteen participants (1.9%) were diagnosed with preeclampsia. Gestational hypertension and proteinuria were only weakly correlated with each other (Kappa = 0.06): 10.7% participants with gestational hypertension only, 8.8% with proteinuria only, 1.9% with both, and 78.6% with neither. Five common dietary patterns were identified: vegetable, meat, fruit, snack, and wheat staple patterns. After adjusting for calories, other dietary pattern scores and baseline blood pressure, a higher vegetable pattern scores was associated with lower risk of preeclampsia (P for trend = 0.041; the highest vs lowest quartile, adjusted relative risk = 0.20 [95% confidence interval, 0.04-0.98]). A similar association was also observed for the risk of proteinuria (P for trend = 0.015): the highest vs lowest quartiles of the vegetable pattern score, adjusted relative risk = 0.44 (95% confidence interval, 0.24-0.80). The other four pattern scores were not associated with preeclampsia.
Adherence to vegetable dietary pattern may be associated with the lower risk of preeclampsia, possibly through reducing development of proteinuria. The original full study was registered at clinicaltrials.gov as NCT02537392.
关于饮食模式在子痫前期风险中的潜在作用的证据仍然有限。
研究妊娠期间饮食模式与子痫前期风险之间的关系。
我们分析了中国西北部三个农村县的 987 名健康孕妇参与的一项集群随机对照试验的数据。在分娩前使用包含比例大小的 107 项食物频率问卷评估孕妇整个孕期的饮食。采用主成分因子分析和方差极大旋转法识别常见的饮食模式。由经过培训的临床医生诊断子痫前期，并在分娩记录中记录。
19 名参与者（1.9%）被诊断为子痫前期。妊娠期高血压和蛋白尿之间仅有微弱的相关性（Kappa=0.06）：仅患有妊娠期高血压的参与者占 10.7%，仅患有蛋白尿的参与者占 8.8%，同时患有两种疾病的参与者占 1.9%，两种疾病均未患的参与者占 78.6%。确定了 5 种常见的饮食模式：蔬菜、肉类、水果、零食和主食模式。在校正了热量、其他饮食模式评分和基线血压后，较高的蔬菜模式评分与子痫前期风险降低相关（趋势 P 值=0.041；最高与最低四分位数，调整后的相对风险=0.20[95%置信区间，0.04-0.98]）。对于蛋白尿的风险也观察到类似的关联（趋势 P 值=0.015）：蔬菜模式评分的最高与最低四分位数，调整后的相对风险=0.44（95%置信区间，0.24-0.80）。其他四个模式评分与子痫前期无关。
遵循蔬菜饮食模式可能与子痫前期风险降低相关，这可能是通过减少蛋白尿的发生来实现的。原始完整研究在 clinicaltrials.gov 上注册为 NCT02537392。
