Japan Environment and Children's Study Programme Office National Institute for Environmental Studies Ibaraki Japan.
Japan Society for the Promotion of Science Tokyo Japan.
J Am Heart Assoc. 2024 Sep 17;13(18):e033702. doi: 10.1161/JAHA.123.033702. Epub 2024 Sep 11.
Little is known about the relationship of healthy diets, which are widely recommended to prevent diseases in general populations, with the risk of hypertensive disorders of pregnancy (HDP), particular among non-Western populations with different dietary habits. We aimed to investigate the association between periconceptional diet quality and the risk of HDP among pregnant Japanese women.
Dietary intake over 1 year before the first trimester of pregnancy was assessed using a validated, self-administered food frequency questionnaire among 81 113 pregnant Japanese women who participated in a prospective cohort of the Japan Environment and Children's Study. Overall diet quality was assessed by the Balanced Diet Score (BDS) based on adherence to the country-specific dietary guidelines and the Dietary Approaches to Stop Hypertension (DASH) score. Cases of HDP were identified by medical record transcription. The association between diet quality and HDP risk was examined using Bayesian logistic regression models with monotonic effects. We identified 2383 (2.9%) cases of HDP. A higher BDS was associated with a lower risk of HDP. When comparing the highest with the lowest quintile of the BDS, the adjusted odds ratio (aOR) of HDP was 0.83 (95% credible interval [CrI], 0.73-0.94). The DASH score and HDP risk were inversely associated in a monotonic dose-response manner (aOR per 1-quintile increase in the DASH score, 0.92 [95% CrI, 0.89-0.95]).
A high-quality diet, which is recommended for disease prevention in general populations, before conception may also reduce the risk of HDP among pregnant Japanese women.
人们对健康饮食与妊娠高血压疾病（HDP）风险之间的关系知之甚少，而健康饮食被广泛推荐用于预防一般人群的疾病，特别是在具有不同饮食习惯的非西方人群中。我们旨在研究日本孕妇围孕期饮食质量与 HDP 风险之间的关系。
在日本环境与儿童研究前瞻性队列中，81113 名参与研究的日本孕妇在妊娠前 1 个月内使用经过验证的自我管理食物频率问卷评估了 1 年内的饮食摄入情况。根据对特定国家饮食指南的依从性和停止高血压的饮食方法（DASH）评分，使用均衡饮食评分（BDS）评估整体饮食质量。通过医疗记录转录确定 HDP 病例。使用具有单调效应的贝叶斯逻辑回归模型检查饮食质量与 HDP 风险之间的关系。我们确定了 2383 例（2.9%）HDP 病例。BDS 越高，HDP 的风险越低。当比较 BDS 的最高五分位数与最低五分位数时，HDP 的调整比值比（aOR）为 0.83（95%置信区间[CrI]，0.73-0.94）。DASH 评分与 HDP 风险呈单调反比关系（DASH 评分每增加一个五分位数，aOR 为 0.92[95%CrI，0.89-0.95]）。
在一般人群中推荐用于预防疾病的高质量饮食，在怀孕前可能也会降低日本孕妇发生 HDP 的风险。
