Prepregnancy adherence to dietary recommendations for the prevention of cardiovascular disease in relation to risk of hypertensive disorders of pregnancy
Prepregnancy adherence to dietary recommendations for the prevention of cardiovascular disease in relation to risk of hypertensive disorders of pregnancy
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DOI：
10.1093/ajcn/nqaa214
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发表时间：
2020-12-01
影响因子：
7.1
通讯作者：
Chavarro, Jorge E.
中科院分区：
文献类型：
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作者：
Arvizu, Mariel;Stuart, Jennifer J.;Chavarro, Jorge E.
背景资料：目前尚不清楚在一般人群中坚持预防心血管疾病（CVD）的饮食建议是否也与妊娠高血压疾病（包括先兆子痫和妊娠高血压（GHTN））的风险有关。目的：目的是评估孕前对美国心脏协会（AHA）饮食建议的依从性与阻止高血压饮食方法（DASH）之间的关系方法：在1991年至2009年期间，我们前瞻性地随访了11,535名参加护士健康研究H的16892例单胎妊娠妇女。每4年评估一次孕前饮食，从中我们计算了DASH饮食（8个组成部分）的饮食模式评分和AMA 2020战略影响目标的饮食建议（主要评分：5个组成部分;次要评分：主要评分加3个组成部分）。妊娠结局自我报告，我们估计的RR（95%CI）的先兆子痫和GHTN与对数二项回归使用广义估计方程，以解释重复怀孕和调整潜在的confers.Results：妇女的平均（SD）年龄为34.4（34.0）y在怀孕。在495例（2.9%）妊娠中报告了先兆子痫，在561例（3.3%）妊娠中报告了GHTN。DASH最高五分位数的女性先兆子痫的RR（95%CI）为0.65（0.48。与得分最低的五分之一的妇女相比，在AHA初级（0.74; 95% CI：0.55，1.00）和次级（0.81; 95% CI：0.61，1.07）评分中，对最高和最低评分五分位数的妇女进行比较，观察到类似的反向趋势。DASH和AHA评分均与GHTN.Conclusions：在一般人群中，坚持饮食建议预防CVD的女性患先兆子痫的风险较低-这是一种常见的妊娠并发症，与女性中较高的CVD风险相关-比坚持这些建议的女性更低。
Background: It is unclear whether adherence to diet recommendations for the prevention of cardiovascular disease (CVD) in the general population is also related to the risk of hypertensive disorders of pregnancy, including pre-eclampsia and gestational hypertension (GHTN).Objectives: The aim was to evaluate the relation of prepregnancy adherence to the American Heart Association (AHA) diet recommendations and the Dietary Approaches to Stop Hypertension (DASH) with the risk of pre-eclampsia and GHTN.Methods: Between 1991 and 2009, we prospectively followed 16.892 singleton pregnancies among 11,535 women who participated in the Nurses' Health Study H. Prepregnancy diet was assessed every 4 y, from which we calculated dietary pattern scores from the DASH diet (8 components) and the diet recommendations from the AMA 2020 Strategic Impact Goals (primary score: 5 components; secondary score: primary score plus 3 components). Pregnancy outcomes were self-reported, and we estimated the RR (95% CI) of pre-eclampsia and GHTN with log-binomial regression using generalized estimating equations to account for repeat pregnancies and adjusting for potential confounders.Results: Women had a mean (SD) age of 34.4 (34.0) y at pregnancy. Pre-eclampsia was reported in 495 (2.9%) pregnancies and GHTN in 561 (3.3%) pregnancies. The RR (95% CI) of pre-eclampsia for women in the highest quintile of the DASH was 0.65 (0.48. 0.87) compared with women in the lowest score quintile. A similar inverse trend was observed for the AHA primary (0.74; 95% CI: 0.55, 1.00) and secondary (0.81; 95% CI: 0.61, 1.07) scores comparing women in the highest versus the lowest score quintile. Neither the DASH nor the AHA scores were related to GHTN.Conclusions: Women with higher adherence to dietary recommendations for the prevention of CVD in the general population had a lower risk of pre-eclampsia-a common pregnancy complication related to higher CVD risk among women-than women with lower adherence to these recommendations.