Nutrient intake and hypertensive disorders of pregnancy: Evidence from a large prospective cohort

Objective: The objective of this analysis was to prospectively determine the effects of nutrient intakes on the incidences of preeclampsia and pregnancy-associated hypertension among women enrolled in the Calcium for Preeclampsia Prevention study. Study Design: This was a prospective observational cohort study of women in a randomized clinical trial that included women seeking prenatal care at university medical centers and affiliated clinics and hospitals in 5 US communities. A total of 4589 nulliparous women were recruited between 13 and 21 weeks’ gestation. Preeclampsia and pregnancy-associated hypertension were the main outcome measures. Results: Preeclampsia was noted in 326 (7.6%) of the 4314 women with known pregnancy outcomes followed up until ≥20 weeks’ gestation, and pregnancy-associated hypertension was noted in 747 (17.3%). As previously reported, there was no significant difference in these outcomes between cohorts randomly assigned to supplementation with calcium or placebo. By means of logistic regression a baseline risk model was constructed for preeclampsia and pregnancy-associated hypertension. After adjustment for treatment and clinical site, body mass index >26 kg/m2 and race were significantly associated with an increased risk of preeclampsia. Body mass index ≥35 kg/m2, race, and never smoking were significantly associated with an increased risk of pregnancy-associated hypertension. After adjustment for baseline risks, none of the 28 nutritional factors analyzed were significantly related to either preeclampsia or pregnancy-associated hypertension. Conclusion: We found no evidence in this study for a significant association of hypertensive disorders of pregnancy with any of the 23 nutrients measured. (Am J Obstet Gynecol 2001;184:643-51.)