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

OBJECTIVE: The objective of this analysis was to prospectively determine th e effects of nutrient intakes on the incidences of preeclampsia and pregnan cy-associated hypertension among women enrolled in the Calcium for Preeclam psia 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 u niversity medical centers and affiliated clinics and hospitals in 5 US comm unities. 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 greater than or equal to 20 weeks' ges tation, 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 placeb o. By means of logistic regression a baseline risk model was constructed fo r preeclampsia and pregnancy-associated hypertension. After adjustment for treatment and clinical site, body mass index >26 kg/m(2) and race were sign ificantly associated with an increased risk of preeclampsia. Body mass inde x greater than or equal to 35 kg/m(2), race, and never smoking were signifi cantly associated with an increased risk of pregnancy-associated hypertensi on. After adjustment for baseline risks, none of the 28 nutritional factors analyzed were significantly related to either preeclampsia or pregnancy-as sociated hypertension. CONCLUSION: We found no evidence in this study for a significant associatio n of hypertensive disorders of pregnancy with any of the 23 nutrients measu red.