Ultraprocessed foods consumption and risk of preeclampsia: a secondary analysis of the improving mothers for a better prenatal care trial Barcelona (IMPACT BCN) randomized clinical trial.

BACKGROUND

Preeclampsia is a pregnancy-specific condition affecting 2%-8% of pregnant females and a leading cause of maternal and perinatal morbimortality. High ultraprocessed food (UPF) consumption has been associated with the development of noncommunicable chronic diseases, but evidence on pregnancy outcomes is scarce.

OBJECTIVES

To study the association of maternal UPF consumption and the risk of preeclampsia.

METHODS

This study is a secondary analysis of the IMPACT BCN, a randomized clinical trial including 1221 pregnant females at high risk for small for gestational age newborns, conducted in Barcelona, Spain. Among these, 812 participants with complete dietary data at 2 timepoints during pregnancy (between weeks 19-23 of gestation and weeks 34-36 of gestation) were included in this analysis and classified into tertiles of change in UPF consumption during pregnancy. Dietary UPF consumption was assessed using NOVA classification with a validated 151-item food frequency questionnaire. Preeclampsia was defined as high blood pressure plus targeted organ involvement. Analyses were performed using logistic regression models adjusted for potential confounding factors.

RESULTS

Associations between change of UFP consumption during pregnancy and overall preeclampsia were observed across tertiles [odds ratio (OR)T3 compared with T1: 2.29; 95% confidence interval (CI): 1.06, 4.97, P-trend 0.026], but not when UPF change was modeled as a continuous variable [OR: 1.04; 95% CI: 0.95, 1.14]. Among UPF subclasses, pre-prepared dishes were significantly associated with preeclampsia risk [ORT3 compared with T1: 2.36; 95% CI: 1.09, 5.12].

CONCLUSIONS

In a high-risk population, a higher change in dietary intake of UPF consumption from the second to third trimester of pregnancy was associated with a higher risk of preeclampsia. This trial was registered at clinicaltrials.gov as NCT03166332.