Abstract 051: Pre-pregnancy Cardiometabolic Risk Factors, Mediterranean Style Diet, And Risk Of Preeclampsia In The Boston Birth Cohort

Background: Preeclampsia carries high acute and chronic maternal and fetal morbidity and mortality. It is still unclear how pre-pregnancy conditions affect preeclampsia risk, and whether diet reduces risk. We examined associations of pre-pregnancy hypertension, obesity, and diabetes with preeclampsia, and investigated if a Mediterranean-style diet associates with lower risk. Methods: We used data from the Boston Birth Cohort, which comprises racially/ethnically diverse, urban, low-income mothers. We obtained maternal demographic and dietary intake frequencies via interviewer-administered questionnaires within 24-72 hours after birth. We extracted additional pregnancy-related clinical information, including physician diagnosis of preexisting conditions and preeclampsia from medical records. We created tertiles of a Mediterranean-style diet score previously created by our group. We performed logistic regression to assess associations of pre-pregnancy conditions and Mediterranean style diet with odds of preeclampsia. Results: Of 8,507 women in the sample, 849 developed preeclampsia. 47% were black, 28% were Hispanic, and the remaining were white/other. After multivariable adjustment (see table), pre-pregnancy hypertension had the strongest association with preeclampsia (OR 7.81; 95% CI 6.25-9.76), followed by obesity (OR 1.67; 95% CI: 1.41-1.99). Pre-pregnancy diabetes was not associated with preeclampsia after adjustment for obesity and hypertension (table). A higher Mediterranean-style diet score associated with lower preeclampsia odds, but it did not attenuate associations of hypertension or obesity with preeclampsia (table). Conclusions: Pre-pregnancy hypertension and obesity are independently associated with higher preeclampsia odds. Self-report of adherence to Mediterranean-style diet was also associated with lower preeclampsia odds, but this did not mediate risk among obese and hypertensive women. Strategies to prevent preeclampsia among high-risk women are needed.