Maternal macro- and micronutrient intake six months after hypertensive versus normotensive pregnancy: is poor diet quality contributing to future cardiometabolic disease risk?

S S Siritharan; A Henry; M L Gow; L M Roberts; A Yao; M Ojurovic; A J O'Sullivan

doi:10.1016/j.preghy.2020.11.002

Maternal macro- and micronutrient intake six months after hypertensive versus normotensive pregnancy: is poor diet quality contributing to future cardiometabolic disease risk?

Pregnancy Hypertens. 2021 Mar:23:196-204. doi: 10.1016/j.preghy.2020.11.002. Epub 2020 Nov 13.

Authors

S S Siritharan¹, A Henry², M L Gow³, L M Roberts⁴, A Yao⁵, M Ojurovic⁶, A J O'Sullivan⁷

Affiliations

¹ School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia. Electronic address: saisankare.siritharan@health.nsw.gov.au.
² School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia; Department of Women's and Children's Health, St George Hospital - Prichard Wing Level 1, Gray Street, Kogarah, NSW 2217, Australia; Global Women's Health Program, The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW 2042, Australia.
³ The University of Sydney Children's Hospital Westmead Clinical School, Corner Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia.
⁴ Department of Women's and Children's Health, St George Hospital - Prichard Wing Level 1, Gray Street, Kogarah, NSW 2217, Australia; St George and Sutherland Clinical School, Short Street, St George Hospital, Kogarah, NSW 2217, Australia; Faculty of Health - University of Technology Sydney, 235 Jones Street, Ultimo, NSW 2007, Australia.
⁵ School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia; Department of Endocrinology, St George Hospital, Kogarah, NSW 2217, Australia.
⁶ School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia.
⁷ St George and Sutherland Clinical School, Short Street, St George Hospital, Kogarah, NSW 2217, Australia; Department of Endocrinology, St George Hospital, Kogarah, NSW 2217, Australia.

PMID: 33515976
DOI: 10.1016/j.preghy.2020.11.002

Abstract

Background: Hypertensive pregnancy is associated with increased long-term cardiometabolic disease risk. Assessing dietary intake patterns after hypertensive (HP) versus normotensive pregnancy (NP) may provide insights into the mechanism of this risk.

Methods: This study was a prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatrics) cohort. Women were studied six months after NP versus HP (preeclampsia or gestational hypertension). Dietary energy, macronutrient and micronutrient intake were measured using a three-day food diary (FoodWorks™) and assessed against Australian and New Zealand Nutrient Reference Values to determine nutritional adequacy. Comparisons between breastfeeding and non-breastfeeding women were assessed, and linear regression modelling (using hypertensive status, breastfeeding status, and demographic/pregnancy variables) performed to assess predictors of energy intake.

Results: Seventy-four women (60 NP, 14 HP) were included. HP women had higher mean body mass index (p = 0.02) and lower breastfeeding rates (29% HP versus 83% NP, p < 0.001) compared to NP women. Twenty-four-hour energy intake and total fat intake were 17% and 20% lower after HP respectively. Nutrient deficiencies were prevalent across all participants, however more HP women had inadequate magnesium, calcium and phosphorus intake. Breastfeeding women had significantly increased energy (17%), carbohydrate (15%) and total fat intake (21%), and increased vitamin A, vitamin E, riboflavin, magnesium and iron intake compared to non-breastfeeding women. HP and breastfeeding status were independent predictors of energy intake.

Conclusions: HP women had lower micronutrient intake and greater prevalence of nutritional inadequacy compared to NP women, reflecting poorer diet quality and potentially contributing to future increased cardiometabolic disease risk.

Keywords: Breastfeeding; Energy intake; Hypertensive pregnancy; Macronutrient; Micronutrient; Postpartum.

MeSH terms

Adult
Case-Control Studies
Diet Records
Eating*
Energy Intake*
Female
Heart Disease Risk Factors
Humans
Nutritional Status*
Postpartum Period
Pre-Eclampsia
Pregnancy
Prospective Studies
Recommended Dietary Allowances