A Simple data-driven dietary pattern associated with lower risk for adverse pregnancy outcomes

Area of Science:

• Obstetrics and Gynecology
• Nutritional Science
• Epidemiology

Background:

• Periconceptional diet is linked to adverse pregnancy outcomes (APOs).
• Existing dietary recommendations are often complex and regionally specific.
• A simpler dietary index could improve clinical translation and patient adherence.

Purpose of the Study:

• To evaluate if adherence to a simple, data-driven dietary index (DDI) is associated with a reduced risk of APOs.
• To develop a parsimonious dietary index from periconceptional dietary data.

Main Methods:

• Prospective analysis of 7,798 pregnant individuals from the nuMoM2b study.
• Sparse regression modeling to identify key food categories for the DDI.
• Internal validation in nuMoM2b and external validation in the ECHO study (2,240 participants).

Main Results:

• The DDI identified legumes, citrus fruits, dark green vegetables, and whole grains as protective foods.
• High DDI alignment was associated with a 22% relative risk reduction for APOs, including preeclampsia and gestational hypertension.
• External validation in the ECHO study showed a 31% reduction in APOs with high DDI alignment.

Conclusions:

• A simple, data-driven dietary index (DDI) was successfully developed and validated.
• Adherence to the DDI is associated with a significant reduction in the risk of adverse pregnancy outcomes.
• The DDI shows potential for future interventions and broader clinical application in maternal health.