Association between a Periconception Healthy Plant-Based Diet and Adverse Pregnancy Outcomes

Area of Science:

• Obstetrics and Gynecology
• Nutritional Science
• Public Health

Background:

• Plant-based diets are gaining popularity for potential cardiometabolic benefits.
• The association between plant-based diets and adverse pregnancy outcomes (APOs) remains unclear.
• Dietary patterns can be influenced by neighborhood food access.

Purpose of the Study:

• To investigate the association between plant-based dietary patterns and APOs.
• To determine if neighborhood food access modifies the relationship between diet and APOs.

Main Methods:

• Secondary analysis of the Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be (nuMoM2b) cohort.
• Diet scores (hPDI, DASH) derived from first-trimester food frequency questionnaires.
• Modified Poisson regression adjusted for demographic and socioeconomic factors.

Main Results:

• Higher Healthy Plant-Based Diet Index (hPDI) scores were associated with lower risks of hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM).
• Higher Dietary Approaches to Stop Hypertension (DASH) scores were associated with lower risks of HDP and GDM.
• No significant associations were found between either diet and preterm birth, small-for-gestational-age, or large-for-gestational-age infants.
• The association between diet and APOs did not vary by neighborhood food access.

Conclusions:

• A healthy plant-based diet in early pregnancy is associated with a reduced risk of HDP and GDM in nulliparous individuals.
• The protective effect of a healthy plant-based diet on HDP and GDM risk is comparable to that of the DASH diet.
• Neighborhood food access did not modify the observed diet-APO associations.