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Assessing the Role of Dietary Acid Load in the Development of Hypertensive Disorders During Pregnancy: Uncovering the Association Through Prospective Cohort Analysis Publisher Pubmed



Safarpour F1 ; Shafaatdoost M2 ; Naeimi R1 ; Moini A3, 4 ; Pirjani R3 ; Basirat Z5 ; Mardimamaghani A6 ; Esmaeili M7 ; Rezaeinejad M8 ; Sepidarkish M9, 10
Authors
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Authors Affiliations
  1. 1. Student research committee, Babol University of Medical Sciences, Babol, Iran
  2. 2. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Breast Disease Research Center (BDRC), Tehran University of Medical Science, Tehran, Iran
  5. 5. Department of Obstetrics and Gynecology, Babol University of Medical Sciences, Babol, Iran
  6. 6. Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  7. 7. Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  8. 8. Department of Obstetrics and Gynaecology, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran
  9. 9. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
  10. 10. Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran

Source: Nutrition Journal Published:2024


Abstract

Background: Hypertensive disorders of pregnancy (HDPs) are common complications encountered in pregnancy that affect between 5% and 15% of pregnancies worldwide. Some studies have associated adherence to a diet with a high acid load with an increased risk of HDPs. This study investigates the association between Dietary Acid Load (DAL) and the incidence of preeclampsia, chronic hypertension (HTN), and gestational hypertension (GHTN). Methods: Pregnant women aged 18 to 45 in the first trimester of pregnancy were selected and followed up until delivery. Diet was evaluated using a 168-question semi-quantitative food frequency questionnaire (FFQ). After calculating the DAL score, the inverse probability weight of the propensity scores, estimated from augmented generalized models, was used to obtain a causal risk ratio (RR) adjusted for potential confounders. Results: Out of 1,856 women, 92 (4.95%) developed preeclampsia. The potential renal acid load (PRAL) score ranged from − 16.14 to 0.58, while the net endogenous acid production (NEAP) score ranged from 34.61 to 50.15. Multivariable analysis revealed a significant association between PRAL and preeclampsia in the first (aRR: 1.87, 95% CI: 1.01, 3.49, p = 0.048) and third (aRR: 2.01, 95% CI: 1.07, 3.81, p = 0.030) quartiles compared to the reference group (Q2). No significant linear association was found in continuous analyses. For chronic HTN, significant associations were observed in the first (aRR: 2.56, 95% CI: 1.21, 5.42, p = 0.014) and fourth (aRR: 4.79, 95% CI: 2.37, 9.71, p < 0.001) PRAL quartiles, with similar findings for NEAP. Continuous analysis showed a significant linear association between both PRAL and NEAP scores and chronic HTN. Regarding GHTN, significant associations were found in the first (aRR: 1.48, 95% CI: 1.02, 2.16, p = 0.041) and fourth (aRR: 1.88, 95% CI: 1.31, 2.70, p = 0.001) PRAL quartiles, and in Q4 for NEAP (aRR: 1.56, 95% CI: 1.10, 2.21, p = 0.012), with no significant linear association in continuous analysis. Conclusion: Extremes in DAL, as indicated by PRAL and NEAP, are associated with an increased risk of preeclampsia, chronic HTN, and GHTN, particularly in the highest and lowest quartiles. These findings highlight the potential impact of DAL on HDPs. © The Author(s) 2024.
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