Ultraprocessed foods consumption and risk of preeclampsia: a secondary analysis of the improving mothers for a better prenatal care trial Barcelona (IMPACT BCN) randomized clinical trial

Background Preeclampsia is a pregnancy-specific condition affecting 2-8% of pregnant females and a leading cause of maternal and perinatal morbimortality. High ultra-processed foods (UPF) consumption has been associated with the development of non-communicable chronic diseases, but evidence on pregnancy outcomes is scarce. Objective To study the association of maternal UPF consumption and the risk of preeclampsia. Methods This study is a secondary analysis of the IMPACT BCN, a randomized clinical trial including 1,221 pregnant females at high risk for small for gestational age newborns, conducted in Barcelona, Spain. Among these, 812 participants with complete dietary data at two time points during pregnancy (between weeks 19-23 of gestation and 34-36 weeks of gestation) were included in the present analysis and classified into tertiles of change in UPF consumption during pregnancy. Dietary UPF consumption was assessed using NOVA classification with a validated 151-item food frequency questionnaire (FFQ). Preeclampsia was defined as high blood pressure plus targeted organ involvement. Analyses were performed using logistic regression models adjusted for potential confounding factors. Results Associations between change of UFP consumption during pregnancy and overall preeclampsia were observed across tertiles ( OR T3 compared to T1 : 2.29 [95% CI 1.06, 4.97], p for trend 0.026), but not when UPF change was modeled as a continuous variable ( OR 1.04 [95% CI 0.95, 1.14]. Among UPF subclasses, pre-prepared dishes were significantly associated with preeclampsia risk (OR T3 compared to T1 : 2.36 [95% CI 1.09, 5.12]). Conclusions In a high-risk population, a higher change in dietary intake of UPF consumption from the second to third trimester of pregnancy was associated with a higher risk of preeclampsia. Trial registration ClinicalTrials.gov Identifier: NCT03166332