(P24-042-23) Association of Dietary Essential Fatty Acid Intakes During Pregnancy and Pregnancy Induced Hypertension in a Cohort of South-Indian Pregnant Women

Objectives: Pregnancy induced hypertension; PIH affect 11% of Indian women and causes adverse maternal & infant outcomes. Low consumption of n-3 fatty acids (particularly docosahexaenoic acid; DHA) is a potential risk factor for PIH, preterm delivery, and low birth weight. We hypothesize that adequate DHA intake may help reduce incidence of PIH. Hence, we aimed to characterize n-3 fatty acid consumption in South Indian pregnant women and relate it with PIH.

Methods: A longitudinal observational cohort of 3297 apparent healthy normotensive pregnant women of reproductive age were recruited in trimester 1 and followed until delivery. Details of socio economic status at baseline; intakes of macro & micronutrients, n3/n6 fatty acids were assessed at each trimester using a 3 month food frequency questionnaire. Anthropometry, blood pressure (BP) monitoring and clinical examination were performed at each antenatal visit. PIH was defined as systolic BP (SBP) >140 mmHg and diastolic BP (DBP) >90 mmHg after 20weeks of gestation according to the World Health Organization.

Results: Of the total participants, 313 (~10.5%) developed PIH at mid-pregnancy. Of these 157(5.2%) mildly and 131(4.2%) were moderately hypertensive while 25(0.8%) were preeclamptic. At trimester 1, median intakes of linoleic acid, alpha linolenic acid, DHA, eicosapentaenoic acid; EPA and docosapentaenoic acid; DPA were not statistically different among PIH vs normotensive women (13.4 vs 13.2; 0.49 vs 0.50; 0.009 vs 0.010; 0.002 vs 0.002; 0.001 vs 0.001 g/d, respectively). Intakes of DHA, EPA and DPA in trimester 2 were significantly lower in PIH women vs normotensive. The significant association of DHA with PIH continued even after adjusting for covariates. Multivariate logistic regression analysis in trimesters 2 & 3 showed an odds of 1.44 (95% CI: 1.02-2.05, p=0.046 and 1.69 (95% CI: 1.16-2.46, p=0.023, respectively) for women in the first tertile as compared to the women in highest tertile of DHA (adjusted for maternal age, weight, height, education, parity, energy intake).

Conclusions: The study participants had low consumption of n-3 fatty acid. Low intake of DHA in trimester 2 & 3 of pregnancy was associated with PIH. The findings need to be interpreted with caution since there are many confounding factors in relation to PIH.

Funding Sources: Department of Biotechnology, Government of India