Abstract 4134379: Mediterranean-Style Diet and Adverse Pregnancy Outcomes by Race and Overweight or Obesity Status in the Boston Birth Cohort

Introduction: Mediterranean-style diet (MSD) is associated with a lower risk of cardiovascular and metabolic diseases. However, the association of MSD during pregnancy with adverse pregnancy outcomes (APOs) among different racial and ethnic groups and overweight or obesity (OWO) status remains unclear. Question: We examined if MSD during pregnancy is protective for developing any APO and individual APOs in a large cohort of racially and ethnically diverse, urban, low-income women. Methods: Among 8,511 patients in the Boston Birth Cohort (mean age 28.2±6.5 yrs), 47% were non-Hispanic Blacks and 28% were Hispanics. Among 4,343 (51%) with pre-pregnancy OWO status, 25% Black and 12% Hispanic women developed any APO (Figure 1). Individual Mediterranean-style diet score (MDS) was based on maternal diet intake during pregnancy via food frequency questionnaire interviews at 24-72 hours postpartum. Results: Increase in the MDS by one standard deviation was inversely associated with any APO (aOR, 0.86 [95% CI, 0.82–0.90]), preeclampsia or eclampsia or HELLP (aOR, 0.89 [95% CI, 0.82–0.97]), gestational diabetes (aOR, 0.88 [95% CI, 0.81–0.95]), preterm birth (aOR, 0.90 [95% CI, 0.86–0.95]), and low birth weight (aOR, 0.87 [95% CI, 0.83–0.92]) (Table 1). In the subgroup analysis, higher adherence to MSD was associated with lower odds of developing, preeclampsia or eclampsia or HELLP, low birth weight, and preterm birth in Black women with or without OWO. The benefit of MDS was also observed for gestational diabetes in Hispanic women with OWO (Figure 2). Conclusion: Greater adherence to MSD during pregnancy is associated with a lower risk of composite APOs, with benefits varying across types of APOs, racial/ethnic groups, and OWO status.