Sleep Quality, Dietary Pattern, and Physical Activity As Modifiable Factors Associated with Preeclampsia: A Comparative Cross-sectional Study From A Tertiary Care Center in North India

Abstract Background: The objective was to evaluate the role of lifestyle factors (diet, sleep quality, and physical activity) among preeclamptic (PE) and normotensive pregnant women. Methods: This cross-sectional analytical study included 95 cases of PE and 95 normotensive controls between 32 to 37 weeks of gestation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Pregnancy Physical Activity Questionnaire was used to assess physical activity. Dietary factors were evaluated using a validated Food Frequency Questionnaire. A P value of less than 0.05 was considered statistically significant. Results: The maternal age ranged from 19 to 38 years and was higher in cases than in controls ( P = 0.021). The mean PSQI score in cases (5.52 ± 1.52) was significantly higher than in controls (3.67 ± 1.28) ( P < 0.001). Cases had significantly higher sedentary activity and lower moderate-intensity activity ( P < 0.001). Preeclamptic women consumed fewer dairy products ( P < 0.001), green leafy vegetables ( P = 0.002), fruits ( P = 0.042), and nuts ( P = 0.0002) but consumed more animal meat ( P < 0.001, OR: 1.472) and additional salt ( P = 0.003, OR: 3.617). The Spearman’s correlation coefficient between mean arterial pressure and different lifestyle factors was in a statistically significant range ( P < 0.001). Significant correlation was also observed between different lifestyle factors ( P < 0.001). The highest AUROC was for PSQI scores (0.830), followed by consumption of chicken or meat (0.720) and sedentary activity (0.699). Conclusion: Seep, diet, and physical activity were significantly different between PE and normotensives and were significantly elevated in cases, suggesting the influence of lifestyle on preeclampsia.