Association between pre-pregnancy food group intakes and hyperemesis gravidarum: a case-control study

Abstract

Introduction: Some of the etiological factors of hyperemesis gravidarum are increased fatty acid peroxidation and deficiency of vitamins and antioxidants. This study was performed with aim to determine the relationship between pre-pregnancy food group intakes and severe hyperemesis gravidarum.Methods: This case-control study was performed in 2020-2021 on 171 pregnant women aged 18-35 years referred to the hospitals of Tehran. Hyperemesis gravidarum was diagnosed using the American College of Obstetrics and Gynecology criteria, and participants were divided into the case and control groups. A semi-quantitative valid and reliable food frequency questionnaire containing 168 food items was used to assess food intake of participants in the past year before pregnancy. Data analysis was performed by SPSS statistical software (version 22), using Chi-square, Mann-Whitney and logistic regression tests. A p-value lower than 0.05 was considered statistically significantResults: The case group had significantly higher total fat and saturated fat intakes compared with controls. Median intakes of vitamin B groups, vitamin A and vitamin C were significantly higher among controls than cases. After adjusting for confounding variables, participants in the upper tertile of intakes of vegetables (OR=0.39, CI: 0.19-0.43) and fruits (OR=0.51, CI: 0.31-0.83) had a lower possibility of hyperemesis gravidarum. However, participants in the upper tertile of intakes of processed meats (OR=3.93, CI: 1.04-6.11) and organ meats (OR=2.39, CI: 1.23-5.03) were significantly more likely to be suffering from hyperemesis gravidarum.Conclusion: There was a significant inverse association between intake of vegetables, fruits, fish and seafood, whole grains, legumes, nuts, olives and olive oil with hyperemesis gravidarum. However, intake of high-fat dairy products, processed meats, organ meats, sweets, solid fats had a significant direct association with hyperemesis gravidarum.

Keywords

• hyperemesis gravidarum
• pregnancy
• food intake analysis
• case-control study