(1225) Ultra-processed food consumption is associated with higher risk of adverse pregnancy outcomes

To examine the association between ultra-processed food (UPF) consumption and the occurrence of adverse pregnancy outcomes (APOs).


Study Design:

This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be. Patients were excluded if they experienced pregnancy loss < 20 weeks or had missing data from the Food Frequency Questionnaire (FFQ). Foods from the FFQ were classified using the NOVA scale, which groups items by processing level: category 1 foods are unprocessed/minimally processed, category 2 contains processed culinary ingredients (e.g. oils, butter, sugar), category 3 contains processed foods (e.g. canned vegetables, cheeses, bread) and category 4 comprised of ultra-processed foods (industrial ready-to-eat items with additives). The daily percentage of UPF intake was calculated by dividing kilocalories of category 4 foods by total daily energy intake. Univariate and multivariable analyses explored the relationship between increasing UPF intake and APOs, including preterm birth, preeclampsia, gestational diabetes (GDM), and small for gestational age (SGA).


Results:

A total of 6,041 participants were included in the analysis. The sample was predominantly White (75.5%) and not Hispanic (83.1%), and a majority had commercial insurance (71.8%). UPF comprised an average of 54% (±14%) of the daily total intake among participants (Table 1). Increasing total UPF intake was significantly associated with preterm birth, SGA, and preeclampsia (Table 2). While UPF intake was not significantly associated with overall GDM incidence, it was significantly associated with a higher risk of GDMA2 among all patients with GDM. After adjusting for education level and chronic hypertension, every 10% increase in daily UPF intake was significantly associated with preeclampsia (aOR 1.08, 95% CI 1.02-1.14) and GDMA2 (aOR 1.25, 95% CI 1.02-1.52).


Conclusion:

On average, more than half of participants’ daily diet was composed of UPF. Increasing UPF intake was associated with higher rates of preeclampsia and GDMA2.