Association of the maternal fish and PUFA intake with the risk of hypertensive disorders of pregnancy: a nationwide birth cohort—The Japan Environment and Children’s Study (JECS)
Nationwide cohort study reveals reduced hypertensive disorders of pregnancy risk in pregnant women with higher fish intake, indicating benefits of sustained preconception consumption.
Key Points
To examine associations between maternal fish and polyunsaturated fatty acid intake both before and during pregnancy and the risk of hypertensive disorders of pregnancy.
Analyzed data from N=86,009 women enrolled in the nationwide Japan Environment and Children's Study.
Assessed dietary fish and n-3/n-6 PUFA intake via validated food-frequency questionnaires administered in early pregnancy (median 15.0 weeks) to capture preconception diet, and in mid-to-late pregnancy (median 27.0 weeks).
Calculated adjusted odds ratios across intake quintiles for overall, early-onset (<32 weeks), and late-onset (≥32 weeks) hypertensive disorders of pregnancy using logistic regression and multiple imputation.
In the overall cohort, pre-pregnancy fish intake in the highest quintile was associated with reduced early-onset HDP risk, while mid-to-late pregnancy intake in quintile 4 was linked to lower overall HDP risk.
Among nulliparous women, higher pre-pregnancy fish intake significantly lowered the risk of early-onset HDP (Q4: aOR 0.57; 95% CI 0.34–0.97; p for trend = 0.02).
Among nulliparous women, higher fish consumption during pregnancy decreased the risk of late-onset HDP (Q4: aOR 0.79; 95% CI 0.64–0.96), whereas total n-3 PUFA intake showed limited and less consistent associations.