Fish consumption and cod liver oil intake withthe risk of hypertensive disorders in pregnancy

Thinh Tran Xuan1, Bryndis E. Birgisdottir1, Thorhallur I. Halldorsson1

Inga Thorsdottir1, Reynir T. Geirsson2

1Unit for Nutrition Research, Landspitali National University Hospital & Faculty of Human Nutrition, University of Iceland, 101 Reykjavik, Iceland.

2Department of Obsterics and Gynecology, Landspitali National University Hospital & Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland

ABSTRACT

Gestational hypertension and preeclampsia are common hypertensive disorders in pregnancy, associated with substantial morbidity and mortality for both mother and infants. A number of dietary factors have been related to hypertensive disorders in pregnancy. Fish consumption, fish liver oil supplements during pregnancy might be associated with gestational hypertension or preeclampsia.

Objectives

To examine the association between fish consumption and intake of cod liver oil with hypertensive disorders in pregnancy.

Methods

This retrospective cohort study was conducted at Landspitali National University Hospital, Reykjavik, Iceland in 1998. A total of 491 pregnant Icelandic women who gave birth at Landspitali National University Hospital in Reykjavik, aged 20-40, of normal weight before pregnancy were randomly selected from maternal records. Information on frequency of fish and cod liver oil consumption during pregnancy was collected from maternal records. We used gestational hypertension is defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or a diastolic blood pressure (DBP) ≥ 90 mmHg as a primary outcome measure. Systolic and diastolic, isolated systolic, and isolated diastolic hypertension were used as secondary outcome measures.

Results

The prevalence of gestational hypertension and preeclampsia was 21% and 3%, respectively. Fish consumption was not associated with hypertensive disorders in pregnancy. Intake of fish liver oil was, however, positively associated with combined gestational hypertension (SBP) ≥ 140 and (DBP) ≥ 90. Using this definition women consuming one table spoon (≈ 9g) a day or more had an adjusted odds ratio of 6.3 (95% confidence interval: 2.2, 17.9) of having pregnancy hypertension compared to those with no intake. This association appeared to be driven by a relative shift from isolated diastolic hypertension to combined systolic and diastolic hypertension as overall fish liver oil was not associated with hypertension defined as (SBP) ≥ 140 and/or (DBP) ≥ 90.

Conclusions

No association was found between fish consumption and hypertensive disorders in pregnancy. Our results suggest that high (≈ 9 g/day) intake of fish liver oil may affect the severity of gestational hypertension. These findings are in line with previous reports from Iceland were high consumption of fish liver oil has been associated with hypertensive disorders in pregnancy.

Keywords

Fish, fish liver oil, n-3 PUFA, gestational hypertension, preeclampsia and hypertensive disorders in pregnancy.

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