The proposed research is designed to assess the impact of dietary behaviors and activity-related variables on the risk of pregnancy-induced hypertension in a cohort of pregnant women. Only a handful of studies to date have evaluated such associations. Identification of risk factors for pregnancy-induced hypertension (PIH) has assumed even greater importance in the 1990s in light of recent evidence that calcium supplementation and aspirin use during pregnancy may reduce the risk of these conditions. In regard to the outcomes of preeclampsia and gestational hypertension, this research will examine the following: 1) whether caffeine intake is a positive risk factor; 2) whether alcoholic beverage consumption during pregnancy influences risk; 3) whether employment status and occupational factors such as organic solvent exposure increase risk; and 4) whether leisure time physical activity during pregnancy confers protection. Dose-response relationships and risks associated with early and late pregnancy exposures will also be examined. Data for this research come form the Yale Health in Pregnancy Study (1988-1992), a longitudinal epidemiological study of pregnancy outcomes among 2967 pregnant women who received private prenatal care from one of 13 practices in the New Haven area. All women were personally interviewed before 16 weeks gestation, on one to three other occasions during pregnancy, and within days of delivery regarding the factors targeted for analysis. The cohort to be analyzed for the proposed research will be restricted to women who had a live or still- birth after 20 weeks gestation (n=2657). Because the original study was not designed to evaluate PIH as a primary outcome of interest, the principal investigator will review the prenatal and delivery charts of all women who had any mention of hypertension on their charts (N=382) in order to diagnose preeclampsia and gestational hypertension using standardized case definitions. Preeclampsia is defined as hypertension in pregnancy diagnosed after 20 weeks gestation in the presence of proteinuria, and/or edema, and/or a five pound weight gain in one week. Gestational hypertension is hypertension in pregnancy diagnosed after 20 weeks gestation in the absence of proteinuria, edema, and a five pound weight gain in one week. This research will employ standard epidemiologic analytic techniques, including logistic regression analysis, to evaluate exposure/disease associations while controlling simultaneously for the potential effects of interaction and confounding.
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|Saftlas, Audrey F; Triche, Elizabeth W; Beydoun, Hind et al. (2010) Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension? Ann Epidemiol 20:584-91|
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