Dietary carotenoid intake and risk of developing preeclampsia: a hospital-based case-control study

Abstract

Background: The effect of carotenoids on the risk of preeclampsia (PE) is uncertain. We aimed to examine the associations between the intake of dietary carotenoids and related compounds by pregnant women in China, and the risk of their developing PE.

Methods: Four hundred and forty PE cases and 440 age- (± 3 years), gestational age- (± 1 weeks) and gestational diabetes mellitus status- (yes/no) matched healthy controls were recruited from March 2016 to June 2019. Dietary intake of carotenoids was assessed using a 79-item validated food-frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.

Results: After adjusting for potential confounders, we found that the intake of total carotenoids, β-carotene, β-cryptoxanthin, lycopene, and lutein and zeaxanthin (lut-zea) were negatively associated with the odds of developing PE. Compared with the lowest quartile intake, the multivariate-adjusted OR (95% CI) of the highest quartile intake was 0.29 (0.16-0.54, P_trend < 0.001) for total carotenoids, 0.31 (0.16-0.58, P_trend < 0.001) for β-carotene, 0.50 (0.27-0.90, P_trend = 0.007) for β-cryptoxanthin, 0.55 (0.30-0.99, P_trend = 0.04) for lycopene and 0.32 (0.17-0.61, P_trend = 0.001) for lut-zea. However, no significant associations were observed between the risk of developing PE and α-carotene intake (OR = 0.75, 95% CI: 0.41-1.36, P_trend = 0.28). Moreover, similar negative associations were found for every one-standard-deviation increase in the intake of total carotenoids, β-carotene, β-cryptoxanthin, lycopene and lut-zea.

Conclusion: These results indicate that a high intake of total carotenoids, β-carotene, β-cryptoxanthin, lycopene and lut-zea may be associated with a low risk of developing PE.

Keywords: Carotenoids; Case–control study; Chinese; Preeclampsia; Pregnant women.

Fig. 1

Multivariable-adjusted spline curve of association between energy-adjusted dietary carotenoid intake and the risk of developing PE. Multivariable-adjusted odds ratios (ORs) (solid lines) and 95% confidence intervals (CIs) (dashed lines) for risk of developing PE based on the dietary intake of total carotenoids (a), α-carotene (b), β-carotene (c), β-cryptoxanthin (d), lycopene (e) and lutein-zeaxanthin (lut-zea) (f). The horizontal dashed line represents an OR of 1. The ORs were adjusted for age (years), gestational age (weeks), pre-pregnancy BMI (kg/m²), total energy intake (kcal/d), gravidity, parity, gestational diabetes mellitus (GDM) status (yes/no), family hypertension history (yes/no), physical activity (MET [h/d]) and education and income level