Effects of the Dietary Approaches to Stop Hypertension (DASH) on Pregnancy/Neonatal Outcomes and Maternal Glycemic Control: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Suhua Li; Yanqiong Gan; Min Chen; Min Wang; Xiaojuan Wang; Heitor O Santos; Kehinde Okunade; Vaani Kathirgamathamby

doi:10.1016/j.ctim.2020.102551

Effects of the Dietary Approaches to Stop Hypertension (DASH) on Pregnancy/Neonatal Outcomes and Maternal Glycemic Control: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Complement Ther Med. 2020 Nov:54:102551. doi: 10.1016/j.ctim.2020.102551. Epub 2020 Sep 2.

Authors

Suhua Li¹, Yanqiong Gan², Min Chen², Min Wang², Xiaojuan Wang², Heitor O Santos³, Kehinde Okunade⁴, Vaani Kathirgamathamby⁵

Affiliations

¹ Obstetrics Department, Affiliated Hospital of North Sichuan Medical College, No.18 Jinhua Street, Shunqing District, Nanchong, Sichuan Province, 637000, China. Electronic address: suhuali0@163.com.
² Obstetrics Department, Affiliated Hospital of North Sichuan Medical College, No.18 Jinhua Street, Shunqing District, Nanchong, Sichuan Province, 637000, China.
³ School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
⁴ Oncology and Pathological Studies (OPS) Unit, Department of Obstetrics & Gynaecology, College of Medicine, University of Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
⁵ Department of Medicine and Life Sciences, Kings College London, University of London, Strand, London, WC2R 2LS, United Kingdom.

PMID: 33183669
DOI: 10.1016/j.ctim.2020.102551

Abstract

Background & objective: No systematic review to date has appraised the impact of the Dietary Approaches to Stop Hypertension (DASH) eating plan on maternal glycemic control and pregnancy outcomes. Thus, we conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to ascertain whether the DASH diet in pregnant women ameliorates their glycemic control and neonatal outcomes when compared to standard diets.

Methods: We performed a comprehensive systematic review and meta-analysis of RCTs on PubMed/MEDLINE, Web of Science, SCOPUS, and Embase from the inception until October 2019.

Results: Six studies met the eligibility criteria and were included in the quantitative meta-analysis. The pregnant women had cardiometabolic disorders such as gestational diabetes, obesity, and hypertension. The meta-analysis suggested a significant effect of DASH diet on fasting plasma levels of glucose (WMD = -6.239 mg/dl; 95% CI: -11.915, -0.563, p = 0.031), but not for the homeostasis model assessment of insulin resistance (WMD = -1.038; 95% CI: -2.704, 0.627, p = 0.22). Following the DASH diet during pregnancy decreased the risk of gestational preeclampsia (RR = 0.667; 95% CI: 0.451, 0.987, p = 0.043), macrosomia (birth weight >4000 g) (RR = 0.294; 95% CI: 0.120, 0.721, p = 0.043), and large for gestational age (RR = 0.452; 95% CI: 0.211, 0.969, p = 0.041). Consuming DASH diet during pregnancy neither increased nor decreased the risk of cesarean section, polyhydramnios, preterm birth (<37 weeks), and small for gestational age. The mean newborn head circumference (cm) (WMD = -0.807; 95% CI: -1.283, -0.331, p = 0.001) and ponderal index (kg/m³) (RR = -0.396; 95% CI: -0.441, -0.350, p = 0.000) in the group receiving the DASH diet were lower than in the control group.

Conclusion: The adherence of pregnant women with cardiometabolic disorders to DASH eating pattern has a significant effect on decreasing fasting plasma glucose levels, ponderal index, incidence of preeclampsia, fetal macrosomia, large for gestational age, and newborn head circumference.

Keywords: DASH; glycemic control; meta-analysis; pregnancy.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Blood Glucose / metabolism
Dietary Approaches To Stop Hypertension / methods*
Female
Humans
Pregnancy
Pregnancy Complications / prevention & control*
Pregnancy Outcome*
Randomized Controlled Trials as Topic

Substances

Blood Glucose