American Heart Association diet prior to conception linked to lower risk of pregnancy loss

Key takeaways:

• Among women treated for infertility, probability of pregnancy loss was lowest with greatest adherence to the AHA dietary pattern.
• No dietary pattern was associated with probability of conception or live birth.

Adherence to the American Heart Association dietary pattern prior to conception may be associated with a lower likelihood of pregnancy loss during infertility treatment, according to a cohort study published in JAMA Network Open.

“The present study aimed to investigate whether women’s adherence to eight commonly used, a priori-defined dietary patterns originally designed to assess the role of diet on cardiovascular disease and other chronic conditions are associated with outcomes of infertility treatment,” Albert Salas-Huetos, MSc, PhD, department of nutrition at the Harvard T. H. Chan School of Public Health and the Unit of Preventive Medicine and Public Health, faculty of medicine in the department of food, nutrition, development and mental health at the Pere Health Research institute at Rovira I Virgili University and the department of pathophysiology, obesity and nutrition at the Network Biomedical Research Center Consortium at the Carlos III Health Institute in Madrid, Spain, and colleagues wrote.

Salas-Huetos and colleagues enrolled 612 women (median age, 35 years; 82.8% white) into a prospective cohort study conducted at a fertility center at an academic medical center in Boston. All women were undergoing infertility treatment cycles including intrauterine insemination cycles and in vitro fertilization with or without intracytoplasmic sperm injection.

Researchers assessed each participant’s pretreatment diet with a validated food frequency questionnaire, in which eight a priori-defined scores were calculated with higher scores representing greater adherence. The eight scores were the Trichopoulou Mediterranean diet, alternate Mediterranean diet, Panagiotakos Mediterranean diet, Healthy Eating Index, Alternate Healthy Eating Index, American Heart Association (AHA) index, Dietary Approaches to Stop Hypertension index and plant-based diets.

Overall, 450 participants underwent in vitro fertilization and 302 participants underwent intrauterine insemination. Researchers observed no association between a participant’s adherence to the eight a priori dietary patterns and probability of clinical pregnancy or live birth after receiving either infertility treatment. In addition, researchers noted an inverse association between adherence to the AHA dietary pattern and risks of total and clinical pregnancy loss.

Of pregnancies conceived during infertility treatment, the adjusted probability of total pregnancy loss in the lowest quartile of the AHA dietary pattern was 0.41 compared with 0.28 in the highest quartile (P = .02). The adjusted probability of clinical pregnancy loss in the lowest quartile of the AHA dietary pattern was 0.30 compared with 0.15 in the highest quartile (P = .007).

Researchers also observed a similar pattern for all other dietary patterns studied except the plant-based diet pattern.

“The literature on the association between nutrition and infertility treatment outcomes remains sparse, and it is therefore important that this association is evaluated in additional studies,” the researchers wrote. “Nevertheless, our findings provide useful information that can be used in the design of future studies aimed at testing the effects of nutritional interventions on human fertility.”