Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension?

Department of Epidemiology, University of Iowa College of Public Health, Iowa City, USA.
Annals of epidemiology (Impact Factor: 2.95). 08/2010; 20(8):584-91. DOI: 10.1016/j.annepidem.2010.05.010
Source: PubMed

ABSTRACT Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine whether regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH).
Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at <16 weeks' gestation to ascertain risk factors for adverse pregnancy outcomes. Hospital delivery and prenatal records were abstracted to classify preeclampsia (n = 58), GH (n = 158), and normotensive pregnancies (n = 2351). Chocolate consumption (servings/week) during the first and third trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of less than 1 serving/week comprised the referent group. Adjusted odds ratios (aORs) were estimated by the use of logistic regression.
Chocolate intake was more frequent among normotensive (80.7%) than preeclamptic (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (first trimester: aOR, 0.55; 95% confidence interval [95% CI], 0.32-0.95; third trimester: aOR, 0.56; 95% CI, 0.32-0.97). Only first trimester intake was associated with reduced odds of GH (aOR,0.65; 95% CI, 0.45-0.87).
These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The most common method of antepartum fetal surveillance is the nonstress test (NST). Although it has satisfactory false-negative rates, dubious nonreactive results may challenge the physician. Any method or factor increasing the reactive NST results or shortening the time to attain a reactive test may be considerably useful. Most of the studies have found no effect of maternal glucose administration on fetal heart rate and fetal activity, specificity of NST, time to reactivity and percentage of reactive NST results when compared with the control group. Maternal intake of 70% cocoa or caffeine had stimulating action on the fetal reactivity, and this effect on the fetal heart rate was more marked with high concentrations of cocoa (80%). Studies on maternal positioning during NST had equivocal results. Fetal manipulation has no impact on the NST reactivity. Vibroacoustic and halogen light stimulation may be associated with a reduction in time to reactivity. These methods may increase the reactivity during a NST and may facilitate the antenatal fetal surveillance.
    Current opinion in obstetrics & gynecology 04/2014; 26(2):61-6. · 2.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Pre-eclampsia (PE) is one of the most common pregnancy complication characterized by placental and maternal vascular dysfunction. It affects about 3 - 8% of women during the second half of pregnancy and represents one of the major causes of neonatal morbidity and mortality. The etiology of PE largely remains unknown. Areas covered: PE is considered a syndrome with multisystem involvement, so the ideal predictive test for it should utilize a combination of many predictors. Measurement in early pregnancy of a variety of biophysical and biochemical markers implicated in the pathophysiology of PE associated with clinical risk factors has been proposed to predict the development of the syndrome, thereby mitigating an adverse outcome. Expert opinion: The identification of reliable indicators is a clinically relevant issue that could result in early therapeutic intervention and leading to the prevention of maternal and fetal injuries before the manifestation of clinical signs. Many factors complicate the prevention of PE cases. Most are attributed to unknown etiology, the low predictive value of current screening tests and the several presentations of the disease. Although preventative treatments have been studied extensively, an effective intervention to avoid the development of PE has not yet been discovered.
    Expert opinion on biological therapy 04/2014; · 3.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Dietary factors have been suggested to play a role in the prevention of hypertensive disorders of pregnancy (HDP), including gestational hypertension and pre-eclampsia, but inconsistent findings have been reported. A systematic review and meta-analyses were performed to synthesize evidence from observational studies of reproductive-aged women on the association between dietary factors and HDP.MethodsMEDLINE and EMBASE were searched to identify studies published until the end of May 2014. Studies were included if they were observational studies of reproductive-age women and reported results on dietary factors (energy, nutrients, foods or overall dietary patterns, alone or in combination with dietary supplements) and gestational hypertension and/or pre-eclampsia. Studies were excluded if they reported on supplements not in combination with dietary intake, or examined a biomarker of dietary intake. Random effects meta-analyses were performed on calculated weighted mean differences (WMD) of dietary intake between cases and non-cases, and effect estimates were pooled.ResultsIn total, 23 cohort and 15 case¿control studies were identified for systematic review, of which 16 could be included in the meta-analyses. Based on meta-analyses of cohort studies, unadjusted energy intake was higher for pre-eclampsia cases (WMD 46 kcal/day, 95% confidence interval (CI) ¿13.80 to 106.23; I 2¿=¿23.9%, P¿=¿0.26), although this was not statistically significant. Unadjusted intakes of magnesium (WMD 8 mg/day, 95% CI ¿13.99 to ¿1.38; I 2¿=¿0.0%, P¿=¿0.41) and calcium (WMD 44 mg/day, 95% CI ¿84.31 to ¿3.62, I 2¿=¿51.1%, P¿=¿0.03) were lower for the HDP cases, compared with pregnant women without HDP. Higher calcium intake consistently showed lower odds for HDP after adjustment for confounding factors (OR¿=¿0.76, 95% CI 0.57 to 1.01, I 2¿=¿0.0%, P¿=¿0.79). A few studies examining foods and dietary patterns suggested a beneficial effect of a diet rich in fruit and vegetables on pre-eclampsia, although not all the results were statistically significant.Conclusions Based on a limited number of studies, higher total energy and lower magnesium and calcium intake measured during pregnancy were identified as related to HDP. Further prospective studies are required to provide an evidence base for development of preventive health strategies, particularly focusing on dietary factors during pre-pregnancy and early pregnancy.
    BMC Medicine 09/2014; 12(1):157. · 7.28 Impact Factor

Full-text (2 Sources)

Available from
May 31, 2014