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Volume 6, Issue 3 (2025)
J Clinic Care Skill 2025, 6(3): 113-119 |
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Ethics code: IR.SBMU.NNFTRI.REC.1399.067
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Received: 2025/06/12 | Accepted: 2025/07/19 | Published: 2025/08/15
Received: 2025/06/12 | Accepted: 2025/07/19 | Published: 2025/08/15
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Haghshenosabet F, Eslamian G, Kazemi S, Rashidkhani B. Association Between Ultra-Processed Foods Before Pregnancy and Hyperemesis Gravidarum. J Clinic Care Skill 2025; 6 (3) :113-119
URL: http://jccs.yums.ac.ir/article-1-416-en.html
URL: http://jccs.yums.ac.ir/article-1-416-en.html
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1- “Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology” and “National Nutrition and Food Technology Research Institute”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- “Department of Obstetrics and Gynecology, Faculty of Medicine” and “Preventative Gynecology Research Center”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- “Department of Community Nutrition, Faculty of Nutrition and Food Technology” and “National Nutrition and Food Technology Research Institute”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- “Department of Obstetrics and Gynecology, Faculty of Medicine” and “Preventative Gynecology Research Center”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- “Department of Community Nutrition, Faculty of Nutrition and Food Technology” and “National Nutrition and Food Technology Research Institute”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract (653 Views)
Aims: Hyperemesis gravidarum is a multifactorial pregnancy disorder characterized by severe nausea and vomiting, often necessitating hospitalization. While its etiology remains incompletely understood, dietary factors may play a significant role. This study investigated the association between pre-pregnancy consumption of ultra-processed foods and the incidence of hyperemesis gravidarum.
Instrument & Methods: This hospital-based case-control study was conducted in Tehran, Iran, from April 2020 to June 2021, involving 45 newly diagnosed hyperemesis gravidarum cases and 126 controls. Hyperemesis gravidarum diagnosis followed the criteria set by the American College of Obstetrics and Gynecology. Pre-pregnancy ultra-processed food intake was assessed using a validated Semi-Quantitative Food Frequency Questionnaire, with foods classified according to the NOVA system. Multivariable logistic regression analyses, adjusted for potential confounders, were employed to evaluate the association between ultra-processed food consumption and hyperemesis gravidarum risk.
Findings: After adjusting for covariates, significant inverse associations were observed between higher ultra-processed food intake and hyperemesis gravidarum risk. The multivariable-adjusted odds ratios for the highest versus lowest tertile of ultra-processed food consumption were as follows: Total ultra-processed foods (odds ratio: 0.31; 95% CI: 0.19-0.48; p-value=0.002), dairy beverages (odds ratio: 0.18; 95% CI: 0.09-0.52; p-value=0.048), and processed meats/fast foods (odds ratio: 0.13; 95% CI: 0.06-0.71; p-value=0.015).
Conclusion: Lower pre-pregnancy ultra-processed food consumption is associated with reduced odds of developing hyperemesis gravidarum.
Instrument & Methods: This hospital-based case-control study was conducted in Tehran, Iran, from April 2020 to June 2021, involving 45 newly diagnosed hyperemesis gravidarum cases and 126 controls. Hyperemesis gravidarum diagnosis followed the criteria set by the American College of Obstetrics and Gynecology. Pre-pregnancy ultra-processed food intake was assessed using a validated Semi-Quantitative Food Frequency Questionnaire, with foods classified according to the NOVA system. Multivariable logistic regression analyses, adjusted for potential confounders, were employed to evaluate the association between ultra-processed food consumption and hyperemesis gravidarum risk.
Findings: After adjusting for covariates, significant inverse associations were observed between higher ultra-processed food intake and hyperemesis gravidarum risk. The multivariable-adjusted odds ratios for the highest versus lowest tertile of ultra-processed food consumption were as follows: Total ultra-processed foods (odds ratio: 0.31; 95% CI: 0.19-0.48; p-value=0.002), dairy beverages (odds ratio: 0.18; 95% CI: 0.09-0.52; p-value=0.048), and processed meats/fast foods (odds ratio: 0.13; 95% CI: 0.06-0.71; p-value=0.015).
Conclusion: Lower pre-pregnancy ultra-processed food consumption is associated with reduced odds of developing hyperemesis gravidarum.
Keywords:
References
1. McCarthy FP, Lutomski JE, Greene RA. Hyperemesis gravidarum: Current perspectives. Int J Womens Health. 2014;6:719-25. [Link] [DOI:10.2147/IJWH.S37685]
2. Parker SE, Starr JR, Collett BR, Speltz ML, Werler MM. Nausea and vomiting during pregnancy and neurodevelopmental outcomes in offspring. Paediatr Perinat Epidemiol. 2014;28(6):527-35. [Link] [DOI:10.1111/ppe.12151]
3. Lacasse A, Rey E, Ferreira E, Morin C, Bérard A. Epidemiology of nausea and vomiting of pregnancy: Prevalence, severity, determinants, and the importance of race/ethnicity. BMC Pregnancy and Childbirth. 2009;9:26. [Link] [DOI:10.1186/1471-2393-9-26]
4. Fejzo MS, Ingles SA, Wilson M, Wang W, MacGibbon K, Romero R, et al. High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals. Eur J Obstet Gynecol Reprod Biol. 2008;141(1):13-7. [Link] [DOI:10.1016/j.ejogrb.2008.07.003]
5. Kuşcu NK, Koyuncu F. Hyperemesis gravidarum: Current concepts and management. Postgrad Med J. 2002;78(916):76-9. [Link] [DOI:10.1136/pmj.78.916.76]
6. Sonkusare S. Hyperemesis gravidarum: A review. Med J Malaysia. 2008;63(3):272-6. [Link]
7. Bolin M, Åkerud H, Cnattingius S, Stephansson O, Wikström AK. Hyperemesis gravidarum and risks of placental dysfunction disorders: A population-based cohort study. BJOG. 2013;120(5):541-7. [Link] [DOI:10.1111/1471-0528.12132]
8. Kim HY, Cho GJ, Kim SY, Lee KM, Ahn KH, Han SW, et al. Pre-pregnancy risk factors for severe hyperemesis gravidarum: Korean population based cohort study. Life. 2020;11(1):12. [Link] [DOI:10.3390/life11010012]
9. O'Sullivan TA, Hafekost K, Mitrou F, Lawrence D. Food sources of saturated fat and the association with mortality: A meta-analysis. Am J Public Health. 2013;103(9):e31-42. [Link] [DOI:10.2105/AJPH.2013.301492]
10. Silva Meneguelli T, Viana Hinkelmann J, Hermsdorff HHM, Zulet MÁ, Martínez JA, Bressan J. Food consumption by degree of processing and cardiometabolic risk: A systematic review. Int J Food Sci Nutr. 2020;71(6):678-92. [Link] [DOI:10.1080/09637486.2020.1725961]
11. Weaver CM, Dwyer J, Fulgoni VL, King JC, Leveille GA, MacDonald RS, et al. Processed foods: Contributions to nutrition. Am J Clin Nutr. 2014;99(6):1525-42. [Link] [DOI:10.3945/ajcn.114.089284]
12. Elizabeth L, Machado P, Zinöcker M, Baker P, Lawrence M. Ultra-processed foods and health outcomes: A narrative review. Nutrients. 2020;12(7):1955. [Link] [DOI:10.3390/nu12071955]
13. Martínez Steele E, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: Evidence from a nationally representative cross-sectional study. Popul Health Metr. 2017;15(1):6. [Link] [DOI:10.1186/s12963-017-0119-3]
14. Monteiro CA, Cannon G, Levy R, Moubarac JC, Jaime P, Martins AP, et al. NOVA. The star shines bright. World Nutr. 2016;7(1-3):28-38. [Link]
15. Lawrence MA, Baker PI. Ultra-processed food and adverse health outcomes. BMJ 2019;365:l2289. [Link] [DOI:10.1136/bmj.l2289]
16. Poti JM, Braga B, Qin B. Ultra-processed food intake and obesity: What really matters for health-processing or nutrient content?. Curr Obes Rep. 2017;6(4):420-31. [Link] [DOI:10.1007/s13679-017-0285-4]
17. Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin No. 189: Nausea and vomiting of pregnancy. Obstet Gynecol. 2018;131(1):e15-30. [Link] [DOI:10.1097/AOG.0000000000002456]
18. Aadahl M, Jørgensen T. Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc. 2003;35(7):1196-202. [Link] [DOI:10.1249/01.MSS.0000074446.02192.14]
19. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr. 2010;13(5):654-62. [Link] [DOI:10.1017/S1368980009991698]
20. Willett W, Hu F. The food frequency questionnaire. Cancer Epidemiol Biomarkers Prev. 2007;16(1):182-3. [Link] [DOI:10.1158/1055-9965.EPI-06-0843]
21. Edalati S, Bagherzadeh F, Asghari Jafarabadi M, Ebrahimi-Mamaghani M. Higher ultra-processed food intake is associated with higher DNA damage in healthy adolescents. Br J Nutr. 2021;125(5):568-76. [Link] [DOI:10.1017/S0007114520001981]
22. Haugen M, Vikanes A, Brantsaeter AL, Meltzer HM, Grjibovski AM, Magnus P. Diet before pregnancy and the risk of hyperemesis gravidarum. Br J Nutr. 2011;106(4):596-602. [Link] [DOI:10.1017/S0007114511000675]
23. Signorello LB, Harlow BL, Wang S, Erick MA. Saturated fat intake and the risk of severe hyperemesis gravidarum. Epidemiology. 1998;9(6):636-40. [Link] [DOI:10.1097/00001648-199811000-00013]
24. Haghshenosabet F, Eslamian G, Kazemi S, Rashidkhani B. Association between pre-pregnancy food group intakes and hyperemesis gravidarum: A case-control study. Iran J Obstet Gynecol Infertil. 2022;24(12):77-87. [Persian] [Link]
25. Kan E, Emektar E, Corbacioglu K, Safak T, Sariaydin T, Cevik Y. Evaluation of relationship between inflammatory markers and hyperemesis gravidarum in patients admitted to emergency department. Am J Emerg Med. 2020;38(2):292-5. [Link] [DOI:10.1016/j.ajem.2019.05.007]
26. Silva CA, Santos IDS, Shivappa N, Hebert JR, Crivellenti LC, Sartorelli DS. The role of food processing in the inflammatory potential of diet during pregnancy. Rev Saude Publica. 2019;53:113. [Link] [DOI:10.11606/S1518-8787.2019053001154]
27. Fait V, Sela S, Ophir E, Khoury S, Nissimov J, Tkach M, et al. Hyperemesis gravidarum is associated with oxidative stress. Am J Perinatol. 2002;19(2):93-8. [Link] [DOI:10.1055/s-2002-23554]
28. Duhig K, Chappell LC, Shennan AH. Oxidative stress in pregnancy and reproduction. Obstet Med. 2016;9(3):113-6. [Link] [DOI:10.1177/1753495X16648495]
29. Al-Juhaimi F, Ghafoor K, Özcan MM, Jahurul MHA, Babiker EE, Jinap S, et al. Effect of various food processing and handling methods on preservation of natural antioxidants in fruits and vegetables. J Food Sci Technol. 2018;55(10):3872-80. [Link] [DOI:10.1007/s13197-018-3370-0]