First Trimester Dietary Intake, Biochemical Measures, and Subsequent Gestational Hypertension Among Nulliparous Women

Tande, Desiree L.; Ralph, Jody L.; Johnson, LuAnn K.; Scheett, Angela J.; Hoverson, Bonita S.; Anderson, Cindy M.

doi:10.1111/jmwh.12007

Cited by 32Pregnancy and preeclampsia studiesTrace Elements in HealthGestational Diabetes Research and Management

First Trimester Dietary Intake, Biochemical Measures, and Subsequent Gestational Hypertension Among Nulliparous Women

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Tande, Desiree L., Ralph, Jody L., Johnson, LuAnn K., Scheett, Angela J., Hoverson, Bonita S., Anderson, Cindy M.·2013·Journal of Midwifery & Women's Health

DOI 10.1111/jmwh.12007

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Abstract

Introduction: The purpose of this study was to evaluate the relationships between first‐trimester dietary factors and biochemical measures and subsequent risk of gestational hypertension. Methods: This pilot study used a prospective design utilizing a convenience sample of nulliparous women enrolled at their first prenatal visit. A total of 57 women completed the study. Participants were divided into 2 groups for data analysis: normotensive pregnancy and gestational hypertension. Results: Nearly one‐quarter of study participants (22.8%) developed gestational hypertension, of whom 84.6% had significant proteinuria meeting the criteria for preeclampsia. There were no significant differences in micronutrient or macronutrient dietary intakes between groups. Serum iron and zinc levels were lower for the gestational hypertension group compared with the normotensive pregnancy group (P ≤ .01). Low serum zinc levels were related to a risk of developing gestational hypertension (adjusted odds ratio, 0.930; 95% confidence interval, 0.872‐0.992). Discussion: Ensuring adequate intake of zinc and monitoring serum zinc levels in nulliparous pregnant women may help to prevent or contribute to early detection of gestational hypertension.

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Controversy still exists regarding the relationship between iron supplementation during pregnancy and the occurrence of HDP.
“some controversy still exists regarding the relationship between iron supplementation during pregnancy and the occurrence of HDP.”
From Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study (2021) · cites this paper as [31]
Differences in findings on serum iron and HDP are potentially explained by the use of different methodologies and gestational times of serum sample collection.
“Differences in these findings are potentially explained by the use of different methodologies and gestational times of serum sample collection [31].”
From Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study (2021) · cites this paper as [31]
Pregnant women who subsequently developed HDP had lower serum iron levels in the first trimester than those who did not develop HDP.
“One study found that pregnant women who subsequently developed HDP had lower serum iron levels in the first trimester than those who did not develop HDP.”
From Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study (2021) · cites this paper as [31]

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Additional file 5 of Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
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Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021) · Figshare · doi:10.6084/m9.figshare.14561258
Additional file 1 of Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021) · Figshare · doi:10.6084/m9.figshare.14561243
Additional file 2 of Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021) · Figshare · doi:10.6084/m9.figshare.14561246
Additional file 3 of Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021) · Figshare · doi:10.6084/m9.figshare.14561249
Additional file 8 of Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021) · Figshare · doi:10.6084/m9.figshare.14561264
Additional file 7 of Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study
Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021) · Figshare · doi:10.6084/m9.figshare.14561261

Journal of Midwifery &Women’s Health www.jmwh.org Original Research First Trimester Dietary Intake, Biochemical Measures, and Subsequent Gestational Hypertension Among Nulliparous Women
Hoverson, B. S. (2016)
Self-citation
The Relationship Between Maternal Serum Iron and Zinc Levels and Their Nutritional Intakes in Early Pregnancy with Gestational Diabetes
Behboudi‐Gandevani, S., Safary, K., Moghaddam‐Banaem, L., Lamyian, M., Azita, G., & Alianmoghaddam, N. (2013) · Biological Trace Element Research · doi:10.1007/s12011-013-9703-y · Cited by 50 · see citing works
Assessment of serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension: a case-control study
Bilbeisi, A. H. E., Khosa, S. M. A., Taleb, M. H., & Afifi, A. M. E. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1155529 · Cited by 9 · see citing works
Relationships between Iron and Zinc Serum Levels in Early Second Trimester of Pregnancy and Gestational Diabetes
Mokhlesi, S., Momenzadeh, F., Mohebi, S., & Moghaddam‐Banaem, L. (2014) · Alborz University Medical Journal · doi:10.18869/acadpub.aums.3.3.127 · Cited by 3 · see citing works
First-Trimester Zinc Supplementation Reduces Preeclampsia Incidence in Chronic Hypertensive Pregnancies: A Single-Center Retrospective Observational Study
Gao, L., Dong, Y., Lv, L., Liu, X., Liu, X., & Liu, J. (2026) · Biological Trace Element Research · doi:10.1007/s12011-026-05142-1

Authors: Tande, D. L., Ralph, J. L., Johnson, L. K., Scheett, A. J., Hoverson, B. S., & Anderson, C. M.
Affiliations: University of North Dakota (US)
Corresponding author: Anderson, Cindy M.
ORCID: Ralph, Jody L.
Johnson, LuAnn K.
Scheett, Angela J.
Anderson, Cindy M.
Venue: Journal of Midwifery & Women's Health
Publisher: Wiley
Published: 2013-07
Volume: 58
Issue: 4
Pages: 423-430
ISSN: 1526-9523 (ISSN-L)
1542-2011
DOI: 10.1111/jmwh.12007
OpenAlex: W2009672457
Cited by: 32
References: 54
Citations by year: 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 14 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 2
FWCI: 2.98
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 29 d)
Locations: Journal of Midwifery & Women s Health (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Agriculture
Robert Wood Johnson Foundation
Sigma Theta Tau International
Agricultural Research Service
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords: gestational hypertension, preeclampsia, serum zinc, serum iron, micronutrient intake, macronutrient intake, nulliparous women, proteinuria, pregnancy risk factors
MeSH terms: Adult, Energy Intake, Deficiency Diseases, Diet, Female, Humans, Iron, Nutritional Status, Parity, Pilot Projects, Pre-Eclampsia, Pregnancy, Pregnancy Trimester, First, Prenatal Care, Prospective Studies, Proteinuria, Reference Values, Risk Factors, Zinc, Biomarkers, Prevalence, Odds Ratio, Prenatal Nutritional Physiological Phenomena, Hypertension, Pregnancy-Induced, Young Adult

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