Mediterranean Diet Linked to a Significantly Lower Risk of Developing Preeclampsia During Pregnancy

A Centers for Disease Control and Prevention’s 2022 National Center for Health Statistics report indicates that pregnancy-related mortality in the United States has been on the increase steadily over the past 30 years, with significant disparities by race and maternal age. Adverse pregnancy outcomes (APOs) are leading factors associated with maternal morbidity and mortality, underscoring the importance of APO prevention for preserving and extending a healthy lifespan among women. APOs have been associated with an increased risk of the subsequent development of metabolic diseases, cardiovascular disease (CVD) risk factors, and overt CVD. As such, a history of APO is considered a risk enhancer and a prompt for more vigorous lifestyle interventions for primary prevention of CVD, the leading cause of death among US women.

Preeclampsia is a serious blood pressure condition that develops during pregnancy and puts stress on the mother’s heart. Left untreated, the condition can cause serious complications like weakened kidney and liver function and decreased blood supply to the fetus.

In addition to preeclampsia, the risk of gestational diabetes also decreased in women who more closely followed the heart-healthy diet.

In a new study evaluating the Mediterranean diet and adverse pregnancy outcomes, investigators from the Smidt Heart Institute at Cedars-Sinai found that women who conceived while adhering to the anti-inflammatory diet had a significantly lower risk of developing preeclampsia during pregnancy.

The study, published today in the peer-reviewed journal JAMA Network Open, also evaluated the association between the Mediterranean diet and other adverse pregnancy outcomes, including gestational diabetes and hypertension, preterm birth, delivery of a small-for-gestational-age infant, and stillbirth.

Natalie Bello, MD, MPH, senior and corresponding author of the study and director of Hypertension Research in the Smidt Heart Institute, found the association was stronger in women who are traditionally considered to be of advanced maternal age, those 35 or older.

The study was part of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be, which enrolled 10,038 women between 2010-2013. Women who were pregnant with their first child were asked to complete a semi-quantitative food frequency questionnaire during their first study visit, which occurred in the first trimester.


The data was compiled, analyzed and studied by researchers and showed:

  • Of the 7,798 women enrolled, 10% were 35 years old or older, 11% were non-Hispanic Black, 17% were Hispanic, and 4% were Asian.
  • 20% of enrollees had obesity at the onset of their participation.
  • A high Mediterranean diet score was related to 21% lower odds of having any adverse pregnancy outcome, as well as a 28% and 37% lower risk of having preeclampsia/eclampsia and gestational diabetes.

 These findings uniquely demonstrate that in United States women, adoption of a Mediterranean diet pattern may represent an important lifestyle approach for the prevention of adverse pregnancy outcomes, particularly in women with advanced maternal age.

These findings add to the growing body of evidence demonstrating that the Mediterranean-style diet may play an important role in preserving the health of women across the lifespan, including during pregnancy.  Long-term studies are needed to assess whether promoting a Mediterranean-style diet around the time of conception and throughout pregnancy can prevent adverse pregnancy outcomes and reduce future cardiovascular risk.


Nour Makarem, Kristi Chau, Eliza C. Miller, Cynthia Gyamfi-Bannerman, Isabella Tous, Whitney Booker, Janet M. Catov, David M. Haas, William A. Grobman, Lisa D. Levine, Rebecca McNeil, C. Noel Bairey Merz, Uma Reddy, Ronald J. Wapner, Melissa S. Wong, Natalie A. Bello. Association of a Mediterranean Diet Pattern With Adverse Pregnancy Outcomes Among US Women. JAMA Network Open, 2022; 5 (12): e2248165 DOI: 10.1001/jamanetworkopen.2022.48165