OC14.03: ΔEffects of a Mediterranean diet or a stress reduction intervention during pregnancy on the incidence of early‐late pre‐eclampsia: the IMPACT‐BCN trial

To investigate whether structured intervention based on a Mediterranean diet (MedDiet) or mindfulness-based stress reduction (MBSR) in high-risk pregnancies for small-for-gestational-age (SGA) newborns, can reduce the incidence of pre-eclampsia. In a randomised clinical trial with parallel-group conducted at a University Hospital in Barcelona, Spain (2017-2020), 1221 pregnant women at high-risk for SGA newborns were randomly allocated at 19-23 weeks of gestation into three groups: a MedDiet intervention, a MBSR program or non-intervention. Participants in the MedDiet group (n = 407) received monthly individual and group educational sessions, and free provision of extra-virgin olive oil and walnuts. Women in the MBSR group (n = 407) underwent an 8-week MBSR program adapted for pregnancy. While the main outcome was the prevalence of SGA, early (delivery < 34 weeks) and late (delivery >= 34 weeks) pre-eclampsia were analysed as secondary outcomes. Among 1182 participants included for the intention- to-treat-analysis (n = 392 MedDiet, n = 390 MBSR, n = 400 no intervention), pre-eclampsia occurred in 83 women (7%), and in the majority (n = 77, 6.5%) occurred late. Whereas the prevalence of early pre-eclampsia was similar among study groups (n = 2 MedDiet, n = 3 MBSR, n = 1 non-intervention), late pre-eclampsia was significantly reduced in the MedDiet group compared to non-intervention: n = 20 (5.1%) versus 36 (9%); OR 0.54, 95% CI 0.31-0.96; p = 0.035. Results persisted significantly after the exclusion of those cases of pre-eclampsia with also SGA: n = 13 (3.3%) versus 26 (6.5%); OR 0.49, 95% CI 0.25-0.98; p = 0.042. In MBSR group, there was a non-significant tendency of lower pre-eclampsia prevalence (n = 22 (5.5%), p = 0.054). A structured intervention during pregnancy based on Mediterranean diet reduced remarkably the prevalence of late pre-eclampsia. These results must be confirmed but open new research lines on preventive strategies for this unsolved condition.