title: Dietary acid load and blood pressure development in pregnancy: The Generation R Study.
abstract: Dietary intake could induce a mild maternal metabolic acidosis that might lead to a higher level of blood pressure. Because studies in pregnancy are scarce, we evaluated the association between maternal dietary acid load and changes in blood pressure during pregnancy, pregnancy-induced hypertension and pre-eclampsia.
  
  
  
  We included 3411 pregnant women of Dutch ancestry from a prospective population-based cohort (Rotterdam, The Netherlands). Dietary data was self-reported via a food-frequency questionnaire in early pregnancy. Four dietary acid load measurements were calculated: dietary potential renal acid load (dPRAL), net endogenous acid production (NEAP), animal protein/potassium ratio, and vegetable protein/potassium ratio. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured three times during pregnancy. Information on pregnancy-induced hypertension and pre-eclampsia was obtained from medical records. Linear mixed models and logistic regression were used and adjusted for sociodemographic and lifestyle factors.
  
  
  
  The results indicated that dPRAL, NEAP and animal protein/potassium ratio were not associated with DBP or SBP in pregnancy. One standard deviation higher vegetable protein/potassium ratio was associated with lower DBP (-0.30 mmHg [95% CI -0.54; -0.06]) but not with SBP (-0.29 mmHg [95% CI -0.60; 0.01]). Dietary acid load measurement was neither associated with the prevalence of pregnancy-induced hypertension nor with pre-eclampsia.
  
  
  
  Dietary acid load was not associated with changes in DBP or SBP during pregnancy, although women with a higher vegetable protein/potassium ratio had a slightly lower DBP. Dietary acid load was not associated with pregnancy-induced hypertension or pre-eclampsia.
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: m.tielemans@erasmusmc.nl.
authors.forename: Myrte J
authors.initials: MJ
authors.lastname: Tielemans
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Erler
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Vincent W V
authors.initials: VWV
authors.lastname: Jaddoe
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Eric A P
authors.initials: EAP
authors.lastname: Steegers
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Leiden University College, The Hague, The Netherlands.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Kiefte-de Jong
mesh_terms: D000138:Acidosis / Q000453:epidemiology*; D000328:Adult; D001794:Blood Pressure; D015897:Comorbidity; D004032:Diet / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy
keywords: Blood pressure; Dietary acid load; Dietary intake; Pre-eclampsia; Pregnancy