(991) Poor periconceptional diet and sleep quality are associated with hypertensive disorders of pregnancy.

Objective: Hypertensive disorders of pregnancy (HDP) remain a leading problem in the US and risk factor for future adverse cardiovascular health. While recommendations to support long-term cardiovascular health exist for adults, specific lifestyle and wellness guidelines intended to improve pregnancy health are limited. We sought to examine the relationship between periconceptional lifestyle-related factors, including nutrition, sleep, and physical activity and development of HDP.

Study Design: We conducted a secondary analysis of singleton pregnancies to nulliparous individuals in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) prospective cohort. We studied 7,942 participants without chronic hypertension or pregestational diabetes. We assessed periconceptional dietary quality using the Alternative Healthy Eating Index-2010 (AHEI-2010) score, sleep quality based on duration and snoring, and physical activity based on duration and adequacy as reported at study visit 1 (6 to 13 weeks’ gestation). Multivariable logistic regression estimated odds ratios for HDP adjusted for markers of socioeconomic status, depression, perceived social support, maternal age, tobacco use, and medical comorbidities.

Results: Individuals who developed HDP were more likely to be older, non-Hispanic Black, unmarried, and use tobacco, with higher BMI compared to those who did not (Table 1). In adjusted models, AHEI-2010 score in the lowest quartile was associated with 1.3 times (95% confidence interval 1.04-1.58) higher odds of HDP compared to the highest quartile (Table 2). Early pregnancy snoring was associated with 1.4 times (95% confidence interval 1.18-1.63) higher odds of HDP (Table 2).

Conclusion: Poor diet quality and early pregnancy snoring were associated with HDP in nulliparas without preexisting hypertension or diabetes. Findings support developing low-cost lifestyle interventions targeting diet and snoring to reduce HDP risk, emphasizing the importance of preconception and early pregnancy care to improve maternal and infant health.