Effect of a cholesterol-lowering diet on maternal, cord, and neonatal lipids, and pregnancy outcome: A randomized clinical trial

Objective: We assessed the effect of a cholesterol-lowering diet on maternal, cord, and neonatal plasma lipids and pregnancy outcome. Study design: Nonsmoking white women with singleton pregnancies (n = 290), aged 21 to 38 years, and with no previous pregnancy-related complications, were randomized to either continue their usual diet or to adopt a diet that promoted fish, low-fat meats and dairy products, oils, whole grains, fruits, vegetables, and legumes from gestational week 17 to 20 to birth. Results: Maternal total and low-density lipoprotein cholesterol levels were lowered in the intervention compared with the control group (P <.01). Lipid levels in cord blood and in neonates born to mothers in the intervention versus the control groups did not differ. In the intention-to-treat cohort 1 (0.7%) of 141 women in the intervention group versus 11 (7.4%) of 149 women in the control group delivered before 37 weeks (RR 0.10; 95% CI 0.01-0.77). The incidence of other pregnancy complications and birth weight was similar in both groups. Conclusion: A cholesterol-lowering diet may modify maternal lipid levels but not cord and neonatal lipids. The marked observed effect of this diet on the reduction of preterm delivery in low-risk pregnancies should encourage future larger studies to clarify the role of such a diet in the prevention of preterm birth. (C) 2005 Mosby, Inc. All rights reserved.