# Association of Antioxidant Diet with Risk of Hyperemesis Gravidarum Among Chinese Pregnant Women: A Population-Based Cross-Sectional Study

## TL;DR

A diet rich in antioxidants is linked to a lower risk of hyperemesis gravidarum in Chinese pregnant women.

## Contribution

This study is the first to associate a composite antioxidant diet index with reduced HG risk in a large Chinese population.

## Key findings

- Higher CDAI and DAPS scores were associated with significantly lower odds of HG.
- The protective effect of antioxidant-rich diets remained consistent across sensitivity and subgroup analyses.
- Antioxidant intake may play a crucial role in preventing HG.

## Abstract

(1) Background: Oxidative stress plays a pivotal role in the pathophysiologic of hyperemesis gravidarum (HG). Epidemiological studies have explored the associations of specific antioxidant foods and nutrients with HG. However, evidence regarding the relationship between an antioxidant-rich diet and the risk of HG remains limited. The objective of this research was to explore the relationship between antioxidant-rich diet and HG. (2) Methods: This was a population-based cross-sectional study. A total of 2980 pregnant women were included in our population. A composite dietary antioxidant index (CDAI) was calculated by summing the standardized intakes of vitamins A, C, and E, selenium, zinc, and total carotene. A dietary antioxidant potential score (DAPS) was derived using reduced rank regression. Binary logistic regression models were employed to analyze the associations of CDAI and DAPS with risk of HG. (3) Results: In total, 241 (8.09%) cases of HG were identified in this study. After adjusting for potential confounders, including age, socioeconomic status, ethnicity, physical activity, current smoking status, current alcohol consumption, pre-pregnancy body mass index, nutritional supplement usage, total energy intake, gestational week, menstruation regularity, family history of HG, primigravida status, and quality of life during pregnancy, ORs (95% CIs) of HG in the highest tertiles were 0.31 (0.21–0.47) for CDAI and 0.41 (0.28–0.57) for DAPS when comparing lowest tertiles (all p-trend < 0.001). Such associations remained robust across multiple sensitivity analyses and subgroup analyses. (4) Conclusions: Higher CDAI and DAPS, indicative of greater adherence to an antioxidant-rich diet, were associated with a lower risk of HG. This finding underscores the crucial role of consuming antioxidant-rich foods in the prevention of HG.