Association between sweet food consumption and preeclampsia: Insights from an observational study and Mendelian randomization analysis

Previous studies suggest links between sweet food consumption and metabolic conditions, but its role in preeclampsia (PE) remains unclear. This study combines a case‒control design with Mendelian randomization (MR) to explore the potential causal relationship between sweet food intake and PE. This retrospective cohort study included 1146 pregnant women from Fujian Provincial Maternity and Children's Hospital (60 with PE, 1086 controls). Dietary habits, specifically sweet food consumption (≥3 times/week), were recorded pre-delivery. Logistic regression assessed the association between sweet food intake and PE, adjusting for confounders like age, prenatal weight, blood glucose, and anemia. MR analysis used genetic variants from UK Biobank and FinnGen databases, analyzed via the inverse variance weighted (IVW) method, with sensitivity tests (MR-Egger, weighted median). Frequent sweet food consumption was associated with increased PE risk in the cohort study (OR = 2.51, 95% CI: 1.46–4.44, P = 0.001) after adjustments. However, MR analysis found no causal link between sweet food intake and PE. Instead, a causal association between higher BMI and PE was identified (OR = 1.56, 95% CI: 1.40–1.74, P = 6.51 × 10⁻¹⁶). While the case–control study linked frequent sweet food consumption to higher PE risk, MR analysis did not confirm causality. Elevated BMI, driven by excessive energy intake, emerged as a significant PE risk factor. Further research is needed to clarify dietary influences on PE and the interplay of diet, weight, and metabolic health in pregnancy.