Pengaruh Pola Diet DASH Terhadap Risiko Preeklamsia Pada Ibu Hamil: Literature Review

Abstract

Latar Belakang: Preeklampsia merupakan gangguan hipertensi kehamilan yang signifikan mempengaruhi morbiditas dan mortalitas ibu di seluruh dunia, menjadi penyebab utama kematian ibu di negara berkembang. Angka Kematian Ibu (AKI) di Indonesia pada tahun 2017 masih mencapai 177 per 100.000 kelahiran hidup, di mana hipertensi dan/atau preeklampsia menyumbang 32,4% dari penyebab terbesar AKI. Mengingat belum adanya pengobatan definitif selain persalinan dini, pencegahan primer melalui modifikasi pola diet dan gaya hidup, seperti pola makan, menjadi sangat penting.

Tujuan: Literature review ini bertujuan untuk meringkas dan mensintesis bukti mengenai peran Diet Dietary Approaches to Stop Hypertension (DASH) dan pola makan ibu lainnya dalam pencegahan preeklampsia.
Metode: Penelitian ini adalah literature review sistematis yang menggunakan pendekatan berbasis pedoman Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Pencarian artikel dilakukan melalui basis data ilmiah seperti PubMed, ScienceDirect, Google Scholar, Scopus, Wiley Online Library, dan Garuda. Kata kunci yang digunakan disesuaikan berdasarkan Medical Subject Headings (MeSH). Sebanyak dua puluh artikel jurnal nasional dan internasional yang terbit dalam 10 tahun terakhir dianalisis. Analisis data dilakukan dengan sintesis naratif dan deskriptif.

Hasil: Hasil analisis menunjukkan konsistensi bahwa kepatuhan tinggi terhadap Diet DASH (kaya buah, sayur, biji-bijian utuh, dan rendah lemak jenuh/natrium) memiliki efek protektif. Kepatuhan tinggi terhadap Diet DASH dikaitkan dengan penurunan risiko preeklampsia sebesar 35% hingga 45%. Mekanisme perlindungan melibatkan perbaikan fungsi endotel, penurunan stres oksidatif, dan stabilisasi tekanan darah. Sebaliknya, faktor risiko seperti obesitas (IMT ≥25 kg/m²), defisiensi mikronutrien (misalnya vitamin D), dan penyakit metabolik (DM, hipertensi kronik) terbukti meningkatkan risiko preeklampsia. Berdasarkan hasil kajian studi literatur

Kesimpulan: Pola diet DASH memiliki pengaruh signifikan dan terbukti efektif sebagai strategi preventif non-farmakologis untuk menurunkan risiko preeklampsia pada ibu hamil, terutama pada kelompok berisiko tinggi, melalui pengendalian tekanan darah dan perbaikan keseimbangan metabolik.

Background: Preeclampsia is a significant hypertensive disorder of pregnancy that contributes substantially to maternal morbidity and mortality worldwide and remains one of the leading causes of maternal death in developing countries. In Indonesia, the maternal mortality ratio (MMR) in 2017 was still as high as 177 per 100,000 live births, with hypertension and/or preeclampsia accounting for 32.4% of the major causes of maternal mortality. Given that there is currently no definitive treatment for preeclampsia other than early delivery, primary prevention through modification of dietary patterns and lifestyle factors, particularly maternal diet, is of great importance.

Objective: This literature review aimed to summarize and synthesize the evidence regarding the role of the Dietary Approaches to Stop Hypertension (DASH) diet and other maternal dietary patterns in the prevention of preeclampsia.

Methods: This study was a systematic literature review conducted using an approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Article searches were conducted using scientific databases, including PubMed, ScienceDirect, Google Scholar, Scopus, Wiley Online Library, and Garuda. The search keywords were adapted based on Medical Subject Headings (MeSH). A total of 20 national and international journal articles published within the past 10 years were analyzed. Data were analyzed using narrative and descriptive synthesis.

Results: The analysis consistently demonstrated that high adherence to the DASH diet, which is rich in fruits, vegetables, and whole grains and low in saturated fat and sodium, has a protective effect against preeclampsia. High adherence to the DASH diet was associated with a 35%–45% reduction in the risk of preeclampsia. The protective mechanisms may involve improved endothelial function, reduced oxidative stress, and better blood pressure control. Conversely, risk factors such as obesity (BMI ≥25 kg/m²), micronutrient deficiencies (e.g., vitamin D deficiency), and metabolic conditions, including diabetes mellitus and chronic hypertension, were associated with an increased risk of preeclampsia. Overall, the reviewed studies indicate that healthy dietary patterns play an important role in reducing the risk of preeclampsia.

Conclusion: The DASH dietary pattern has a significant beneficial effect and may serve as an effective non-pharmacological preventive strategy to reduce the risk of preeclampsia among pregnant women, particularly those at high risk, through improved blood pressure control and metabolic balance.