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Previous studies showed conflicting results regarding the role of chocolate consumption during pregnancy and the risk of preeclampsia. We aimed to evaluate the impact of high-flavanol chocolate in a randomized clinical trial.
We conducted a single-center randomized controlled trial including women with singleton pregnancy between 11 and 14 weeks gestation who had double-notching on uterine artery Doppler. The pregnant women selected were randomized to either high-flavanol (HFC) or low-flavanol chocolate (LFC). A total of 30 g of chocolate was consumed daily for 12 weeks and women were followed until delivery. Uterine artery Doppler pulsatility index (UtA PI), reported as multiple of medians (MoM) adjusted for gestational age, was assessed at baseline and 12 weeks after randomization. Preeclampsia, gestational hypertension, placenta weight, and birthweight were also evaluated.
One hundred twenty nine women were randomized at a mean gestational age of 12.4 ± 0.6 weeks with a mean UtA PI of 1.4 ± 0.4 MoM. Although adjusted UtA PI significantly decreased from baseline to 12 weeks in the 2 groups (<0.0001), the difference between the 2 groups was not significant (p=0.16). At 12 weeks, we observed no significant difference between HFC and LFC groups in the rate of preeclampsia (4.7% vs 3.1%, p=0.49) and gestational hypertension (6.2% vs 12.5%, p=0.56). Placental weight (466 vs 464 grams, p=0.93) and birthweight (3348 vs 3215 grams, p=0.07) were comparable between the two groups.
Compared with low-flavanol chocolate, daily intake of 30g of high-flavanol chocolate did not improve placental function, placental weight and the risk of preeclampsia. Nevertheless, the marked improvement of the pulsatility index observed in the 2 chocolate groups might suggest that chocolate effects are not solely and directly due to flavanol content.