Background Gestational hypertension GH defined as newonset hypertension after 20 weeks of gestation affects up to 10 percent of pregnancies and significantly increases the risk of maternal and perinatal morbidity While pharmacological management is limited due to safety concerns in pregnancy dietary interventions offer a promising nonpharmacological strategy However evidence regarding their effectiveness once GH is already diagnosed remains limited

Objective To systematically review the effect of postdiagnosis dietary pattern interventions on blood pressure BP reduction in pregnant women with GH and to evaluate associated maternal and fetal outcomes

Methods This systematic review adhered to PRISMA 2020 guidelines A comprehensive search of PubMed Embase Scopus and Chinese databases from January 2000 to June 2025 was conducted Studies were included if they evaluated the impact of wholediet interventions eg DASH lowsodium Mediterranean initiated after GH diagnosis Risk of bias was assessed using RoB2 and ROBINSI tools

Results Five controlled studies n 509 participants met inclusion criteria Interventions included DASHstyle or lowsodium diets alone or combined with moderate exercise All studies reported significant reductions in systolic and diastolic BP compared to standard care with mean SBP reduction ranging from 8 to 19 mmHg Three studies also reported reduced rates of preeclampsia and preterm birth Risk of bias ranged from moderate to critical largely due to allocation methods and lack of blinding

Conclusion Dietary pattern interventionsparticularly DASHstyle and saltrestricted dietsappear effective in lowering BP in women with GH with potential benefits for maternal and fetal outcomes However most evidence comes from small trials in limited settings Larger highquality RCTs isolating dietary effects are needed to inform clinical guidelines