MINIMISING THE RISK OF PRE-ECLAMPSIA

Consider what the theoretical risk factors for pre-eclampsia have in common. These risks include: being blood group AB (J Hum Hyperten, 1995; 9: 623-5), environmental poisons, impaired kidney and/or liver function, obesity, diabetes, the placenta not implanting deep enough and immune system malfunction.

What all these factors may have in common is that the body is not receiving enough of the essential nutrients it needs to function at the optimum level. In order for a woman to maintain her own health while nurturing a healthy baby, she should seriously consider the following:Keep levels of essential minerals and vitamins up. Zinc is important for foetal growth, and plays an important part in hormonal balance. In one trial of 52 women, low zinc levels were associated with a higher risk of pre-eclampsia (Eur J Ob Gyn Reprod Biol; 1979; 9: 75-80).

Reduced levels of certain other essential minerals, especially calcium (Int J Ob Gyn, 1983; 21: 271-8) and magnesium (Magnesium Bull, 1982; 4: 73-8) are sometimes also associated with pre-eclampsia. Supplementation with calcium (N Eng J Med, 1991; 325: 1399-405; JAMA, 1996, 275: 1113-7) and magnesium (Stroke, 1989; 20: 1273-5) has been shown to protect against the development of toxaemia in certain groups of women.

According to one study, vitamin E supplementation may assist when oxidative stress is present (Am J Ob Gyn, 1996; 76: 1024-8). Other antioxidants such as vitamin C may also be of benefit.

Don’t restrict your weight gain. Unrestrained maternal weight gain is associated with healthy increases in infant birth weight (J MA Diet Assoc, 1980; 77: 662-7).

Quit smoking. Although there are studies to show that smoking slightly decreases the risk of pre-eclampsia, when pre-eclampsia does develop in those who smoke at least 10 cigarettes per day, the risk of perinatal mortality increases (from 24 per 1000 in non smoking pre-eclamptics to 36 per 1000), as does the risk of abruptio placentae (from 31 to 67 per 1000) and low birth weight (from 28 to 68 per cent).

Lower carbohydrate intake. There is evidence to suggest that carbohydrate metabolism can be altered in some women during pregnancy (Br J Ob Gyn, 1976; 83: 124-31). Other studies have shown that a high intake of carbohydrates can result in lower foetal and placental weight, with knock on ill effects for the child’s long term cardiovascular health (BMJ, 1996; 312: 410-14). Low birth weight has also been linked to behavioural and learning problems (N Eng J Med, 1994; 331: 753-9).

Reduce stress. There is a correlation between high stress levels and pre-eclampsia (J Psychosom Res, 1995; 39: 563-95). High stress levels can interfere with the body’s ability to metabolise certain nutrients. Lack of social support may also have a role in low birth weight.

Change your diet. Try following the Brewer Diet, details of which can be obtained from the Pre-Eclampsia Society (PETS), 17 South Avenue, Hullbridge, Essex, SS5 6HA. Tel: 01702 232533. PETS also publish a useful booklet called Healthy Eating, Healthy Baby.

Another solution might work for some at higher risk. In one community, the records of 775 vegan mothers were retrospectively examined. Only one mother fulfilled the criteria for pre-eclampsia.

Since pre-eclampsia is associated with the unrestrained consumption of fast foods (those with high levels of saturated fat), this sort of diet (with particular attention being paid to an adequate protein intake) would alleviate most, if not all, of the signs and symptoms of pre-eclampsia (South Med J, 1987; 80: 692-7).