Preeclampsia, or toxemia of pregnancy, is a pregnancy complication that can progress to eclampsia, which is a life-threatening condition to both the mother and her unborn child. Finnish researchers conducted a study to determine whether low-dose aspirin could reduce the risk of developing preeclampsia in high risk women. Although their small study, did not report a benefit from low-dose aspirin, a meta-analysis including their trial suggested that early introduction of aspirin can prevent preeclampsia and severe preeclampsia. They published their findings online in the journal BJOG on November 6.
According to UCLA Health System, the exact cause of preeclampsia is not known. However, possible causes include: autoimmune disorders, blood vessel problems, diet, and genetic factors. Risk factors include:
- First pregnancy
- Multiple pregnancy (twins or more)
- Obesity
- Older than age 35
- Past history of diabetes, high blood pressure, or kidney disease
The researchers conducted a randomized, randomized, double-blinded, placebo-controlled trial comprised of 152 women with risk factors for pre-eclampsia and abnormal uterine artery Doppler velocimetry. The women attended maternity clinics in 10 Finnish hospitals. The women were randomized to start either aspirin 100 mg/day or placebo; they began one of the regimens between 12 and 14 weeks of gestation. The authors noted that because of the limited power of their trial, they also conducted a meta-analysis of randomized controlled trials that included data on 346 women with abnormal uterine artery Doppler flow velocimetry, and aspirin 50 to 150 mg/day started at or before 16 weeks of gestation.
The main outcome measures for the study were preeclampsia, gestational hypertension, and birthweight standard deviation (SD) score. The main outcome measures for the meta-analysis were pre-eclampsia, severe pre-eclampsia, preterm (delivery at 37 weeks or less of gestation) and term pre-eclampsia.
From the 152 randomized women, 121 were included in the final analysis. The researchers found that low-dose aspirin did not reduce the rate of pre-eclampsia, gestational hypertension , early-onset pre-eclampsia (diagnosed at less than 34 weeks of gestation), or severe pre-eclampsia. Furthermore, the results were not statistically significant in an intention-to-treat analysis. However, their meta-analysis, including the current data, suggested that low-dose aspirin initiated before 16 weeks of gestation reduces the risk of pre-eclampsia and severe pre-eclampsia.
Reducing risk of preeclampsia with dietary supplements
According to the Los Angeles County Department of Health, the statistics for pregnancy complications in the city are better than the national average; however, the health department notes that LA currently has not reached the national Healthy People goals for reproductive health. Preeclampsia (toxemia) is a pregnancy complication that can jeopardize the health of the mother and the child. It can progress to eclampsia, which is manifested by seizures. Good nutrition preceding and during pregnancy can reduce the risk of preeclampsia. According to a study published online in the British Medical Journal, dietary supplementation during pregnancy with L-arginine and antioxidant vitamins helps prevent preeclampsia in women at high risk for preeclampsia. The study was conducted by Felipe Vadillo-Ortega, from the Department of Experimental Medicine, School of Medicine, Universidad Nacional, Autonoma de Mexico, Ciudad Universitaria, Mexico, and colleagues.
The goal of the study was to test the theory that a relative deficiency in L-arginine, which is substance necessary to synthesize the vasodilator nitric oxide, may lead to development of preeclampsia in a high-risk population. At a tertiary public hospital in Mexico City, high-risk pregnant women with a history of preeclampsia in a previous pregnancy or preeclampsia in a first-degree relative were studied from weeks 14 to 32 of gestation and monitored until delivery for development of preeclampsia or eclampsia. (A tertiary hospital provides the highest level of care.) During pregnancy, participants were randomly assigned to receive supplementation with food bars containing L-arginine plus antioxidant vitamins (228 women), antioxidant vitamins alone (222 women), or a placebo (222 women). While receiving the bars, participants had four to eight prenatal visits.
Compared with women receiving placebo, those receiving L-arginine plus antioxidant vitamins had a lower incidence of preeclampsia. The group receiving L-arginine plus antioxidant vitamins also had a lower incidence of preeclampsia than the group receiving antioxidant vitamins alone. Preeclampsia developed in 30.2% of the placebo group, 22.5% of the vitamin-only group, and 12.7% in the L-arginine plus vitamin group.
The take-home message is that taking L-Arginine in addition to a prenatal vitamin might reduce the risk of preeclampsia. L-Arginine is an inexpensive over-the-counter product, which is readily available. Discuss adding it to your daily regimen with your healthcare professional.
