Pregnancy is a time in a woman's life when she should be as healthy as possible to ensure the best possible outcome for herself and her unborn baby.
Unfortunately, there are a number of conditions that can make pregnant women seriously ill and potentially harm the baby.
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One of these conditions is called preeclampsia, which may be followed by eclampsia (severe high blood pressure of pregnancy).
Definition
Preeclampsia is regarded as the early stages of pregnancy-induced hypertension, or high blood pressure (Krause, 2000). This can lead to full-blown pregnancy-induced hypertension or eclampsia.
This severe high blood pressure, that may develop after about 20 weeks of pregnancy, is usually accompanied by proteinuria (loss of protein through the kidneys), and oedema (severe water retention that leads to swelling of the hands, feet, face and other parts of the body).
In some cases, the condition can be so serious that the expectant mother develops convulsions and coma. Such derangements of normal metabolism are potentially harmful to the baby. Severe eclampsia can cause foetal damage and, in some cases, even death.
Approximately 7-8% of pregnant women may develop preeclampsia and full-blown eclampsia. This condition occurs more commonly in young women, during a first pregnancy, in women who are obese, and those with low socioeconomic status.
Other factors that may contribute include lack of prenatal care and poor nutritional status, which are both often associated with poverty.
Causes
Not much is known about the causes of preeclampsia and eclampsia. Doctors and nutritionists have been trying to find a link between diet and preeclampsia and eclampsia for more than 50 years, without much success.
One theory suggested that a lack of protein in the diet of the mother could play a role, but studies were inconclusive.
The idea of limiting salt intake during pregnancy to prevent hypertension, a strategy that works well in some non-pregnant patients with hypertension, particularly those with so-called 'salt-sensitive hypertension', has not produced the expected results in pregnant women at risk of eclampsia.
Promising research into this threatening condition has been the use of calcium and antioxidant supplementation in pregnancy to prevent both pre- and full-blown eclampsia.
New research
A recent edition of the Arbor Clinical Nutrition Updates published in December 2005, reviewed some interesting research studies that looked at dietary interventions to prevent
eclampsia.
a) Calcium
In one study, 48 healthy women in their first pregnancy in Bangladesh and Colombia, with a family history of preeclampsia, were either given placebo (no active treatment) or supplements which contain 600 mg of calcium and 450 mg of conjugated linoleic acid (CLA) as of weeks 18 to 22 of pregnancy.
The women who received active treatment had a significant reduction in pregnancy hypertension and lower pre-delivery blood pressure.
It would seem that calcium, but not magnesium, may help to lower blood pressure during pregnancy and thus prevent pre- and full-blown eclampsia.
b) Antioxidants
Pregnancy is regarded as "a situation of oxidative stress". In other words, pregnancy can increase both the quantities of harmful oxidation products produced by the mother's body and also increase her requirement for antioxidants.
In women who have a diet lacking in protective antioxidants (vitamins C and E, zinc, and selenium) due to poverty or even just poor eating habits, it is feasible that the deficiency of these important nutrients could worsen preeclampsia and eclampsia.
A survey of the results of seven studies involving a total of more than 6 000 women, showed that supplementation with antioxidants produced a significant reduction in risk of developing eclampsia. Vitamins C and E may be the leading antioxidants to have a beneficial effect.
c) Obesity
Obesity is regarded as a significant contributing factor to eclampsia in pregnancy. Obesity is also linked to insulin resistance and development of pregnancy diabetes.
Important factors in preventing eclampsia may, therefore, be ensuring that women start their pregnancies with a normal weight and preventing excessive weight gain during pregnancy.
It is important to understand that women will gain some weight during pregnancy and that this is normal, but if you are pregnant and are piling on the kilos, this could put you and your baby at risk of preeclampsia and eclampsia.
Present solutions
At the moment, our knowledge of what exactly causes preeclampsia and eclampsia, and what we can do to treat this potentially dangerous condition, is still lacking. We are also not yet sure of which dietary interventions will prevent or cure these conditions.
If you are pregnant, you must be monitored by your clinic, doctor, or gynaecologist, so that changes in blood pressure, loss of proteins in the urine and excessive weight gain can be identified at the earliest possible stage.
Discuss the use of calcium and antioxidant supplements with your doctor. Don't just take a complete vitamin and mineral supplement without making sure that the doctor approves - excess intakes of vitamin A in multivitamin supplements can also be potentially harmful to the unborn.
If you are gaining too much weight in your pregnancy, consult a dietician or ask at the hospital if you can speak to the resident dietician. You need a diet that will prevent weight gain, but will still provide all the nutrients you and your baby need for good health, including calcium and antioxidants. – (Dr Ingrid van Heerden, DietDoc)
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