Prevention of preeclampsia
Bed rest and dietary manipulations
The rate of PE is not reduced by bed rest, restriction of physical activity or dietary manipulations, including restriction of salt intake or supplementation with magnesium, zinc, folate vitamins C, D and E or fish oil.
Dietary calcium supplementation in women with low calcium diets may halve the rate of PE. Preliminary data suggest that prophylactic use of pravastatins may also benefit women at high-risk of PE.
Low dose aspirin
The prophylactic use of low-dose aspirin in the prevention of PE has been studied extensively. A meta-analysis of trials showed that the administration of low-dose aspirin in high-risk pregnancies resulted in a 10% lower incidence of PE. However in most studies aspirin was started after 16 weeks’ gestation and at a dose of <100 mg/day.
In contrast, other meta-analyses showed that aspirin started before 16 weeks resulted in halving the rate of PE, whereas aspirin started after 16 weeks did not have a significant benefit. In addition, the beneficial effect of aspirin was dose dependent, with a greater reduction in the incidence of PE being associated with a dose of >100 mg/day.
- Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2014;6: CD001059.
- Askie LM, Duley L, Henderson-Smart DJ, Stewart LA. Antiplatelet agents for prevention of preeclampsia: a meta-analysis of individual patient data. Lancet 2007; 369: 1791-8.
- Roberge S, Nicolaides KH, Demers S, Villa P, Bujold E. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet Gynecol 2013; 41: 491-9.
- Crandon AJ, Isherwood DM. Effect of aspirin on incidence of pre-eclampsia. Lancet 1979; 1: 1356.