Experiencing a healthy pregnancy and avoiding premature birth is a goal of all would-be mothers. A threat to this goal is preeclampsia, a condition that can develop during pregnancy and is characterized by high blood pressure, headaches, swelling in the lower legs, and protein in the urine. If it's not quickly and properly treated, it can turn into a life-threatening condition and require premature delivery.
Also referred to as toxemia, preeclampsia occurs during 5 to 8 percent of all U.S. pregnancies. It is a major cause of early delivery in the United States and is the cause for an estimated 76,000 maternal deaths each year worldwide.
The Risks
It's important to get regular prenatal care and to be aware of the potential problem and get immediate care should symptoms occur. Knowing the symptoms and risk factors can help. Here is a list of some of the known risk factors:
- Heredity. Preeclampsia is more common in women whose mothers had this problem. Now we know that this tendency can also be passed on by fathers to their daughters.
- A high or moderately high blood pressure before 20 weeks of pregnancy increases risk. A study of 13,000 women found that those with a systolic blood pressure of 130 or higher in the first half of pregnancy were nearly four times more likely to have preeclampsia than women with a systolic blood pressure lower than 110.
- First pregnancy. Risk is higher in the first pregnancy.
- Obesity increases the risk for high blood pressure and is also thought to increase risk of preeclampsia, although there is some uncertainty on this risk factor.
- Having diabetes and being insulin resistant increases the risk for preeclampsia.
- Multiple pregnancy (twins, etc.) increases risk.
- Homocysteine. High levels of homocysteine in the blood increase risk.
- Inadequate diet, including low levels of calcium, zinc, vitamins C and E, and essential fatty acids.
Primary Prevention
For a healthy pregnancy all of the following are important, but these suggestions may be especially important if you have risk factors listed above.
- Good prenatal care must be emphasized, even preconception care. Get special guidance if you already have high blood pressure, diabetes, or other existing health problems.
- Achieve and maintain a healthy weight before pregnancy if possible.
- Choose a lifestyle that helps keep your blood pressure low: Get regular, moderate physical activity of 30+ minutes daily. Moderate salt intake (the Institute of Medicine recommends 1,500 mg sodium or less daily for all adults). Eat lots of fruits and vegetables, five to nine servings per day. Use nonfat or low-fat milk and dairy products.
- Choose good nutritional practices: Eat whole grain breads and cereals (higher in the trace minerals and essential fatty acids), healthy fats (non-hydrogenated vegetable oils, nuts, seeds, and nut butters), and plenty of foods high in vitamin C (citrus, berries, melons, papaya).
Researchers are looking at a possible molecular mechanism explaining preeclampsia. One possible explanation is that it is caused be decreased availability of nitric oxide – a substance in the blood that helps arteries to relax, which would allow greater blood flow and potentially reduce blood pressure. Studies show that women who have preeclampsia have greater levels of a form of nitric oxide that is bound to the blood protein albumin, indicating that it might not be released properly to relax the arteries.
Vitamin C is essential to release nitric oxide to function properly. The researchers are speculating that a deficiency of vitamin C (a condition that is often associated with preeclampsia) might be a contributing factor. Low levels of vitamin C can lead to decreased availability of nitric oxide in the circulation. This might cause the vasoconstriction and vasospasm associated with the typical symptoms of preeclampsia and edema.
A precursor to nitric oxide formation is arginine, an amino acid. Nuts are a rich source of this amino acid, and have been found to reduce the risk of heart attacks. They might also be helpful in improving general circulation and with helping arteries relax as they should.
A healthy diet and lifestyle might help prevent serious problems and increase the likelihood of a healthy pregnancy and full-term delivery. |
