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. 2000;1999(2):CD001687.
doi: 10.1002/14651858.CD001687.

Reduced salt intake compared to normal dietary salt, or high intake, in pregnancy

L Duley  1 , D Henderson-Smart
Affiliations

Reduced salt intake compared to normal dietary salt, or high intake, in pregnancy

L Duley et al. Cochrane Database Syst Rev. 2000.

Abstract

Background: In the past women have been advised that lowering their salt intake might reduce their risk of pre-eclampsia. Although this practice has largely ceased, it remains important to assess the evidence about possible effects of advice to alter dietary salt intake during pregnancy.

Objectives: The objective of this review was to assess the effects of dietary advice to alter salt intake compared to continuing a normal diet, on the risk of pre-eclampsia and its consequences.

Search strategy: We searched the register of trials maintained and updated by the Cochrane Pregnancy and Childbirth Group, and the Cochrane Controlled Trials Register Disc Issue 4, 1998.

Selection criteria: Studies were included if they were randomised trials of advice to either reduce or to increase dietary salt during pregnancy.

Data collection and analysis: All data were extracted independently by both reviewers.

Main results: Two trials were included, with 603 women. They compared advice about a low salt diet with no dietary advice. The confidence intervals for all of the outcomes reported were wide, and cross the no effect line. This includes pre-eclampsia (relative risk 1.11, 95% confidence interval 0.46 to 2.66). Even when taken together, these trials are insufficient to provide reliable information about the effects of advice on salt restriction during normal pregnancy. None of the trials included women with pre-eclampsia, so this review provides no reliable information about changes in salt intake for treatment of pre-eclampsia.

Reviewer's conclusions: Salt consumption during pregnancy should remain a matter of personal preference.

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Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 1 Hypertension.
1.2
1.2. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 2 Pre‐eclampsia.
1.3
1.3. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 3 Referral to hospital, no admission.
1.4
1.4. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 4 Admission to hospital.
1.5
1.5. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 5 Placental abruption.
1.6
1.6. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 6 Caesarean section.
1.7
1.7. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 7 Perinatal mortality.
1.8
1.8. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 8 Birthweight <10th centile.
1.9
1.9. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 9 Birthweight <2500g.
1.10
1.10. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 10 Preterm delivery.
1.11
1.11. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 11 Apgar at 5 min <7.
1.12
1.12. Analysis
Comparison 1 Low vs normal salt intake in pregnancy, Outcome 12 Paediatric admission.
See this image and copyright information in PMC

References

References to studies included in this review

Netherlands 1997 {published data only}
    1. Steegers EAP, Lakwijk HPJM, Jongsma HW, Fast JH, Boo T, Eskes TKAB, et al. (Patho)physiological implications of chronic dietary sodium restriction during pregnancy; a longitudinal prospective randomized study. Br J Obstet Gynaecol 1991;98:980‐7. - PubMed
    1. Maten GD. Low sodium diet in pregnancy: effects on maternal nutritional status. Eur J Obstet Gynecol Reprod Biol 1995;61:63‐64. - PubMed
    1. Buul BJA, Steegers EAP, Jongsma HW, Rijpkema AL, Eskes TKAB, Thomas CMG, et al. Dietary sodium restriction in the prophylaxis of hypertensive disorders of pregnancy: effects on the intake of other nutrients. Am J Clin Nutr 1995;62:49‐57. - PubMed
    1. Buul BJA, Steegers EAP, Maten GD, Delemarre FMC, Jongsma HW, Oosterbaan HP, et al. Dietary sodium restriction does not prevent gestational hypertension: a Dutch two‐center randomized trial. Hyper Preg 1997;16:335‐346.
    1. Buul E, Rijpkema A, Steegers E, Jonggsma T, Eskes P. Chronic dietary sodium restriction in pregnancy reduces calcium intake. J Perinat Med 1992;20 Suppl 1:216.
Netherlands 1998 {published data only}
    1. Knuist M, Bonsel GJ, Zondervan HA, Treffers PE. Low sodium diet and pregnancy‐induced hypertension: a multi‐centre randomised controlled trial. Br J Obstet Gynaecol 1998;105:430‐434. - PubMed

References to studies excluded from this review

Australia 1986a {published data only}
    1. Brown MA, Gallery EDM. Sodium excretion in human pregnancy: a role for arginine vasopressin. Am J Obstet Gynecol 1986;154:914‐919. - PubMed
Australia 1986b {published data only}
    1. Brown MA, Sinosich MJ, Saunders DM, Gallery EDM. Potassium regulation and progesterone‐aldosterone interrelationships in human pregnancy: a prospective study. Am J Obstet Gynecol 1986;155:349‐353. - PubMed
UK 1958 {published data only}
    1. Robinson M. Salt in pregnancy. Lancet 1958;1:178‐181. - PubMed
UK 1961 {published data only}
    1. Bower D. The influence of dietary salt intake on pre‐eclampsia. J Obstet Gynaecol Br Cmmwlth 1961;63:123‐126. - PubMed
USA 1961 {published data only}
    1. Mengert WF, Tacchi DA. Pregnancy toxemia and sodium chloride ‐ preliminary report. Am J Obstet Gynecol 1961;81:601‐605. - PubMed

Additional references

Green 1989
    1. Green J. Diet and the prevention of pre‐eclampsia. In: Chalmers I, Enkin MW, Keirse MJNC editor(s). Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press, 1989:281‐300.

References to other published versions of this review

Duley 1995
    1. Duley L. Low vs high salt intake in pregnancy.. Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database. 1995, Issue 2.

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