Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 5;19(1):188.
doi: 10.1186/s12978-022-01485-9.

Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review

Mai-Lei Woo Kinshella  1 , Shazmeen Omar  1 , Kerri Scherbinsky  1   2 , Marianne Vidler  1 , Laura A Magee  1   3 , Peter von Dadelszen  1   3 , Sophie E Moore  3   4 , Rajavel Elango  5   6 ; PRECISE Conceptual Framework Working Group
Collaborators, Affiliations

Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review

Mai-Lei Woo Kinshella et al. Reprod Health. .

Abstract

Background: Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia.

Methods: A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility.

Results: The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence.

Conclusion: A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.

Plain language summary

Pre-eclampsia is a condition of high blood pressure during the second half of pregnancy with signs of damage to another organ system, often the liver and kidneys. It is a serious and potentially deadly disease and is the second top cause of deaths related to pregnancy and childbirth globally. Though the exact cause of pre-eclampsia is unclear, researchers have discovered that pre-eclampsia develops through abnormal development of the placenta, which is the interface between the growing baby and the mother in the womb. The placenta helps to transfer nutrients, oxygen and waste between the mother and fetus. Nutrition has important roles to play in the development of the placenta and certain vitamins and minerals have clinical properties that may help prevent pre-eclampsia. We conducted a review to summarize observational studies on maternal nutritional risk factors associated with the development of pre-eclampsia. Promising maternal dietary factors that fit with current understandings of how pre-eclampsia develops include vitamin C and its potential relationship with iron, calcium and vitamin D. Healthy dietary patterns with high consumption of fruits, vegetables, whole grains, fish and seafood and monounsaturated vegetable oils are likely beneficial. Foods high in added sugar, such as sugary drinks, may be linked to higher rates of developing pre-eclampsia. Instead of focusing on single nutrient deficiencies, our findings support a broader approach to explore interrelationships between dietary factors and balanced healthy dietary intake for the prevention of pre-eclampsia.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016;36:83–102. doi: 10.1016/j.bpobgyn.2016.05.005. - DOI - PMC - PubMed
    1. Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72:24–43. doi: 10.1161/HYPERTENSIONAHA.117.10803. - DOI - PubMed
    1. von Dadelszen P, Ayres de Campos D, Barivalala W. Classification of the hypertensive disorders of pregnancy. In: Magee L, von Dadelszen P, Stones W, Mathai M, editors. The FIGO textbook of pregnancy hypertension. London: The Global Library of Women’s Medicine; 2016. pp. 33–61.
    1. Magee LA, Sharma S, Nathan HL, Adetoro OO, Bellad MB, Goudar S, et al. The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: a prospective population-level analysis. PLoS Med. 2019;16(4):e1002783. doi: 10.1371/journal.pmed.1002783. - DOI - PMC - PubMed
    1. Payne B, Hanson C, Sharma S, Magee L, von Dadelszen P. Epidemiology of the hypertensive disorders of pregnancy. In: Magee L, von Dadelszen P, Stones W, Mathai M, editors. The FIGO textbook of pregnancy hypertension. London: The Global Library of Women’s Medicine; 2016. pp. 63–74.

Publication types