In August last year I wrote about the possible role of a diet in the prevention of preeclampsia with specific reference to maintaining a healthy body weight, dietary fibre, fruits, vegetables, antioxidant vitamins and omega 3 fatty acids. I was very interested to read a recently published study (1) which has found that regular multivitamin use in the very early period of pregnancy is associated with a reduced risk of preeclampsia in normal weight, but not overweight, women.
Preeclampsia is a very serious condition. Around 3% of all pregnant women suffer from preeclampsia each year and it is the principal cause of maternal death in the UK. Preeclampsia is a form of high blood pressure that develops in conjunction with water retention and/or excess protein in the urine. Around 10 mothers and 1000 babies die each year as a result of the effects of preeclampsia and the condition is also the most common reason for elective, often early, delivery. Usually preeclampsia occurs between the 20th week of Pregnancy and the end of the first week postpartum. The earlier it presents in pregnancy the more threatening it can become. For more information please visit the Action On Pre-eclampsia charity website.
The study (1) looked at a large group of Danish women, over 28,000 women, between the years 1997-2003 who reported multivitamin supplement use during a 12 week periconceptional period, the very earliest weeks of pregnancy, measured as 4 weeks prior to and 8 weeks after the last menstrual period. The researchers then looked to see whether the frequency and timing of multivitamin use was associated with preeclampsia risk – regular use of multivitamins in the periconceptual period was related to a reduced risk of preeclampsia among normal-weight women. Compared with women who did not use multivitamins, regular multivitamin users with the same body mass index (of 22) had a 20% reduced risk of preeclampisa. In addition, regular use of multivitamins in the post-conception period only seemed to be associated with a reduced risk of preeclampsia in women with a BMI less than 25 (a healthy BMI is usually measured at 18.5-20). This is only an association study, it does not show cause and effect and further controlled supplement trials are certainly necessary before any firm conclusions can be drawn. However, the data does indicate that multivitamins in early pregnancy may be useful in preventing preeclampsia in some women.
BMI (Body Mass Index) is a measure often used for healthy weight, it is worked out as weight divided by height squared. To check your own BMI you may find it useful to visit the Food Standards Agency website where an online BMI calculator can be found.
In previous weeks I have talked about early use of folic acid and vitamin B12 being important for a number of pregnancy related conditions so a multi-nutrient supplement could be a way of ensuring a good intake of a variety of nutrients linked to improved health of both the mother and child during pregnancy. Many multi-nutrient preparations are available specifically for use by pregnant women but please always check with a doctor or health professional before starting supplementation if you are planning a pregnancy. It is also important for me to mention that supplements cannot be seen as an alternative to a healthy diet and lifestyle. Pregnant women really do need to ensure that they are eating well in order to give their baby the best start in life. A healthy diet, low in processed and refined foods and rich in vegetables, fruits, oily fish, lean unprocessed meats and fish, nuts/seeds, beans, pulses and unrefined/unprocessed wholegrains will go far in providing the body with an abundance of vitamins, minerals, flavonoids (bioactive plant chemicals) and essential fats.
Since I seem to be mentioning Vitamin D quite regularly I thought I would briefly include a study(2) that I came across very recently. The researchers wanted to see if intake of vitamin D during pregnancy was associated with preeclampsia risk. The study involved 23,423 Norwegian pregnant women who had not previously had children.
Participating women filled in questionnaires at week 15, 22, and 30 of pregnancy. From these questionnaires nutrient intakes were calculated from food and dietary supplements. Data showed that women with the lowest levels of vitamin D were more at risk of developing preeclampsia than women with the highest levels. When the data was analysed to considering only the intake of vitamin D from supplements, the scientists found a 27% reduction in risk of preeclampsia for women taking 10-15 micrograms per day compared with women taking no supplements. No association was found between intake of vitamin D from the diet alone and the occurrence of preeclampsia. The report concludes (2) that “These findings are consistent with other reports of a protective effect of vitamin D on preeclampsia development”. However, the authors make an interesting point: Vitamin D intake is highly correlated with the intake of long chain omega 3 fatty acids in the Norwegian diet and further research is needed to disentangle the separate effects of these nutrients. Oily fish are a great source of omega 3 fatty acids and one of the few good dietary sources of vitamin D.
As mentioned in many blog posts on Vitamin D many of us in the UK do not achieve good levels from the diet or from sunlight exposure. If you rarely get out into the sun, you may wish to consider a vitamin D supplement which provides around 12mcg/day (around 500iu a day). Such a supplement may be particularly useful during the autumn and winter months. Before considering any supplementation during pregnancy please check with your doctor and be aware that multi-vitamin and mineral supplement may already contain ample amounts of vitamin D.
(1)Catov JM et al. 2009. Association of Periconceptional Multivitamin Use With Reduced Risk of Preeclampsia Among Normal-Weight Women in the Danish National Birth Cohort. American Journal of Epidemiology 2009 169(11):1304-1311; doi:10.1093/aje/kwp052
(2) Haugen M et al. 2009. Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology. [Epub ahead of print]
Written by Ani Kowal
Related posts:
- Low vitamin D levels linked to preeclampsia
- Can a healthy diet help reduce the risk of developing preeclampsia during pregnancy?
- Can vitamin supplements play a role in reducing the risk of miscarriage?
- Can vitamin B12 help to prevent birth defects?
- A group of researchers recommend vitamin D supplementation in pregnancy
