Natural treatments for preeclampsia and pregnancy-induced hypertension
Natural treatments for preeclampsia and pregnancy-induced hypertension (PIH) focus on managing increased blood pressure and associated symptoms during pregnancy. Preeclampsia, a serious condition marked by high blood pressure and protein in the urine, can have severe consequences for both mother and baby if left untreated. Among natural remedies, calcium supplementation has been the most extensively studied, showing some promise in reducing the risk of preeclampsia, particularly in women at high risk or with low calcium intake, although evidence is mixed. Other proposed natural treatments include antioxidants like vitamin C and E, which have shown some potential in reducing the incidence of preeclampsia, yet larger studies often fail to confirm these benefits.
Additional treatments such as coenzyme Q10 and magnesium have been explored, with magnesium showing some effectiveness when administered by injection. However, many other compounds, including folate and omega-3 fatty acids, have not consistently demonstrated benefits. While there is interest in various natural supplements, the complexity and risks associated with preeclampsia necessitate that any natural treatments be pursued in conjunction with medical care. The exploration of these natural options underscores the importance of individualized care and the need for further research to establish safe and effective treatment protocols.
Natural treatments for preeclampsia and pregnancy-induced hypertension
DEFINITION: Treatment of increased blood pressure, protein in the urine, and other symptoms during pregnancy.
- PRINCIPAL PROPOSED NATURAL TREATMENT: Calcium
- OTHER PROPOSED NATURAL TREATMENTS: Arginine, coenzyme Q10, evening primrose oil, folate, lycopene, magnesium, N-acetylcysteine, omega-3 fatty acids, vitamin C and vitamin E in combination, zinc
Introduction
Pregnant women occasionally experience an increase in blood pressure known as gestational hypertension or pregnancy-induced hypertension (PIH). In a more severe condition called preeclampsia, a rise in blood pressure is accompanied by protein in the urine and sometimes by sudden weight gain, swelling in the face or hands, and other symptoms. When left untreated, preeclampsia can lead to seizures (called eclampsia) or to liver, kidney, or bleeding problems in the pregnant woman and distress or growth impairments in the fetus. Unless preeclampsia is mild, doctors usually seek to deliver the baby early, as preeclampsia is one of the leading causes of morbidity and mortality amongst pregnant women and fetuses.
Principal Proposed Natural Treatments
Although there are no fully established natural treatments for the prevention of preeclampsia or PIH, calcium has shown significant promise.
Calcium. A meta-analysis (statistical review) of eleven studies of calcium supplementation in pregnancy, involving more than six thousand women, found that calcium slightly reduced the risk of preeclampsia and hypertension, particularly in two groups of women: those at high risk for hypertension and those with low calcium intakes.
However, by far, the largest single study in the meta-analysis found no benefits. In this double-blind study, researchers gave either two grams (g) of calcium or placebo daily to 4,589 women from weeks thirteen to twenty-one of their pregnancy onward. In the end, researchers found no significant decreases in rates of hypertension or preeclampsia, not even when they looked specifically at women whose daily calcium consumption mirrored that of women in developing countries. The meta-analysis included this negative study in its calculations but still found that calcium seemed to be helpful.
In a subsequent double-blind, placebo-controlled study conducted by the World Health Organization, calcium supplements (1.5 g per day) were tried in 8,325 pregnant women whose calcium intake was inadequate. Calcium failed to reduce the incidence of preeclampsia, but it did appear to reduce the severity of preeclampsia episodes. Calcium might be of some benefit for those pregnant women who are at high risk for hypertension or deficient in calcium. However, for well-nourished, low-risk women, effects are likely to be minimal or nonexistent.
One double-blind, placebo-controlled study suggests that calcium supplements are not effective for treating preeclampsia that has already developed. Calcium does, however, appear to offer the additional benefit of reducing blood levels of lead during pregnancy. Weak evidence hints that the use of calcium by pregnant women might reduce the risk of hypertension in their children.
One study examined the impact of various studies on several compounds—baicalin, curcumin, epigallocatechin gallate, punicalagin, quercetin, resveratrol, salvianolic acid A (danshensu), silibinin, and vitexin—and found reasonable support for the use of natural compounds as a compliment to medical care, but because of the seriousness of these conditions, it is critical that medical care is also sought.
Other Proposed Natural Treatments
Antioxidants are substances that fight free radicals, dangerous and naturally occurring molecules that may play a role in preeclampsia. For various theoretical reasons, it has been proposed that the use of antioxidants by pregnant women may help stop preeclampsia from developing. One double-blind, placebo-controlled study found evidence that a combination of the antioxidant vitamin E (400 international units [IU] daily) and vitamin C (1,000 milligrams [mg] daily) reduced the incidence of preeclampsia. Benefits were also seen in another study of this combination and in a study using a mixture of numerous antioxidants with other nutrients. Additionally, a double-blind trial found potential preventive effects with the antioxidant substance lycopene (taken at two mg twice daily). However, researchers caution that further study is necessary: Many other treatments have shown initial promise for preventing preeclampsia, but these treatments lost luster when subsequent studies were performed.
The most prominent of these once-promising substances include folate, magnesium, omega-3 fatty acids (fish oil), and zinc. Furthermore, a large follow-up study of vitamin E combined with vitamin C failed to find any benefit, and in a review of ten studies involving 6,533 persons, antioxidant supplementation (of mostly vitamins E and C) during pregnancy did not reduce the risk of preeclampsia or any of its complications. In addition, a high-quality randomized trial of 1,365 high-risk pregnant women found that daily supplementation with combination vitamin E (400 IU) and vitamin C (1,000 mg) through delivery was not associated with reduced risk of preeclampsia or other serious outcomes.
One study involving 235 pregnant women in Ecuador (average age 17.5 years) suggests that daily supplementation with 200 mg of coenzyme Q10 during the second half of pregnancy may reduce the risk of developing preeclampsia. Though promising, the reliability of these results is in question because of low compliance with the supplements.
Other studies have looked at possible treatments of preeclampsia once it has already occurred. Results are somewhat positive, though mixed, on the potential benefits of arginine for this purpose. Evening primrose oil has failed to prove helpful, as has a combination of vitamin C, vitamin E, and the drug allopurinol. However, magnesium, taken by injection (but not orally) appears to provide meaningful benefits. One study failed to find N-acetylcysteine helpful for severe preeclampsia.
Bibliography
Ożarowski, Marcin, et al. “Plant Phenolics and Extracts in Animal Models of Preeclampsia and Clinical Trials-Review of Perspectives for Novel Therapies.”Pharmaceuticals, vol. 14, no. 3, Mar. 2021, p. 269, doi:10.3390/ph14030269. Accessed 15 Nov. 2024.
"Preeclampsia." Cleveland Clinic, 28 May 2024, my.clevelandclinic.org/health/diseases/17952-preeclampsia. Accessed 15 Nov. 2024.
"Pregnancy Hypertension – How to Lower Blood Pressure Naturally." TopLine MD Alliance, 17 July 2021, www.toplinemd.com/trogolo-obstetrics-and-gynecology/pregnancy-hypertension-how-to-lower-blood-pressure-naturally. Accessed 15 Nov. 2024
Rumbold A. R., and C. A. Crowther, et al. “Vitamins C and E and the Risks of Pre-eclampsia and Perinatal Complications.” New England Journal of Medicine, vol. 354, 2006, pp. 1796-1806.
Rumiris, D., et al. “Lower Rate of Pre-eclampsia after Antioxidant Supplementation in Pregnant Women with Low Antioxidant Status.” Hypertension and Pregnancy, vol. 25, 2006, pp. 241-53.
Staff, A. C., et al. “Dietary Supplementation with L-Arginine or Placebo in Women with Pre-eclampsia.” Acta Obstetricia et Gynecologica Scandinavica, vol. 83, 2004, pp. 103-07.
Teran, E., et al. “Coenzyme Q10 Supplementation during Pregnancy Reduces the Risk of Pre-eclampsia.” International Journal of Gynaecology and Obstetrics, vol. 105, 2009, pp. 43-45.
Villar, J., et al. “World Health Organisation Multicentre Randomised Trial of Supplementation with Vitamins C and E among Pregnant Women at High Risk for Pre-eclampsia in Populations of Low Nutritional Status from Developing Countries.” BJOG: An International Journal of Obstetrics and Gynaecology, vol. 116, 2009, pp. 780-88.