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

TY - JOUR

T1 - Maternal nutritional risk factors for pre-eclampsia incidence

T2 - findings from a narrative scoping review

AU - PRECISE Conceptual Framework Working Group

AU - Kinshella, Mai Lei Woo

AU - Omar, Shazmeen

AU - Scherbinsky, Kerri

AU - Vidler, Marianne

AU - Magee, Laura A.

AU - von Dadelszen, Peter

AU - Moore, Sophie E.

AU - Elango, Rajavel

N1 - Funding Information: The PRECISE Network is funded by the UK Research and Innovation Grand Challenges Research Fund GROW Award scheme (Grant number: MR/P027938/1). MWK is supported by the Vanier Canada Graduate Scholarship funded by the Government of Canada through the Canadian Institutes of Health Research (CIHR); and Canadian Institute of Health Research (FRN 10321) to R.E. Funding Information: This manuscript is part of the PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network. The authors would like to express their gratitude to the PRECISE Team for their support. The PRECISE Conceptual Framework Working Group includes: King’s College London (Peter von Dadelszen, Laura A. Magee, Lucilla Poston, Hiten D. Mistry, Marie-Laure Volvert, Cristina Escalona Lopez, Sophie Moore, Rachel Tribe, Andrew Shennan, Tatiana Salisbury, Lucy Chappell, Rachel Craik); Aga Khan University, Nairobi (Marleen Temmerman, Angela Koech Etyang, Sikolia Wanyonyi, Geoffrey Omuse, Patricia Okiro, Grace Mwashigadi); Centro de Investigação de Saúde de Manhiça (Esperança Sevene, Helena Boene, Corssino Tchavana, Eusebio Macete, Carla Carillho, Lazaro Quimice, Sonia Maculuve); Donna Russell Consulting (Donna Russell); Imperial College London (Ben Baratt); London School of Hygiene and Tropical Medicine (Joy Lawn, Hannah Blencowe, Veronique Filippi, Matt Silver); Midlands State University (Prestige Tatenda Makanga, Liberty Makacha, Yolisa Dube, Newton Nyapwere, Reason Mlambo); MRC Unit The Gambia at LSHTM (Umberto D’Alessandro, Anna Roca, Melisa Martinez-Alvarez, Hawanatu Jah, Brahima Diallo, Abdul Karim Sesay, Fatima Touray, Abdoulie Sillah); University of Oxford (Alison Noble, Aris Papageorghiou); St George’s, University of London (Judith Cartwright; Guy Whitley, Sanjeev Krishna, Rosemarie Townsend, Asma Khalil); University of British Colombia (Marianne Vidler, Joel Singer, Jing Li, Jeffrey Bone, Mai-Lei Woo Kinshella, Kelly Pickerill, Ash Sandhu, Domena Tu, Rajavel Elango); University of Malawi (William Stones). Publisher Copyright: © 2022, The Author(s).

PY - 2022/9/5

Y1 - 2022/9/5

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85137195623&partnerID=8YFLogxK

U2 - 10.1186/s12978-022-01485-9

DO - 10.1186/s12978-022-01485-9

M3 - Review article

C2 - 36064716

AN - SCOPUS:85137195623

SN - 1742-4755

VL - 19

SP - 188

JO - Reproductive Health

JF - Reproductive Health

IS - 1

M1 - 188

ER -