supplements in pregnancy

[expert@preeclampsia.org]

What supplements are recommended for subsequent pregnancies after a hypertensive pregnancy? I have noticed that other women are told to supplement with baby aspirin, vitamins C and E, calcium, folic acid, omega 3s like flaxseed oil... and that some women have been put on low-salt diets. Which steps are supported by the current research, and should women with chronic hypertension be taking different supplements from women with clotting problems or from women with no known risk factors apart from a previous pregnancy with PE?

[expert@preeclampsia.org]

The data during pregnancy certainly does not support Ca, vit E or vit C for the prevention of preeclampsia. Vit E and C could be harmful. Aspirin may help a few women, we just do not know clearly who they are.

[expert@preeclampsia.org]

A quick answer is the rcommended diet for pregnancy and a standard prenatal vitamin is the only recommendation I would give.

[expert@preeclampsia.org]

There are currently two interventions which based on evidence my be helpful. Aspirin in meta-analyisis of 35,000 women had a small effect to improve outcome. However the effect is quite small and was not demonstrated in studies of high or low risks groups in the US, The Royal College of Ob gyn in England says that aspirin may be useful in very high risk women. I would categorize very high risk as preeclampsia in more than one pregnancy or chronic hypertension with preeclampsia in a prior pregnancy. Calcium may be useful in women with very low calcium intake (unlikely in the USA).

Observational studies suggest that taking vitamins prior to pregnancy reduces preeclampsia and there is solid evidence that folic acid taken prior to pregnancy reduced the risk of neural tube defects. Thus taking folic acid 0.4 mg/day as part of a preconceptional vitamin use is a very good idea for neural tube defect prevention and might reduce preeclampsia.