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Could antioxidant supplementation prevent pre-eclampsia?

Published online by Cambridge University Press:  07 March 2007

Valerie A. Holmes  and
David R. McCance
Valerie A. Holmes
Affiliation:
Centre for Clinical and Population Sciences, Queen's University Belfast, Belfast BT7 1NN, UK
David R. McCance*
Affiliation:
Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast BT12 6BA, UK
*
*Corresponding author: Dr D. R. McCance, fax +44 2890 235900, email [email protected]
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Abstract

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Pre-eclampsia is a disorder characterised by pregnancy-induced hypertension and new-onset proteinuria occurring in the second half of pregnancy. Worldwide, approximately 2–3% of all pregnant women develop pre-eclampsia. The condition is a major cause of maternal and fetal morbidity and mortality. Abnormal placentation is an important predisposing factor for pre-eclampsia, while endothelial activation appears to be central to the pathophysiological changes, possibly indicative of a two-stage disorder characterised by reduced placental perfusion and a maternal syndrome. There is increasing evidence that pre-eclampsia is associated with both increased oxidative stress and reduced antioxidant defences, which has led to the hypothesis that oxidative stress may play an important role in the pathogenesis of pre-eclampsia, perhaps acting as the link in a two-stage model of pre-eclampsia. In support of this hypothesis a small, but important, preliminary study has shown a highly significant (P = 0.02) reduction in the incidence of pre-eclampsia in women at risk who were taking a supplement of vitamins C and E from mid-pregnancy. Furthermore, these findings support the hypothesis that oxidative stress is at least partly responsible for the endothelial dysfunction of pre-eclampsia. Several larger multicentre trials are currently underway to evaluate the efficacy, safety and cost benefits of antioxidant supplementation during pregnancy for the prevention of pre-eclampsia in both low- and high-risk women, including women with diabetes. The results of these trials are awaited with interest.

Keywords

AntioxidantsPre-eclampsiaOxidative StressPregnancyDiabetes
Type
Symposium on ‘Micronutrients through the life cycle’
Information
Proceedings of the Nutrition Society , Volume 64 , Issue 4 , November 2005 , pp. 491 - 501
Copyright
Copyright © The Nutrition Society 2005

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