nutrition in preeclampsia pregnancies
I know many of the women on my friends-list are very, very involved with the natural birthing community, so I'm appealing to you for help. This is what I tell people about diet and preeclampsia; any recent peer-reviewed studies you can provide which show something *different* from this would be welcomed.
Caryn, if you wouldn't mind, could you summarize the current state of the art thinking on the influence of diet on preeclampsia? Including what the calcium supplementation studies have led to? (Aw, what the heck, throw in aspirin supplementation while you're at it!)
Sure.
Our best understanding at the moment is that preeclampsia is driven by an immune system response to the foreign placenta, which generally implants shallowly as a result of the maternal immune system response to the wholly foreign trophoblast. (As I understand this epigenetic imprinting halts expression of the maternal genes in the trophoblast; as a result it is entirely paternal rather than fetal and thus entirely foreign -- anyone?)
As pregnancy progresses the baby outstrips the ability of the placenta to ferry blood (since it isn't as well perfused as a normal placenta, since it is shallowly implanted), which causes the placenta to develop hypoxia. Hypoxia upregulates the production of some hepatotoxic proteins that elevate blood pressure and damage the maternal vasculature, leading to the downstream symptoms of preeclampsia.
In other words, the initiating event occurs during the first few weeks of pregnancy during placentation, although symptoms do not develop until many weeks later. We have plenty of studies confirming this as a likely mechanism although many details remain to be worked out; anyone interested should come over to the Preeclampsia Foundation's forum where we post links to all the latest research and hold discussions about it.
In some women with underlying disorders the precipitating event can be elevated baseline levels of inflammation or preexisting kidney damage etc., but even in these cases the placenta develops hypoxia as a result of the innate immune system response associated with inflammation and this relative hypoxia causes the downstream symptoms.
Here's an abstract on the topic of vitamin D deficiency and preeclampsia. As I understand it vitamin D sera deficiencies often go along with autoimmune diseases, which are an independent risk factor for preeclampsia as well; women with autoimmune conditions often develop low levels of vitamin D for reasons having nothing to do with their dietary intake, and supplementing them with oral vitamin D does not necessarily raise their sera levels. It has something to do with genetically variant receptors for D analogues that I am not qualified to explain. I understand further research is ongoing at the University of Pittsburgh.
As for aspirin, this is the most recent study I have.
I have this for calcium. I have this for antioxidant supplementation. I have this on the Brewer diet.
Caryn, if you wouldn't mind, could you summarize the current state of the art thinking on the influence of diet on preeclampsia? Including what the calcium supplementation studies have led to? (Aw, what the heck, throw in aspirin supplementation while you're at it!)
Sure.
Our best understanding at the moment is that preeclampsia is driven by an immune system response to the foreign placenta, which generally implants shallowly as a result of the maternal immune system response to the wholly foreign trophoblast. (As I understand this epigenetic imprinting halts expression of the maternal genes in the trophoblast; as a result it is entirely paternal rather than fetal and thus entirely foreign -- anyone?)
As pregnancy progresses the baby outstrips the ability of the placenta to ferry blood (since it isn't as well perfused as a normal placenta, since it is shallowly implanted), which causes the placenta to develop hypoxia. Hypoxia upregulates the production of some hepatotoxic proteins that elevate blood pressure and damage the maternal vasculature, leading to the downstream symptoms of preeclampsia.
In other words, the initiating event occurs during the first few weeks of pregnancy during placentation, although symptoms do not develop until many weeks later. We have plenty of studies confirming this as a likely mechanism although many details remain to be worked out; anyone interested should come over to the Preeclampsia Foundation's forum where we post links to all the latest research and hold discussions about it.
In some women with underlying disorders the precipitating event can be elevated baseline levels of inflammation or preexisting kidney damage etc., but even in these cases the placenta develops hypoxia as a result of the innate immune system response associated with inflammation and this relative hypoxia causes the downstream symptoms.
Here's an abstract on the topic of vitamin D deficiency and preeclampsia. As I understand it vitamin D sera deficiencies often go along with autoimmune diseases, which are an independent risk factor for preeclampsia as well; women with autoimmune conditions often develop low levels of vitamin D for reasons having nothing to do with their dietary intake, and supplementing them with oral vitamin D does not necessarily raise their sera levels. It has something to do with genetically variant receptors for D analogues that I am not qualified to explain. I understand further research is ongoing at the University of Pittsburgh.
As for aspirin, this is the most recent study I have.
I have this for calcium. I have this for antioxidant supplementation. I have this on the Brewer diet.