Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review
Authors: Kinshella Mai-Lei Woo , Omar Shazmeen , Scherbinsky Kerri , Vidler Marianne , Magee Laura A. , von Dadelszen Peter , Moore Sophie E. , Elango Rajavel ,   The PRECISE Conceptual Framework Working Group, von Dadelszen Peter , Magee Laura A. , Poston Lucilla , Mistry Hiten D. , Volvert Marie-Laure , Lopez Cristina Escalona , Moore Sophie , Tribe Rachel , Shennan Andrew , Salisbury Tatiana , Chappell Lucy , Craik Rachel , Temmerman Marleen , Etyang Angela Koech , Wanyonyi Sikolia , Omuse Geoffrey , Okiro Patricia , Mwashigadi Grace , Sevene Esperança , Boene Helena , Tchavana Corssino , Macete Eusebio , Carillho Carla , Quimice Lazaro , Maculuve Sonia , Russell Donna , Baratt Ben , Lawn Joy , Blencowe Hannah , Filippi Veronique , Silver Matt , Makanga Prestige Tatenda , Makacha Liberty , Dube Yolisa , Nyapwere Newton , Mlambo Reason , D’Alessandro Umberto , Roca Anna , Martinez-Alvarez Melisa , Jah Hawanatu , Diallo Brahima , Sesay Abdul Karim , Touray Fatima , Sillah Abdoulie , Noble Alison , Papageorghiou Aris , Cartwright Judith , Whitley Guy , Krishna Sanjeev , Townsend Rosemarie , Khalil Asma , Vidler Marianne , Singer Joel , Li Jing , Bone Jeffrey , Kinshella Mai-Lei Woo , Pickerill Kelly , Sandhu Ash , Domena Tu , Elango Rajavel , Stones William 
Published: September 2022

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.