Pre-eclampsia and Pregnancy-induced Hypertension

Uses

  • Eclampsia
  • Gestational Hypertension
  • Hypertension of Pregnancy
  • PIH
  • Toxemia (Pregnancy)
Pre-eclampsia is high blood pressure during pregnancy. It can cause headaches, nausea, and chest pain. Pre-eclampsia can lead to eclampsia which can cause harm to the baby.
It is treated with medicine and home care. The baby may be delivered early in some women. Natural therapies have been used to lower the risk of preeclampsia. They should not be used in place of standard care.

Natural Therapies

Likely Effective

These supplements are likely to lower the risk:
  • Arginine can be taken as a supplement and is also likely to lower blood pressure. (Note: It should not be taken by women who have heart problems or who have had a heart attack.) A4, A5
  • Calcium is an essential nutrient found in some food products that can be taken as a supplement. (Note: It should not be taken by women who have heart problems.) A3, A7, A9, A12, A13, A29
  • Magnesium is a mineral in the body, in foods, and taken as a supplement. A1, A2, A27, A28
  • Selenium is a mineral found in many foods and in supplements. A21
  • Vitamin D is available in a few foods and as a supplement. Your body also makes it in response to sunlight. A6, A10, A11, A17, A18

May Be Effective

These therapies may lower the risk:
  • Folic acid is a vitamin that is found in foods and can be taken as a supplement. A14, A15, A16, A20, A24
  • Medical food containing L-arginine and antioxidant vitamins C2
  • Micronutrients are elements that are needed by the body for health. C1

May Not Be Effective

n-3 long-chain polyunsaturated fatty acids may not provide benefit. A31

Unlikely to Be Effective

These supplements are unlikely to provide benefit:

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:
  • Arginine should not be taken by women who have heart problems or who have had a heart attack.
  • Calcium should not be taken by women who have heart problems. It may worsen symptoms.

References

A Herbs and Supplements
A1 Duley L, Gülmezoglu AM, et al. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010;(11):CD000025.
A2 Duly L, Henderson-Smart DJ, et al. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev. 2010;(12):CD000127.
A3 Imdad A, Jabeen A, et al. Role of calcium supplementation during pregnancy in reducing risk of developing gestational hypertensive disorders: a meta-analysis of studies from developing countries. BMC Public Health. 2011;11(3):S18
A4 Zhu Q, Yue X, et al. Effect of L-arginine supplementation on blood pressure in pregnant women: a meta-analysis of placebo-controlled trials. Hyperten Pregnancy. 2013;32(1):32-41.
A5 Gui S, Jia J, et al. Arginine supplementation for improving maternal and neonatal outcomes in hypertensive disorder of pregnancy: a systematic review. J Renin Angiotensin Aldosterone Syst. 2014;15(1):88-96.
A6 De-Regil LM, Palacios C, et al. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2016;(1):CD008873.
A7 Khaing W, Vallibhakara SA, et al. Calcium and Vitamin D Supplementation for Prevention of Preeclampsia: A systematic Review and Network Meta-Analysis. Nutrients. 2017;9(10):E1141.
A8 Tenório MB, Ferreira RC, et al. Oral antioxidant therapy for prevention and treatment of preeclampsia: Meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2018;28(9):865-876.
A9 Hofmeyr GJ, Lawrie TA, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2018;10:CD001059.
A10 Maugeri A, Barchitta M, et al. Effect of Vitamin D Supplementation During Pregnancy on Birth Size: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2019;11(2):E442.
A11 Palacios C, Kostiuk LK, et al. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019 Jul 26;7:CD008873.
A12 Sun X, Li H, et al. The association between calcium supplement and preeclampsia and gestational hypertension: a systematic review and meta-analysis of randomized trials. Hypertens Pregnancy. 2019 May;38(2):129-139.
A13 Hofmeyr GJ, Betrán AP, et al. Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2019 Jan 26;393(10169):330-339.
A14 Wen SW, White RR, et al. Effect of high dose folic acid supplementation in pregnancy on pre-eclampsia (FACT): double blind, phase III, randomised controlled, international, multicentre trial. BMJ. 2018 Sep 12;362:k3478.
A15 Liu C, Liu C, et al. Supplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis. Arch Gynecol Obstet. 2018 Oct;298(4):697-704.
A16 Bulloch RE, Lovell AL, et al. Maternal folic acid supplementation for the prevention of preeclampsia: A systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2018 Jul;32(4):346-357.
A17 Roth DE, Leung M, et al. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ. 2017 Nov 29;359:j5237.
A18 Purswani JM, Gala P, et al. The role of vitamin D in pre-eclampsia: a systematic review. BMC Pregnancy Childbirth. 2017 Jul 15;17(1):231.
A19 Wilson RL, Grieger JA, et al. Association between Maternal Zinc Status, Dietary Zinc Intake and Pregnancy Complications: A Systematic Review. Nutrients. 2016 Oct 15;8(10). pii: E641. Review.
A20 Sayyah-Melli M, Ghorbanihaghjo A, et al. The Effect of High Dose Folic Acid throughout Pregnancy on Homocysteine (Hcy) Concentration and Pre-Eclampsia: A Randomized Clinical Trial. PLoS One. 2016 May 11;11(5):e0154400.
A21 Xu M, Guo D, et al. Selenium and Preeclampsia: a Systematic Review and Meta-analysis. Biol Trace Elem Res. 2016 Jun;171(2):283-292.
A22 Rumbold A, Ota E, et al. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015 Sep 29;(9):CD004072.
A23 Rumbold A, Ota E, et al. Vitamin E supplementation in pregnancy. Cochrane Database Syst Rev. 2015 Sep 7;(9):CD004069.
A24 Yang X, Chen H, et al. Periconceptional folic acid fortification for the risk of gestational hypertension and pre-eclampsia: a meta-analysis of prospective studies. Matern Child Nutr. 2016 Oct;12(4):669-679.
A25 Chen B, Ji X, et al. Fish Oil Supplementation does not Reduce Risks of Gestational Diabetes Mellitus, Pregnancy-Induced Hypertension, or Pre-Eclampsia: A Meta-Analysis of Randomized Controlled Trials. Med Sci Monit. 2015 Aug 9;21:2322-30.
A26 Salam RA, Zuberi NF, et al. Pyridoxine (vitamin B6) supplementation during pregnancy or labour for maternal and neonatal outcomes. Cochrane Database Syst Rev. 2015 Jun 3;(6):CD000179.
A27 Alves JG, de Araújo CA, et al. The BRAzil MAGnesium (BRAMAG) trial: a randomized clinical trial of oral magnesium supplementation in pregnancy for the prevention of preterm birth and perinatal and maternal morbidity. BMC Pregnancy Childbirth. 2014 Jul 8;14:222.
A28 Makrides M, Crosby DD, et al. Magnesium supplementation in pregnancy. Cochrane Database Syst Rev. 2014 Apr 3;(4):CD000937.
A29 Hofmeyr GJ, Belizán JM, et al. Low-dose calcium supplementation for preventing pre-eclampsia: a systematic review and commentary. BJOG. 2014 Jul;121(8):951-957.
A30 Dante G, Pedrielli G, et al. Herb remedies during pregnancy: a systematic review of controlled clinical trials. J Matern Fetal Neonatal Med. 2013 Feb;26(3):306-312.
A31 Imhoff-Kunsch B, Briggs V, et al. Effect of n-3 long-chain polyunsaturated fatty acid intake during pregnancy on maternal, infant, and child health outcomes: a systematic review. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1:91-107.
A32 Dror DK, Allen LH. Interventions with vitamins B6, B12 and C in pregnancy. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1:55-74.
A33 Zhou SJ, Yelland L, et al. Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia. Am J Clin Nutr. 2012 Jun;95(6):1378-1384.
A34 Rossi AC, Mullin PM. Prevention of pre-eclampsia with low-dose aspirin or vitamins C and E in women at high or low risk: a systematic review with meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2011 Sep;158(1):9-16.
A35 Conde-Agudelo A, Romero R, et al. Supplementation with vitamins C and E during pregnancy for the prevention of preeclampsia and other adverse maternal and perinatal outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2011 Jun;204(6):503.e1-12.
A36 McCance DR, Holmes VA, et al; Diabetes and Pre-eclampsia Intervention Trial (DAPIT) Study Group. Vitamins C and E for prevention of pre-eclampsia in women with type 1 diabetes (DAPIT): a randomised placebo-controlled trial. Lancet. 2010 Jul 24;376(9737):259-266.
A37 Roberts JM, Myatt L, et al. Vitamins C and E to prevent complications of pregnancy-associated hypertension. N Engl J Med. 2010 Apr 8;362(14):1282-1291.
A38 Olatunbosun F, Gratton R, et al. An international trial of antioxidants in the prevention of preeclampsia (INTAPP). Am J Obstet Gynecol. 2010 Mar;202(3):239.e1-239.e10.
B Mind Body Therapies
B1 Haruna M, Matsuzaki M, et al. Guided imagery for treating hypertension in pregnancy. Cochrane Database Syst Rev. 2019 Apr 27;4:CD011337.
C Other Therapies
C1 Zerfu TA, Ayele HT. Micronutrients and pregnancy; effect of supplementation on pregnancy and pregnancy outcomes: a systematic review. Nutr J. 2013 Jan 31;12:20.
C2 Vadillo-Ortega F, Perichart-Perera O, et al. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ. 2011 May 19;342:d2901.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 08/2019
  • Update Date: 05/11/2020