La prevención de la preeclampsia: un estudio de casos y controles anidado en una cohorte

Abstract

Background: Preeclampsia is the main complication of pregnancy in developing countries. Calcium starting at 14 weeks of pregnancy is indicated to prevent the disease. Recent advances in prevention of preeclampsia endorse the addition of conjugated linoleic acid. Objective: To estimate the protective effect from calcium alone, compared to calcium plus conjugated linoleic acid in nulliparous women at risk of preeclampsia. Methods: A case-control design nested in the cohort of nulliparous women attending antenatal care from 2010 to 2014. The clinical histories of 387 cases of preeclampsia were compared with 1,054 normotensive controls. The exposure was prescriptions for calcium alone, the first period, or calcium plus conjugated linoleic acid, the second period, from 12 to 16 weeks of gestational age to labor. Confounding variables were controlled, allowing only nulliparous women into the study and stratifying by age, education and ethnic group. Results: The average age was 26.4 yrs old (range= 13-45), 85% from mixed ethnic backgrounds and with high school education. There were no differences between women who received calcium carbonate and those who did not (OR= 0.96; 95% CI= 0.73-1.27). The group of adolescents (13 to 18 years old) in the calcium plus conjugated linoleic acid was protected for preeclampsia (OR= 0.00; 95% CI= 0.00-0.44) independent of the confounder variables. Conclusions: 1. Calcium supplementation during pregnancy did not have preventive effects on preeclampsia. 2. Calcium plus Conjugated Linoleic acid provided to adolescents was observed to have preventive effect on Preeclampsia.

Metabolomic analysis of serum and placenta in preeclampsia

“…Herse et al reported that the EETs including 5,6-EET, 14,15-EET, and the dihydroxyeicosatrienoic acids, were elevated in the preeclamptic women due to the up-regulated expression of the CYP subfamily 2J polypeptide 2 (CYP2J2) [34]. More importantly, the supplement of linoleic acid during pregnancy has been reported to be bene cial to the prevention and management of PE [35].…”

Evaluation of Serum Calcium Levels in Pre-eclampsia

“…For example, Levine et al 23 in a prospective study in American population showed that calcium supplementation during pregnancy did not prevent preeclampsia in healthy nulliparous women. Recently Alzate et al 24 reported that calcium supplementation during pregnancy did not have preventive effects on preeclampsia. But calcium plus conjugated linoleic acid provided to adolescents was observed to have preventive effect on preeclampsia.…”

Calcium and linoleic acid supplements in the prevention of pre-eclampsia.

“…Alzate et al 1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4732504/ , conducted a nested case-control study to (quote) "estimate the protective effect from calcium [supplement] alone [CC], compared to calcium plus conjugated linoleic acid [CC+CLA] in nulliparous women at risk of preeclampsia". Based on a crude analysis of the data in Table 3 1 , they concluded that neither CC nor CC+CLA reduced the risk of preeclampsia in the whole sample, but that CC+CLA significantly decreased risk among women 13-18 years old. A quick look analysis of the data in this table shows this conclusion is mostly based on the fact that none of the cases in 13-18 year old women was treated with CC+CLA.…”