Pregnancy Outcomes after Preeclampsia: The Effects of Interpregnancy Weight Change

Tabet, Maya; Banna, Soumya; Luong, Lan; Kirby, Russell S.; Chang, Jen Jen

doi:10.1055/s-0040-1713000

Cited by 8 publications

(9 citation statements)

References 54 publications

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“…The Institute of Medicine defines recommended GWG for pregnant women, stratified by pre-pregnancy BMI (see table 3). 24 Interpregnancy weight gain has also been shown to increase the risk of pre-eclampsia and of recurrent pre-eclampsia; therefore, excessive weight gain during pregnancy and between pregnancies should be avoided 20 25 26. The aim is to maintain a healthy weight prior to conception.…”

Section: Resultsmentioning

confidence: 99%

Dietary factors that affect the risk of pre-eclampsia

Perry

Stephanou

Rayman

2022

BMJNPH

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Pre-eclampsia affects 3%–5% of pregnant women worldwide and is associated with a range of adverse maternal and fetal outcomes, including maternal and/or fetal death. It particularly affects those with chronic hypertension, pregestational diabetes mellitus or a family history of pre-eclampsia. Other than early delivery of the fetus, there is no cure for pre-eclampsia. Since diet or dietary supplements may affect the risk, we have carried out an up-to-date, narrative literature review to assess the relationship between nutrition and pre-eclampsia. Several nutrients and dietary factors previously believed to be implicated in the risk of pre-eclampsia have now been shown to have no effect on risk; these include vitamins C and E, magnesium, salt, ω-3 long-chain polyunsaturated fatty acids (fish oils) and zinc. Body mass index is proportionally correlated with pre-eclampsia risk, therefore women should aim for a healthy pre-pregnancy body weight and avoid excessive gestational and interpregnancy weight gain. The association between the risk and progression of the pathophysiology of pre-eclampsia may explain the apparent benefit of dietary modifications resulting from increased consumption of fruits and vegetables (≥400 g/day), plant-based foods and vegetable oils and a limited intake of foods high in fat, sugar and salt. Consuming a high-fibre diet (25–30 g/day) may attenuate dyslipidaemia and reduce blood pressure and inflammation. Other key nutrients that may mitigate the risk include increased calcium intake, a daily multivitamin/mineral supplement and an adequate vitamin D status. For those with a low selenium intake (such as those living in Europe), fish/seafood intake could be increased to improve selenium intake or selenium could be supplemented in the recommended multivitamin/mineral supplement. Milk-based probiotics have also been found to be beneficial in pregnant women at risk. Our recommendations are summarised in a table of guidance for women at particular risk of developing pre-eclampsia.

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Section: Resultsmentioning

confidence: 99%

Dietary factors that affect the risk of pre-eclampsia

Perry

Stephanou

Rayman

2022

BMJNPH

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“…47,48 In addition, postpartum patients may be more motivated to adopt a healthier lifestyle for family benefit, rather than for individual benefit. 49 Interpregnancy CVD risk factor control (e.g., weight loss) also appears to be important for subsequent pregnancy outcomes 50 and offspring health. 51 Drawing connections between the patient's health and their present and future family's wellness can strengthen postpartum CVD risk counseling and management.…”

Section: Discussionmentioning

confidence: 99%

Primary Care–Based Cardiovascular Disease Risk Management After Adverse Pregnancy Outcomes: a Narrative Review

et al. 2022

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Several common adverse pregnancy outcomes can reveal subclinical or latent cardiovascular disease (CVD) risk, transiently exposed through the physiologic stress of pregnancy. The year after pregnancy may be a singular opportunity to identify and initiate treatment for CVD risk, even before the onset of traditional CVD risk factors. However, clinical guidance regarding CVD risk management after adverse pregnancy outcomes is lacking. We therefore conducted a systematic review of US clinical practice guidelines and professional society recommendations to inform primary care-based CVD risk management after adverse pregnancy outcomes. We identified 13 relevant publications. While most recommendations were based on limited or weak evidence, we identified several areas of consensus. First, individuals with an adverse pregnancy outcome associated with future CVD are likely to benefit from CVD risk assessment-accompanied by education, counseling, and support for lifestyle modification-beginning within the first postpartum year. Second, among clinicians, clear and consistent documentation about adverse pregnancy outcomes and recommended follow-up is important to coordinate care after pregnancy. In addition, patients need to be informed about their pregnancy complications and associated CVD risks, so that they can make informed health care and lifestyle decisions. Finally, in general, CVD prevention in the year after an adverse pregnancy outcome focuses on lifestyle modification, reserving pharmacotherapy for the highest-risk patients and those with traditional CVD risk factors. While postpartum lifestyle interventions show promise for reducing CVD risk after adverse pregnancy outcomes, continued research to determine the optimal content, timing, and long-term effects of such interventions is needed.

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“…For example, obesity is a risk factor for pregnancy and this risk is added to the risk inherent to CKD [ 76 ]. However, for an obese woman losing weight is a difficult task, and setting too low a weight level to reach before pregnancy may prove to be frustrating and useless.…”

Section: Setting Pre-pregnancy Goalsmentioning

confidence: 99%

Pre-gestational counselling for women living with CKD: starting from the bright side

Da Silva,

Orozco-Guillén,

Longhitano

et al. 2024

Clinical Kidney Journal

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Pregnancy in women living with chronic kidney disease (CKD) was often discouraged due to the risk of adverse maternal-fetal outcomes and the progression of kidney disease. This negative attitude has changed in recent years, with greater emphasis on patient empowerment than on the imperative “non nocere”. Although risks persist, pregnancy outcomes even in advanced CKD have significantly improved, both for the mother and the new-born. Adequate counselling can help to minimize risks and support a more conscious and informed approach to those that are unavoidable. Pre-conception counselling enables a woman to plan the most appropriate moment for her to try to become pregnant. Counselling is context sensitive and needs to be discussed also within an ethical framework. Classically, counselling is more focused on risks than on the probability of a successful outcome. “Positive counselling”, highlighting also the chances of a favourable outcome can help to strengthen the patient-physician relationship, which is a powerful means of optimizing adherence and compliance. Since, due to the heterogeneity of CKD, giving exact figures in single cases is difficult and may even be impossible, a scenario-based approach may help understanding and facing favourable outcomes and adverse events. Pregnancy outcomes modulate the future life of the mother and of her baby; hence the concept of “post partum” counselling is also introduced, discussing how pregnancy results may modulate the long-term prognosis of the mother and the child and the future pregnancies.

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Pregnancy Outcomes after Preeclampsia: The Effects of Interpregnancy Weight Change

Cited by 8 publications

References 54 publications

Dietary factors that affect the risk of pre-eclampsia

Dietary factors that affect the risk of pre-eclampsia

Primary Care–Based Cardiovascular Disease Risk Management After Adverse Pregnancy Outcomes: a Narrative Review

Pre-gestational counselling for women living with CKD: starting from the bright side

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