To prevent hypertensive pregnancy diseases (hypertension in pregnancy), attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Diet
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Overweight (BMI ≥ 25; obesity) – with obesity from a BMI of 35 quadruples the risk.
Environmental pollution – intoxications (poisonings).
- Air pollutants: particulate matter (PM2.5) and nitrogen oxides.
Prevention factors (protective factors)
- Calcium (at least 1 g/die) – when alimentary intake (food intake) is low and the risk of preeclampsia PE is high).
- Acetylsalicylic acid (ASA).
- According to Cochrane analysis, especially pregnant women with preexisting risk factors (e.g., PE in previous pregnancy) may benefit from ASA (75-150 mg)Recommendation: daily oral administration of 70-150 mg acetylsalicylic acid (in Germany, the administration of 100 mg is established) from 16 weeks of pregnancy to 36 weeks gestation.
- ASA treatment (150 mg/d) restricted to pregnant women at highest risk, was able to reduce the number of preeclampsias with delivery before 37 weeks by two-thirds (ASA group: 1.6%; placebo group: 4.3%)
- In a randomized clinical trial, metformin significantly reduced the incidence of preeclampsia in pregnant women with obesity but without gestational diabetes (placebo arm, 11.3% preeclampsia; metformin arm, 3%). However, the goal of reducing the rate of infants with macrosomia was missed.
Notice: Nonsteroidal anti-inflammatory drugs (NSAIDs) can damage kidney function in fetuses. This can lead to amniotic fluid deficiency.Between the 20th and 30th week of pregnancy, the NSAID should only be used in exceptional cases. Beyond the 30th week, a contraindication already applies. Low-dose (81 mg) acetylsalicylic acid was excluded from the warning.
Notice. Any eclampsia doubles the risk of subsequent apoplexy (stroke).
