• Sarah GopmanEmail author
  • Larry Leeman
  • Lana K. Wagner
Part of the Nutrition and Health book series (NH)


Preeclampsia is a multi-organ disease that is specific to pregnancy and is characterized by the development of hypertension, with either proteinuria or other evidence of end-organ effects. It complicates 5–7% of pregnancies and specific criteria must be met for diagnosis. The exact etiology or pathophysiology of preeclampsia is poorly understood and as such, there are no well-established methods of primary prevention, or of reliable and cost-effective screening. Calcium and aspirin may have a role in preventing preeclampsia in certain subpopulations, and research continues regarding these and other possible interventions. Preeclampsia is associated with increased maternal mortality and morbidity, and childbirth is the only known cure. Women with preeclampsia need to have regular surveillance. The associated hypertension may warrant treatment under certain conditions, and magnesium sulfate is the drug of choice for the prevention and treatment of eclamptic seizures.


Preeclampsia Eclampsia Hypertensive disorders of pregnancy Gestational hypertension 


  1. 1.
    American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122–31. Scholar
  2. 2.
    Witlin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol. 1998;92(5):883–9.PubMedGoogle Scholar
  3. 3.
    Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennstrom M, et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374(1):13–22. Scholar
  4. 4.
    MacKay AP, Berg CJ, Atrash HK. Pregnancy-related mortality from preeclampsia and eclampsia. Obstet Gynecol. 2001;97(4):533–8.PubMedGoogle Scholar
  5. 5.
    Report of the national high blood pressure education program working group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):S1–S22.Google Scholar
  6. 6.
    ACOG Committee on Practice Bulletins. ACOG practice bulletin. Chronic hypertension in pregnancy. ACOG Committee on practice bulletins. Obstet Gynecol. 2001;98(Suppl 1):177–85.Google Scholar
  7. 7.
    Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2001;2:CD002252. Scholar
  8. 8.
    Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2003;3:CD002863. Scholar
  9. 9.
    ACOG Committee on Obstetric Practice. ACOG Practice Bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Obstet Gynecol. 2002;99(1):159–67.CrossRefGoogle Scholar
  10. 10.
    U.S. Preventive Services Task Force Guide to Clinical Preventative Services. Rockville, MD: Agency for Healthcare Research and Quality (US); 1996.Google Scholar
  11. 11.
    Rodriguez-Thompson D, Lieberman ES. Use of a random urinary protein-to-creatinine ratio for the diagnosis of significant proteinuria during pregnancy. Am J Obstet Gynecol. 2001;185(4):808–11. Scholar
  12. 12.
    Acharya A, Brima W, Burugu S, Rege T. Prediction of preeclampsia-bench to bedside. Curr Hypertens Rep. 2014;16(11):491. Scholar
  13. 13.
    Lin J, August P. Genetic thrombophilias and preeclampsia: a meta-analysis. Obstet Gynecol. 2005;105(1):182–92. Scholar
  14. 14.
    Fong FM, Sahemey MK, Hamedi G, Eyitayo R, Yates D, Kuan V, Thangaratinam S, et al. Maternal genotype and severe preeclampsia: a HuGE review. Am J Epidemiol. 2014;180(4):335–45. Scholar
  15. 15.
    Dekker G, Robillard PY, Roberts C. The etiology of preeclampsia: the role of the father. J Reprod Immunol. 2011;89(2):126–32. Scholar
  16. 16.
    Colucci F, Boulenouar S, Kieckbusch J, Moffett A. How does variability of immune system genes affect placentation? Placenta. 2011;32(8):539–45. Scholar
  17. 17.
    Lynch AM, Salmon JE. Dysregulated complement activation as a common pathway of injury in preeclampsia and other pregnancy complications. Placenta. 2010;31(7):561–7. Scholar
  18. 18.
    Roberts JM, Cooper DW. Pathogenesis and genetics of pre-eclampsia. Lancet. 2001;357(9249):53–6.CrossRefGoogle Scholar
  19. 19.
    Eastabrook G, Brown M, Sargent I. The origins and end-organ consequence of pre-eclampsia. Best Pract Res Clin Obstet Gynaecol. 2011;25(4):435–47. Scholar
  20. 20.
    Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998;179(5):1359–75.CrossRefGoogle Scholar
  21. 21.
    Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C, et al. The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. BMJ. 2005;330(7491):576–80. Scholar
  22. 22.
    Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330(7491):565. Scholar
  23. 23.
    Makrides M, Crosby DD, Bain E, Crowther CA. Magnesium supplementation in pregnancy. Cochrane Database Syst Rev. 2014;4:CD000937. Scholar
  24. 24.
    Makrides M, Duley L, Olsen SF. Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by pre-eclampsia or intrauterine growth restriction. Cochrane Database Syst Rev. 2006;3:CD003402. Scholar
  25. 25.
    Rumbold A, Duley L, Crowther CA, Haslam RR. Antioxidants for preventing pre-eclampsia. Cochrane Database Syst Rev. 2008;1:CD004227. Scholar
  26. 26.
    Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014;6:CD001059. Scholar
  27. 27.
    Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali MM, Zavaleta N, et al. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. Am J Obst Gynecol. 2006;194(3):639–49. Scholar
  28. 28.
    Guideline. Calcium supplementation in pregnant women. Geneva: World Health Organization; 2013.Google Scholar
  29. 29.
    Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007;2:CD004659. Scholar
  30. 30.
    U.S. Preventive Services Task Force. Final recommendation statement: low-dose aspirin to prevent preeclampsia: preventive medication. 2014. Available at: /RecommendationStatementFinal /low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication.
  31. 31.
    Werner EF, Hauspurg AK, Rouse DJ. A cost-benefit analysis of low-dose aspirin prophylaxis for the prevention of preeclampsia in the United States. Obstet Gynecol. 2015;126(6):1242–50. Scholar
  32. 32.
    Frederick IO, Williams MA, Dashow E, Kestin M, Zhang C, Leisenring WM. Dietary fiber, potassium, magnesium and calcium in relation to the risk of preeclampsia. J Reprod Med. 2005;50(5):332–44.PubMedGoogle Scholar
  33. 33.
    Qiu C, Coughlin KB, Frederick IO, Sorensen TK, Williams MA. Dietary fiber intake in early pregnancy and risk of subsequent preeclampsia. Am J Hypertens. 2008;21(8):903–9. Scholar
  34. 34.
    Borgen I, Aamodt G, Harsem N, Haugen M, Meltzer HM, Brantsaeter AL. Maternal sugar consumption and risk of preeclampsia in nulliparous Norwegian women. Eur J Clin Nutr. 2012;66(8):920–5. Scholar
  35. 35.
    Clausen T, Slott M, Solvoll K, Drevon CA, Vollset SE, Henriksen T. High intake of energy, sucrose, and polyunsaturated fatty acids is associated with increased risk of preeclampsia. Am J Obstet Gynecol. 2001;185(2):451–8. Scholar
  36. 36.
    Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003;102(1):181–92.PubMedGoogle Scholar
  37. 37.
    Churchill D, Duley L. Interventionist versus expectant care for severe pre-eclampsia before term. Cochrane Database Syst Rev. 2002;3:CD003106. Scholar
  38. 38.
    Duley L, Henderson-Smart DJ. Drugs for treatment of very high blood pressure during pregnancy. Cochrane Database Syst Rev. 2002;4:CD001449. Scholar
  39. 39.
    Committee on Obstetric Practice. Committee Opinion No. 623: emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2015;125(2):521–5. Scholar
  40. 40.
    Duley L, Gulmezoglu AM, Henderson-Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010;11:CD000025. Scholar
  41. 41.
    Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J, et al. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 2002;359(9321):1877–90.CrossRefGoogle Scholar
  42. 42.
    Sibai BM. Magnesium sulfate prophylaxis in preeclampsia: lessons learned from recent trials. Am J Obstet Gynecol. 2004;190(6):1520–6. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Family and Community MedicineUniversity of New MexicoAlbuquerqueUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of New MexicoAlbuquerqueUSA
  3. 3.Presbyterian Westside Sleep Disorders CenterRio RanchoUSA

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