Are there effective preeclampsia prevention strategies?
Comparative effectiveness of prophylactic strategies for preeclampsia: a network meta-analysis of randomized controlled trials
Finding strategies for preventing preeclampsia is a top priority in the field of preeclampsia research. In this study, the authors reviewed all research papers available up until September 2021 that reported the effect of a preeclampsia prevention strategy and compared the strategies and how well they worked. (What is known as a meta-analysis.)
A total of 130 trials and 112,916 participants were included in this study, spanning 13 strategies for preeclampsia prevention. The strategies studied were lifestyle strategies (exercise, rest), medications (aspirin, metformin, pravastatin, low molecular weight heparin), and supplements (fish oil, folic acid, magnesium, selenium, vitamin C and E, vitamin D, and calcium). The analysis found that aspirin, exercise, calcium supplementation, vitamin D supplementation and low-molecular-weight heparin were all successful strategies for reducing risk for preeclampsia.
When comparing these successful strategies to one another, none were superior to the other for preeclampsia prevention. However, exercise was superior compared to aspirin and calcium supplementation, when considering reducing risk for all pregnancy-induced hypertension diagnoses.
Take Home Message: The sheer number of articles available to analyze in this study is promising evidence for progress in the field of preeclampsia prevention. This article shows there are several worthwhile strategies for patients to discuss with their health care provider to possibly implement to reduce their risk for preeclampsia. A lot more research is still needed to improve preeclampsia prevention.
Link: https://www.ajog.org/article/S0002-9378(22)00819-5/fulltext
Citation: Liu, Yuan-hui et al. Comparative effectiveness of prophylactic strategies for preeclampsia: a network meta-analysis of randomized controlled trials American Journal of Obstetrics & Gynecology, Volume 228, Issue 5, 535 - 546 (2023). https://doi.org/10.1016/j.ajog.2022.10.014
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