Historically, a number of supplements have been used for preeclampsia and preparation for labor.  This Whole Health tool highlights some of those most commonly used, focusing on the research related to their use.

Preeclampsia Prevention

Note: Please refer to the Passport to Whole Health, Chapter 15 on Dietary Supplements for more information about how to determine whether or not a specific supplement is appropriate for a given individual. Supplements are not regulated with the same degree of oversight as medications, and it is important that clinicians keep this in mind. Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer.

Calcium

A Cochrane review of 13 trials involving 15,730 pregnant women reported that the risk of preeclampsia and hypertensive disorders was reduced in those receiving calcium supplements compared to placebo.¹  The effect was greatest in high-risk groups (e.g., those with prior history of preeclampsia) and those with a low baseline calcium intake, which is, unfortunately, a large number of women in the United States. Calcium, as well as magnesium, is essential for maintaining a healthy blood pressure and may prevent leg cramps women experience in the latter half of pregnancy.  Calcium is considered safe for use in pregnancy.  A dietary history that assesses intake of calcium-rich vegetables and dairy products can provide helpful information to guide supplementation.  All calcium intake from diet and supplementation should be taken into consideration, so as to avoid excessive intake.  The World Health Organization recommends an intake of 1.5–2.0 gm elemental calcium/day with the total daily dosage divided into three doses (preferably taken at mealtimes) from 20 weeks’ gestation until the end of pregnancy.²

Dose:  Start a dose of 600 mg per day and increase dietary intake.

Vitamin D

Hypovitaminosis D has been associated with an increased risk of preeclampsia.³  Vitamin D plays a role in the development of preeclampsia by affecting blood pressure through calcium homeostasis and/or modulating inflammation and immunity.³  Insufficiency has also been linked to other adverse maternal and fetal outcomes, including poor fetal and infant bone mineralization, hypocalcemia, and rickets in neonates.⁴  A number of prospective observational studies have shown a high prevalence of hypovitaminosis D during pregnancy across ethnic groups and nationalities.