Preeclampsia Awareness Week
New study: among the factors that increase the risk of developing preeclampsia - frequent use of sunscreen and living in a rural area
Preeclampsia, one of the most dangerous diseases for pregnant women and their fetuses, which sometimes requires an early termination of pregnancy and premature birth and may even endanger the life of the mother and fetus, is the subject of many studies that try to shed light on the reasons for its development and develop ways to expand the few options available today for prevention and treatment. A new study, jointly conducted by the Rambam Medical College and the Faculty of Medicine at the Technion, found some interesting answers that help in understanding the mystery.
The study, conducted during the years 2019-2021, reviewed the dietary habits of approximately 600 women and examined the relationship between the development of preeclampsia and different food consumption habits and lifestyles. The research was led by the Ph.D. student in the Technion's Faculty of Medicine, Shani Abutbol-Vard, the supervisors are Dr. Gila Rosen, a researcher and consultant in the field of preventive medicine and foodtech, Dr. Ido Sholt, director of the Maternal and Fetal Medicine Unit at the Rambam Medical Center and the research assistant of the Department of Clinical Nutrition In Rambam, Dr. Carmit Shani Levy, in collaboration with the Carmel Diagnostics company.
The study examined the diet and lifestyle habits of women, 3 months before they became pregnant (by a food consumption frequency questionnaire), and later followed the results of the pregnancy, including the development of preeclampsia.
Preeclampsia and life in the village
The results of the study show that women who live in a rural area, their chance of developing preeclampsia increases by 4.3 times, compared to women who live in an urban area. According to the researchers, the explanation is that in rural areas there is less access to follow-up and treatment during pregnancy, and thus women living in these areas are not diagnosed in time. Another explanation for the findings is the explanation that the pest control of agricultural crops in rural areas may contribute to environmental pollution, which causes the development of preeclampsia among this population.
And what about sunscreen?
Another interesting finding arising from the results of the study is the relationship between the disease and the use of sunscreen, which was found to be a significant predictor of the development of preeclampsia. "Using sunscreen more frequently resulted in a greater chance of developing preeclampsia," says Dr. Ido Sholt, Director of the Maternal and Fetal Medicine Unit at Rambam, who took part in the study, referring to the data that emerged from it, according to which women who constantly used sunscreen increased the risk of developing preeclampsia by 77%. "This finding is probably related to the fact that with more widespread use of sunscreen, we block the production of vitamin D in the skin. Lack of vitamin D is linked to the development of preeclampsia," explains Dr. Sholt and adds, "It is recommended for women to conceive when their bodies contain vitamin D reserves, to take care of the test Vitamin D status before becoming pregnant and depending on consuming a nutritional supplement containing the vitamin. The vitamin has many advantages in terms of normal development of the pregnancy and the fetus."
In the medicine drawer and also in the kitchen cupboard
These are the products that can prevent preeclampsia or expose women to the disease. As for additional dietary habits that are significant for the chances of developing preeclampsia, two main ones were found in the study:
Women who consumed nutritional supplements during pregnancy, their chances of developing preeclampsia decreased by 48%. The most significant nutritional supplements found in this context are: multivitamin and folic acid, "multivitamin consumption during pregnancy reduced the chance of developing preeclampsia by 56%, while folic acid consumption during pregnancy reduced the chance of developing preeclampsia by 51%", Shani Abutbol-Vard, the doctoral student who carried out the research, points out, "This is good news for women planning a pregnancy, because it is customary to take folic acid as part of the preparation process on a daily basis, although it appears that it is desirable to be careful and continue taking folic acid throughout the pregnancy."
"As for multivitamins, the matter is a bit more complicated," explains Dr. Rosen, former director of the department of clinical nutrition at Rambam, and one of the initiators of the research. "Pregnant women take them according to popular recommendations, and not always according to what they need. It is highly recommended to consult a dietitian or gynecologists who deal with midwives."
However, the more interesting finding focused on a product that exists in the pantry of every Israeli home: "We found that women who consumed more legumes in their diet reduced their risk of developing preeclampsia by 49%," notes Dr. Rosen, "This is a product that we strongly recommend incorporating frequently in the daily diet, thanks to its many advantages."
With reference to risk groups or criteria for a higher probability of developing preeclampsia, the study found that women who are overweight, their chances of developing preeclampsia increased by 24%, while among women with obesity (obesity with a BMI over 30), the chances of developing preeclampsia increased Pregnancy increased by 95%!
In addition, it was found that the chance of developing preeclampsia decreases by 98%, as women consumed natural, unprocessed food.
"Increased inclusion of trans fatty acids in the dietary menu, for example, increased the chance of developing preeclampsia by 4%," Dr. Rosen emphasizes one of the data pointed to by the study in the context of industrialized food consumption.
A new finding in the study showed that an increase in the consumption of foods containing the amino acid tryptophan increases the chance of developing preeclampsia. According to the researchers, the recommendation not to consume tryptophan supplements during pregnancy which can raise blood pressure is well known, but the finding regarding the food is innovative and there are still no recommendations regarding reducing food products rich in tryptophan as they are very important for supplying quality protein and calcium during pregnancy. The issue is expected to be examined as part of a follow-up study.
Will we soon be able to predict preeclampsia at an early stage?
Another part of the research dealt with examining a Carmel Diagnostics tool that measures levels of oxidative stress in body fluids. As part of the study, an inquiry was made using the same tool, regarding the level of oxidative stress in the urine of women in the early week of pregnancy (week 16), a non-invasive and convenient test, without the need for a blood test.
"The basic premise was that the higher the level of oxidative stress, the more markers there are in the urine that probably indicate the development of preeclampsia," explains Abutbul-Ward of the research approach and notes that in the study it was found that the tool is sensitive enough to test the urine fluid, both in healthy women and in sick women in preeclampsia.
"It is an interesting tool to examine as an indication of the development of preeclampsia at a stage that is considered relatively early, and perhaps even further into the pregnancy planning stage as a basis for a preventive plan," says Dr. Schulte, "but studies with a larger sample are required here to test the tool."
"A normal and healthy pregnancy is significant for the health of the fetus, but also for the continuation of its life after birth," concludes Dr. Rosen. "The nine months of pregnancy are a window of opportunity for the development of a health profile for the entire course of adult life, and it is largely determined by maintaining proper nutrition and adopting a lifestyle healthy. The research findings definitely strengthen this connection."
