通常建议原发性高血压患者控制体重,行压力管理,多食水果和蔬菜,摄入低动物脂肪,特别是饱和脂肪。 目前尚不清楚,它对妊娠期高血压疾病是否有益。
对于饮食中钙摄入基础值低的发展中国家的女性,饮食中补充钙已显示出可降低子痫前期和早产的风险,[26]Hofmeyr GJ, Duley L, Atallah A. Dietary calcium supplementation for prevention of pre-eclampsia and related problems: a systematic review and commentary. BJOG. 2007 Aug;114(8):933-43.http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2007.01389.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17565614?tool=bestpractice.com[27]Imdad A, Jabeen A, Bhutta ZA. Role of calcium supplementation during pregnancy in reducing risk of developing gestational hypertensive disorders: a meta-analysis of studies from developing countries. BMC Public Health. 2011 Apr 13;11(suppl 3):S18.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231891/http://www.ncbi.nlm.nih.gov/pubmed/21501435?tool=bestpractice.com[28]Ronsmans C, Campbell O. Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy. BMC Public Health. 2011 Apr 13;11(suppl 3):S8.http://www.biomedcentral.com/1471-2458/11/S3/S8http://www.ncbi.nlm.nih.gov/pubmed/21501459?tool=bestpractice.com[29]Imdad A, Bhutta ZA. Effects of calcium supplementation during pregnancy on maternal, fetal and birth outcomes. Paediatr Perinat Epidemiol. 2012 Jul;26(suppl 1):138-52.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3016.2012.01274.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/22742607?tool=bestpractice.com[30]Hofmeyr GJ, Lawrie TA, Atallah AN, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014;(6):CD001059.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001059.pub4/fullhttp://www.ncbi.nlm.nih.gov/pubmed/24960615?tool=bestpractice.com[29]Imdad A, Bhutta ZA. Effects of calcium supplementation during pregnancy on maternal, fetal and birth outcomes. Paediatr Perinat Epidemiol. 2012 Jul;26(suppl 1):138-52.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3016.2012.01274.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/22742607?tool=bestpractice.com[30]Hofmeyr GJ, Lawrie TA, Atallah AN, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014;(6):CD001059.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001059.pub4/fullhttp://www.ncbi.nlm.nih.gov/pubmed/24960615?tool=bestpractice.com 并可增加婴儿出生体重。[29]Imdad A, Bhutta ZA. Effects of calcium supplementation during pregnancy on maternal, fetal and birth outcomes. Paediatr Perinat Epidemiol. 2012 Jul;26(suppl 1):138-52.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3016.2012.01274.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/22742607?tool=bestpractice.com 妊娠期间摄入 ω-3 脂肪酸可以降低子痫前期的风险。此外,妊娠期和哺乳期摄入 ω-3 脂肪酸可能有利于婴儿的大脑发育。[31]Lopez-Torres E, Doblas PA, del Valle VG, et al. Clinical evaluation of omega-3 fatty acids on pregnancy, breast feeding and infant development [in Spanish]. Clin Invest Ginecol Obstet. 2007;34:100-5.http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13106460&pident_usuario=0&pcontactid=&pident_revista=7&ty=165&accion=L&origen=zonadelectura&web=zl.elsevier.es&lan=es&fichero=7v34n03a13106460pdf001.pdf[32]Horvath A, Koletzko B, Szajewska H, et al. Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Br J Nutr. 2007 Aug;98(2):253-9.https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effect-of-supplementation-of-women-in-highrisk-pregnancies-with-longchain-polyunsaturated-fatty-acids-on-pregnancy-outcomes-and-growth-measures-at-birth-a-metaanalysis-of-randomized-controlled-trials/4F5C1B03808158AEA8F491EECB53B1E5/core-readerhttp://www.ncbi.nlm.nih.gov/pubmed/17419889?tool=bestpractice.com 有证据表明,妊娠期使用抗血小板药物可以降低发展为子痫前期的风险。[28]Ronsmans C, Campbell O. Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy. BMC Public Health. 2011 Apr 13;11(suppl 3):S8.http://www.biomedcentral.com/1471-2458/11/S3/S8http://www.ncbi.nlm.nih.gov/pubmed/21501459?tool=bestpractice.com[33]Bujold E, Morency AM, Roberge S, et al. Acetylsalicylic acid for the prevention of preeclampsia and intra-uterine growth restriction in women with abnormal uterine artery Doppler: a systematic review and meta-analysis. J Obstet Gynaecol Can. 2009 Sep;31(9):818-26.http://www.ncbi.nlm.nih.gov/pubmed/19941706?tool=bestpractice.com[34]Askie LM, Duley L, Henderson-Smart DJ, et al. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet. 2007 May 26;369(9575):1791-8.http://www.ncbi.nlm.nih.gov/pubmed/17512048?tool=bestpractice.com
一篇综述发现,补充锌可以相对减少 14% 的早产,但低出生体重儿数目无伴随减少。[35]Ota E, Mori R, Middleton P, et al. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev. 2015;(2):CD000230.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000230.pub5/fullhttp://www.ncbi.nlm.nih.gov/pubmed/25927101?tool=bestpractice.com 作者指出早产的中度下降能反应营养状况不良。
一项安慰剂对照的随机试验中,子痫前期风险低的初产妇补充维生素 C 和维生素 E(在妊娠第 9 和第 16 周之间)并未降低严重妊娠相关高血压的发病率。[36]Roberts JM, Myatt L, Spong CY, et al. Vitamins C and E to prevent complications of pregnancy-associated hypertension. N Engl J Med. 2010 Apr 8;362(14):1282-91.http://www.nejm.org/doi/full/10.1056/NEJMoa0908056#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/20375405?tool=bestpractice.com