Prevention of Preeclampsia by Linoleic Acid and Calcium Supplementation: A Randomized Controlled Trial

Abstract

Objective: To determine the effect of low doses of linoleic acid and calcium on prostaglandin (PG) levels and the efficacy of this treatment in the prevention of preeclampsia.Methods: In a randomized, double-blind, placebo-controlled study we treated 86 primigravidas with risk factors for preeclampsia (high biopsychosocial risk [above 3 points], positive roll-over test, and high mean blood pressure [above 85 mmHg)] with daily doses of either 450 mg linoleic acid and 600 mg calcium (n = 43) or 450 mg starch and 600 mg lactose placebo (n = 43) during the third trimester of pregnancy.Results: Four women in the experimental group (9.3%) developed preeclampsia compared with 16 (37.2%) controls (relative risk 0.25, 95% confidence interval 0.09, 0.69, P < .001). The median serum levels of PGE2 after 4 weeks of treatment increased by 106% in the experimental group (P = .03) and decreased by 33% in the control group (P = .02). The median ratio between thromboxane B2 and PGE2 decreased by 40% in the experimental group (P = .02) and increased by 18% in the control group (P = .14). No significant differences were observed in the median ratio between thromboxane B2 and 6-keto PGF1α in either group. No serious maternal or neonatal side effects of treatment occurred in either group.Conclusion: The administration of low daily doses of linoleic acid and calcium during the third trimester of pregnancy reduced the incidence of preeclampsia significantly in women at high risk, possibly by correcting the PGE2 levels.