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Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d2901 (Published 19 May 2011) Cite this as: BMJ 2011;342:d2901

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Pre-eclampsia and supplementation with folate under the aspect of hyperhomocysteinaemia and affective disorders

Vadillo-Ortega and colleagues(1)mention a possible association
between the development of pre-eclampsia and a relative deficiency in L-arginine. The authors concluded that antioxidant vitamins alone did not
have a protective effect for prevention of pre-eclampsia. Some points with
practical implications should be completed. There is a strong relationship
between hyperhomocysteinaemia and cardiovascular diseases.

Bibi et
al.(2) investigated elevated serum homocysteine concentrations and vascular
related pregnancy complications in pregnant women, especially in
pregnancies complicated by pre-eclampsia and eclampsia. They observed a
significant reduction of these complications by supplementation with
folate, vitamin B12 and B6. Hyperhomocysteinaemia is associated with
affective disorders, too. Kurki and colleagues (3) observed that
depressions in early pregnancy were associated with risks for subsequent
pre-eclampsia; a newer study(4)showed a relationship of moderat to severe
depression with a 3.2-fold increased risk of pre-eclampsia. Such gender
specific problems give a new chance for a better cooperation between
general practitioners and physicians of obstetrics and
gynaecology, clinical epidemiology and psychiatry.

References

(1)Vadillo-Ortega F,Perichart-Perera O,Espino S, Avila-Vergara MA,Ibarra
I,Ahued R,Godines M, Parry S,Macones G,Strauss JF. Effect of
supplementation during pregnancy with L-arginine and antioxidant vitamins
in medical food on pre-eclampsia in high risk population: randomised
controlled trial
BMJ 2011 342:d2901; doi:10.1136/

2)Bibi S, Qureshi F, Ahmad M, Qureshi PM, Memon A, Qazi
RA., Hyperhomocysteinaemia, vascular related pregnancy complications and
the response to vitamin supplementation in pregnant women of Pakistan. J
Pak Med Assoc. 2010 Sep;60(9):741-5.

3)Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O. Depression
and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol.
2000 Apr;95(4):487-90.

4)Sanchez SE, Lam N, Garcia P, Williams MA. Associations of depression and
depressive symptoms with preeclampsia: results from a Peruvian case-control study. BMC Womens Health. 2007 Sep 27;7:15.

Competing interests: No competing interests

31 May 2011
Detlef Degner
senior consultant
Department of Psychiatry, University of Goettingen, Germany