An investigation into the impact of vitamin supplementation, maternal characteristics and lifestyle choices on the development of pre-eclampsia

Edwards, Alison (2020) An investigation into the impact of vitamin supplementation, maternal characteristics and lifestyle choices on the development of pre-eclampsia. Doctoral thesis, Birmingham City University.

Alison Edwards PhD Thesis published_Final version_Submitted Jan 2020_Final Award Jun 2020.pdf - Accepted Version

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Background: Pre-eclampsia remains in the top five leading causes of maternal mortality and morbidity in the United Kingdom (Knight 2018). For decades, research has striven to establish the aetiology, improved ways of managing the condition and ways to prevent its occurrence. Recent studies have turned their attention to the physiological processes in vitamin metabolism, in particular vitamin D and folic acid, and associated links with a reduction in pre-eclampsia. With a Public Health England (PHE) initiative encouraging women to take the multivitamin supplement Healthy Start, providing a combination of these two vitamins as well as vitamin C, there was opportunity to explore the impact of combined supplementation and the outcome of pre-eclampsia. In addition, some have identified maternal characteristics and socio-economic factors such as age and parity as possible precursors to pre-eclampsia, though not always conclusively.

Methods: A retrospective cross-sectional cohort study was conducted on 952 women (including n = 599 (63%) non-pre-eclampsia women and n = 353 (37%) of women diagnosed with a range of severity of pre-eclampsia. All gave birth at a tertiary maternity unit in the West Midlands. Data collected from medical records regarded uptake of vitamins, along with lifestyle choices and maternal characteristics, such as body mass index (BMI), ethnicity and age. Non-parametric testing and binary regression was conducted using the Statistical Package for Social Sciences (SPSS). Ethical approval was ensured.

Findings: Whilst a combination of vitamins given later in pregnancy demonstrated no correlation between them and pre-eclampsia, folic acid supplementation in particular demonstrated a strong statistical correlation with the incidence of pre-eclampsia p>0.001 when taken pre-conception and during the first trimester. Women experiencing their first pregnancy, with raised BMI giving birth during winter or spring seasons in particular, showed a greater risk of developing pre-eclampsia.

Conclusion: Though no correlation was found between multi vitamins taken later in pregnancy there is evidence from this study to suggest that dual vitamin supplementation could have the potential to decrease the incidence of pre-eclampsia but more likely when administered pre-conception and during the first trimester. It is therefore proposed, that further research into the supplementation of multivitamins preconception and early pregnancy, could be beneficial and this warrants further investigation.

Item Type: Thesis (Doctoral)
January 2020Submitted
June 2020Accepted
Uncontrolled Keywords: Pre-eclampsia, vitamin supplementation, folic acid
Subjects: CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific)
CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific)
CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-04 - midwifery
Divisions: Doctoral Research College > Doctoral Theses Collection
Faculty of Health, Education and Life Sciences > School of Nursing and Midwifery
Depositing User: Jaycie Carter
Date Deposited: 11 Jul 2022 15:39
Last Modified: 11 Jul 2022 15:39

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