Protocol · Pregnancy & Maternal Health
Preeclampsia Prevention Protocol
Calcium and Low-Dose Aspirin are the core of this stack, with 4 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Preeclampsia Prevention.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
6 supplements · 3 graded · 2 graded A
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file |
|---|---|---|---|---|
| Primary stackThe core of this protocol | ||||
| Calcium | Amount listed: 1,000–2,000 mg daily (starting before 20 weeks) | High-dose calcium significantly reduces preeclampsia risk, especially in women with low dietary calcium intake
| Grade A for Pre-Eclampsia Risk4 studies · 15,730 people | |
| Low-Dose Aspirin | Amount listed: 81–150 mg daily at bedtime (starting at 12–16 weeks) | Reduces preeclampsia risk by 17% when started before 16 weeks in high-risk women; affects prostaglandin balance | Not graded yet | |
| Supporting stackListed as additions to the core | ||||
| Vitamin D | Amount listed: 1,000–4,000 IU daily (based on blood levels) | Deficiency associated with increased preeclampsia risk; supplementation may reduce risk
| Grade A for Pre-Eclampsia Risk1 study · 5,035 people | |
| Omega-3 Fatty Acids | Amount listed: 1–2 g EPA+DHA daily | May improve endothelial function and reduce inflammation; modest evidence for preeclampsia prevention
| Grade B for Infant Birth Weight2,302 people | |
| L-Arginine | Amount listed: 3–6 g daily | Precursor to nitric oxide; may improve blood vessel function and reduce blood pressure | Not graded yet | |
| Folic Acid | Amount listed: 800–5,000 mcg daily | Reduces homocysteine; may support endothelial function; higher doses studied for preeclampsia prevention | Not graded yet | |
How this protocol works
In plain language
Preeclampsia is a serious pregnancy complication characterized by high blood pressure and protein in the urine, typically developing after 20 weeks of pregnancy. It can progress to eclampsia (seizures) or HELLP syndrome and is a leading cause of maternal and fetal morbidity and mortality. Prevention in high-risk women is a major focus of prenatal care.
CRITICAL: Preeclampsia is a medical emergency. This protocol is for PREVENTION in high-risk women, not treatment. If you develop symptoms (severe headache, visual changes, upper abdominal pain, sudden swelling), seek immediate medical care.
- Calcium supplementation is one of the most effective interventions for preventing preeclampsia. The WHO recommends 1.5-2g daily for pregnant women in populations with low calcium intake. A large Cochrane review found calcium reduces preeclampsia risk by about 55% and is most effective in women with low baseline calcium intake. Start early in pregnancy.
- Low-Dose Aspirin is recommended by ACOG and USPSTF for women at high risk of preeclampsia. When started at 12-16 weeks gestation and taken at bedtime, it reduces preeclampsia risk by about 17% and reduces severe preeclampsia and preterm birth. High-risk factors include previous preeclampsia, chronic hypertension, diabetes, kidney disease, or multiple gestation.
- Vitamin D deficiency is strongly associated with increased preeclampsia risk. Supplementation may help reduce risk, though evidence is still building. Given that vitamin D deficiency is common and supplementation is safe, correcting deficiency is prudent.
- Omega-3 Fatty Acids may help by reducing inflammation and improving blood vessel function. While evidence for preeclampsia prevention specifically is modest, omega-3s have other pregnancy benefits and are generally recommended.
- L-Arginine is a precursor to nitric oxide, which relaxes blood vessels. Some studies suggest it may help prevent preeclampsia by improving blood flow to the placenta, though evidence is limited and it's not a standard recommendation.
- Folic Acid at higher doses may help by reducing homocysteine levels and supporting endothelial function. While standard doses (400-800mcg) are recommended for all pregnancies, higher doses are being studied for preeclampsia prevention.
Who is high-risk: Previous preeclampsia, chronic hypertension, pregestational diabetes, kidney disease, autoimmune disease (lupus, antiphospholipid syndrome), multiple gestation (twins/triplets), first pregnancy, obesity, age >35.