Priority 6 from the Blood Pressure in Pregnancy PSP

UNCERTAINTY: How can pregnancy hypertension (including pre-eclampsia) be prevented in a subsequent pregnancy? (JLA PSP Priority 6)
Overall ranking	6
JLA question ID	0099/6
Explanatory note	Not available for this PSP
Evidence	The association between calcium supplement and preeclampsia and gestational hypertension: a systematic review and meta-analysis of randomized trials.Sun X, Li H, He X, Li M, Yan P, Xun Y, Lu C, Yang K, Zhang X. Hypertens Pregnancy. 2019 May;38(2):129-139. doi: 10.1080/10641955.2019.1593445. Epub 2019 Apr 2.PMID:30935246 Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.Hofmeyr GJ, Lawrie TA, Atallah ÁN, Torloni MR.Cochrane Database Syst Rev. 2018 Oct 1;10:CD001059. doi: 10.1002/14651858.CD001059.pub5.PMID:30277579 Metformin for prevention of hypertensive disorders of pregnancy in women with gestational diabetes or obesity: systematic review and meta-analysis of randomized trials.Kalafat E, Sukur YE, Abdi A, Thilaganathan B, Khalil A.Ultrasound Obstet Gynecol. 2018 Dec;52(6):706-714. doi: 10.1002/uog.19084. Epub 2018 Nov 1.PMID:29749110 Zinc supplementation for improving pregnancy and infant outcome.Ota E, Mori R, Middleton P, Tobe-Gai R, Mahomed K, Miyazaki C, Bhutta ZA.Cochrane Database Syst Rev. 2015 Feb 2;(2):CD000230. doi: 10.1002/14651858.CD000230.pub5. Review.PMID:25927101 Arginine supplementation for improving maternal and neonatal outcomes in hypertensive disorder of pregnancy: a systematic review.Gui S, Jia J, Niu X, Bai Y, Zou H, Deng J, Zhou R.J Renin Angiotensin Aldosterone Syst. 2014 Mar;15(1):88-96. doi: 10.1177/1470320313475910. Epub 2013 Feb 22. Review.PMID:23435582 Antioxidants for preventing pre-eclampsia.Rumbold A, Duley L, Crowther CA, Haslam RR.Cochrane Database Syst Rev. 2008 Jan 23;(1):CD004227. doi: 10.1002/14651858.CD004227.pub3. Review.PMID:18254042
Health Research Classification System category	Reproductive health and childbirth

Extra information provided by this PSP
Original uncertainty examples	What can I do to prevent preeclampsia? (I was a healthy first time mom with good BPs until around week 36, so it wasn´t prior history for me.) ~ How can it be prevented What are the best ways to help keep blood pressure down in pregnancy Is high blood pressure in pregnancy ever preventable and how? ~ Will it ever be preventable Is there anything that can prevent / reduce risk high BP What can be done to prevent high blood pressure in pregnancy? ~ Are there any risks involved with preventative measures (for baby and mother) ~ Could I have done anything to prevent HELLP syndrome?
Submitted by	11 women, 1 who knew a person/relative/friend with pregnancy hypertension, 1 researcher, 1 other

Extra information provided by this PSP

Original uncertainty examples

What can I do to prevent preeclampsia? (I was a healthy first time mom with good BPs until around week 36, so it wasn´t prior history for me.) ~ How can it be prevented What are the best ways to help keep blood pressure down in pregnancy Is high blood pressure in pregnancy ever preventable and how? ~ Will it ever be preventable Is there anything that can prevent / reduce risk high BP What can be done to prevent high blood pressure in pregnancy? ~ Are there any risks involved with preventative measures (for baby and mother) ~ Could I have done anything to prevent HELLP syndrome?

Submitted by

11 women, 1 who knew a person/relative/friend with pregnancy hypertension, 1 researcher, 1 other

PSP information
PSP unique ID	0099
PSP name	Blood Pressure in Pregnancy
Total number of uncertainties identified by this PSP.	50 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	20 June 2019