Pre-eclampsia: The Silent Threat in Pregnancy Every Expectant Mother Should Know About

Understanding the warning signs, the role of maternal nutrition, and the latest scientific developments in protecting mothers and babies.

Pregnancy brings remarkable physiological changes as a woman’s body adapts to support a developing life. Although most pregnancies progress without major complications, some conditions can emerge unexpectedly and pose significant risks to both maternal and fetal health. Among these, pre-eclampsia remains one of the most serious pregnancy-related disorders, often developing without noticeable symptoms during its early stages.

In October 2026, the World Health Organization (WHO) brought renewed global attention to this condition through its Global Roadmap for Hypertensive Disorders of Pregnancy 2026–2035 and Beyond. The initiative highlights the continuing burden of pregnancy-related hypertension and the need for better screening, prevention, early diagnosis and access to appropriate treatment.

Hypertensive disorders complicate a substantial proportion of pregnancies worldwide and remain an important cause of maternal and newborn illness and mortality. However, many severe complications can be prevented or reduced through timely antenatal monitoring and evidence-based medical care.

Understanding Pre-eclampsia: More Than High Blood Pressure

Pre-eclampsia is a complex multisystem disorder that generally develops after 20 weeks of pregnancy, although it can also occur after childbirth. It is characterised by new-onset hypertension, usually defined as blood pressure of 140/90 mmHg or higher, accompanied by proteinuria, maternal organ dysfunction or certain features of uteroplacental dysfunction.

Although elevated blood pressure is its most recognisable feature, pre-eclampsia involves much more than hypertension alone. It may affect the kidneys, liver, brain, blood-clotting system and placenta, potentially compromising the health of both mother and baby.

The placenta plays a central role in the development of the condition. During a normal pregnancy, maternal blood vessels undergo important adaptations to provide adequate circulation to the developing placenta. In many cases of pre-eclampsia, abnormal placental vascular development and disturbances in maternal endothelial function contribute to impaired circulation, inflammation and increased vascular resistance.

Researchers continue to investigate the complex interactions between placental development, maternal immune responses, cardiovascular health and metabolic factors that influence the onset and progression of this condition.

Why Pre-eclampsia Is Often Called a Silent Threat

One of the most concerning aspects of pre-eclampsia is that it may develop without obvious symptoms. A pregnant woman may feel completely well while her blood pressure gradually rises or abnormalities begin to appear in routine investigations.

As the condition progresses, warning signs may include persistent headaches, blurred vision, flashing lights, pain in the upper abdomen—particularly beneath the right ribs—and sudden swelling of the face or hands. Some women may also experience nausea, vomiting, shortness of breath or a general feeling of being unusually unwell.

However, these symptoms are not present in every case. Routine blood pressure measurement, urine assessment and appropriate clinical evaluation remain essential throughout pregnancy, even when no symptoms are apparent.

Severe headaches, visual disturbances, upper abdominal pain, breathing difficulty or blood pressure readings of 160/110 mmHg or higher require immediate medical assessment. Women experiencing these symptoms should not delay seeking urgent care.

Who Is at Greater Risk?

Pre-eclampsia can occur in any pregnancy, but certain maternal characteristics and medical conditions increase the likelihood of developing it.

Women experiencing their first pregnancy, those carrying multiple pregnancies and those with a previous history of pre-eclampsia are at increased risk. Chronic hypertension, pre-existing diabetes, chronic kidney disease and autoimmune disorders, including systemic lupus erythematosus and antiphospholipid syndrome, are also important recognised risk factors.

Additional factors include obesity, maternal age of 40 years or above and a family history of pre-eclampsia.

Nevertheless, the absence of identifiable risk factors does not eliminate the possibility of developing the condition. Every pregnant woman benefits from consistent antenatal surveillance and individualised risk assessment.

How Pre-eclampsia Affects the Mother and Baby

When pre-eclampsia becomes severe, it can lead to serious maternal complications, including acute kidney injury, liver dysfunction, pulmonary oedema, stroke and abnormalities in blood clotting.

One of its most dangerous complications is eclampsia, characterised by seizures associated with pre-eclampsia. Another is HELLP syndrome, involving haemolysis, elevated liver enzymes and a low platelet count.

For the developing baby, impaired placental function may reduce the delivery of oxygen and nutrients, contributing to fetal growth restriction, premature birth and, in severe cases, stillbirth.

Importantly, the consequences of pre-eclampsia may extend beyond pregnancy. Women who experience the condition have a higher long-term risk of hypertension, cardiovascular disease, stroke and chronic kidney disease, highlighting the importance of postpartum monitoring and long-term preventive healthcare.

Can Pre-eclampsia Be Predicted Before Symptoms Appear?

Advances in maternal-fetal medicine are improving our understanding of how pre-eclampsia develops and how high-risk pregnancies may be identified earlier.

Researchers are investigating combinations of maternal clinical characteristics, ultrasound findings and placental biomarkers to assess the likelihood of developing the condition.

Among the established biomarkers used in selected clinical settings are placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1). Changes in these markers reflect disturbances in placental signalling and may assist clinicians in assessing suspected preterm pre-eclampsia.

Although biomarker-based assessment represents an important advancement, it does not replace routine blood pressure monitoring, laboratory investigations or comprehensive obstetric evaluation. Its clinical use depends on gestational age, local protocols and test availability.

The Role of Maternal Nutrition: Can Certain Nutrients Reduce the Risk?

Maternal nutrition is an essential component of a healthy pregnancy, supporting physiological adaptations, placental function and fetal development. Increasing scientific interest has focused on whether specific nutritional factors may also influence the risk of pregnancy-related hypertensive disorders.

Among the nutrients investigated, calcium has the strongest evidence for a preventive benefit in populations with low dietary calcium intake.

Calcium and Pre-eclampsia

Calcium is essential for normal muscle contraction, nerve transmission and vascular function. Inadequate dietary calcium intake has been associated with disturbances in blood pressure regulation, making it an important consideration in maternal health.

WHO recommends calcium supplementation during pregnancy in populations where dietary calcium intake is low, as evidence indicates that supplementation can reduce the risk of pre-eclampsia, particularly among women with insufficient calcium intake.

WHO’s established recommendation specifies 1.5–2.0 grams of elemental calcium daily for pregnant women in low-calcium-intake populations. However, supplementation should be determined by healthcare professionals according to dietary intake, individual medical circumstances and applicable clinical guidance.

Dietary sources of calcium include milk, yoghurt, cheese, calcium-fortified foods and certain green vegetables. Ensuring adequate calcium intake through a balanced diet remains important, although dietary measures alone may not meet the needs of every woman.

Vitamin D: An Emerging Area of Research

Vitamin D plays an important role in calcium absorption, bone metabolism, immune regulation and several physiological processes relevant to pregnancy.

Observational studies have reported associations between low maternal vitamin D levels and an increased risk of pre-eclampsia. Researchers have also investigated potential relationships between vitamin D status, placental development, inflammation and endothelial function.

However, an association does not establish that vitamin D deficiency directly causes pre-eclampsia.

A 2024 Cochrane systematic review found that evidence from randomised clinical trials remains very uncertain regarding whether vitamin D supplementation reduces the risk of pre-eclampsia. Consequently, vitamin D supplementation should not currently be presented as an established preventive treatment for this condition.

Maintaining adequate vitamin D status remains important for maternal and fetal bone health. Women with suspected or confirmed vitamin D deficiency should receive appropriate clinical assessment and supplementation when indicated, according to established antenatal guidance.

Other Micronutrients and Antioxidants

Oxidative stress and inflammatory pathways are involved in the development of pre-eclampsia, leading researchers to investigate whether antioxidant nutrients such as vitamins C and E could offer protective benefits.

Despite their important physiological roles, clinical trials have not demonstrated sufficient benefit to recommend routine vitamin C or vitamin E supplementation specifically for preventing pre-eclampsia.

Similarly, folic acid, iron and other essential micronutrients remain important for maternal health and fetal development, but their established nutritional benefits should not be confused with proven prevention of pregnancy-related hypertension.

The most scientifically supported approach is to maintain adequate maternal nutrition, identify and correct nutritional deficiencies where appropriate, and follow evidence-based obstetric recommendations.

Nutrition supports a healthy pregnancy, but it cannot replace antenatal screening, blood pressure monitoring or medical treatment for pre-eclampsia.

Prevention and Early Detection: What Really Makes a Difference?

Although pre-eclampsia cannot always be prevented, several evidence-based interventions can reduce risk in selected pregnancies.

Low-dose aspirin is recommended for women with recognised risk factors, usually beginning from 12 weeks of gestation, according to clinical guidelines and under medical supervision. Appropriate calcium supplementation is another important preventive intervention in populations with low dietary calcium intake.

Equally important are early antenatal registration, regular blood pressure monitoring, assessment of maternal risk factors and timely investigations when pre-eclampsia is suspected.

Women with chronic hypertension, diabetes, kidney disease or other significant medical conditions require individualised care and closer monitoring throughout pregnancy.

Healthy dietary habits, appropriate physical activity and management of pre-existing medical conditions contribute to overall maternal wellbeing, but no single food, vitamin or supplement can guarantee prevention of pre-eclampsia.

How Is Pre-eclampsia Managed?

The management of pre-eclampsia depends on the severity of the condition, gestational age and the clinical wellbeing of both mother and baby.

Women with suspected or confirmed pre-eclampsia may require frequent blood pressure monitoring, kidney and liver function tests, platelet counts, urine investigations and ultrasound assessment of fetal growth.

Antihypertensive medications are used when clinically indicated to control blood pressure. Magnesium sulfate is an important treatment for preventing and managing eclamptic seizures in appropriate circumstances.

When preterm delivery is anticipated, antenatal corticosteroids may be administered according to gestational age and established clinical protocols to support fetal lung maturation.

Delivery of the baby and placenta is the definitive obstetric intervention, although the timing must balance maternal safety with fetal maturity. In some cases, careful monitoring allows pregnancy to continue safely for a limited period, while severe or deteriorating disease may require urgent delivery.

Medical surveillance must also continue after childbirth because pre-eclampsia can persist or develop during the postpartum period.

WHO’s 2026 Global Roadmap: A Renewed Commitment to Maternal Health

In October 2026, WHO and international partners launched the Global Roadmap for Hypertensive Disorders of Pregnancy 2026–2035 and Beyond, emphasising the need to reduce preventable maternal and newborn complications associated with hypertensive disorders.

The roadmap focuses on improving research and innovation, clinical standards, access to essential healthcare products, implementation of evidence-based interventions and global advocacy.

It highlights the importance of reliable blood pressure monitoring, accessible diagnostic investigations, essential medicines and appropriately trained healthcare professionals.

For low- and middle-income countries, strengthening antenatal services and timely referral systems remains particularly important in reducing preventable maternal and perinatal complications.

Protecting Maternal Health Beyond Pregnancy

Pre-eclampsia should not be regarded simply as a temporary complication that ends with childbirth. Its association with future cardiovascular and renal disease makes long-term follow-up an important aspect of women’s healthcare.

Women with a history of pre-eclampsia should inform their healthcare providers during future medical assessments and subsequent pregnancies. Blood pressure monitoring, cardiovascular risk evaluation and appropriate preventive care can help address potential long-term health concerns.

Ultimately, protecting maternal health requires more than responding to complications once they develop. It involves early awareness, accessible antenatal services, adequate nutrition, scientific understanding and timely clinical intervention.

At DrWellness, we believe that informed maternal healthcare begins with reliable medical knowledge and an appreciation of the importance of comprehensive antenatal care. Promoting awareness of pregnancy-related conditions, nutritional wellbeing and preventive healthcare is part of our commitment to supporting healthier mothers and healthier beginnings.

Because protecting a baby’s future begins with protecting the health of the mother.

References

1. World Health Organization. (2026). Pre-eclampsia. WHO Fact Sheet.
   https://www.who.int/news-room/fact-sheets/detail/pre-eclampsia
2. World Health Organization. (2026). Global Roadmap for Hypertensive Disorders of Pregnancy 2026–2035 and Beyond.
   https://www.who.int/nepal/publications/i/item/9789240125483
3. National Institute for Health and Care Excellence. Hypertension in Pregnancy: Diagnosis and Management. NICE Guideline NG133.
   https://www.nice.org.uk/guidance/ng133
4. World Health Organization. (2018). WHO Recommendation: Calcium Supplementation During Pregnancy for the Prevention of Pre-eclampsia and Its Complications. Geneva: WHO.
5. Palacios, C., Kostiuk, L. L., Cuthbert, A., & Weeks, J. (2024). Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews, Issue 7, CD008873.
   https://doi.org/10.1002/14651858.CD008873.pub5
6. National Institutes of Health, Office of Dietary Supplements. Calcium: Fact Sheet for Health Professionals.
   https://ods.od.nih.gov/factsheets/calcium-HealthProfessional/
7. World Health Organization. (2021). WHO Recommendations on Antiplatelet Agents for the Prevention of Pre-eclampsia.

Medical Disclaimer

This article is intended solely for general health education and awareness. It does not constitute medical advice, diagnosis or treatment and should not replace consultation with a qualified obstetrician or healthcare professional.

Pre-eclampsia is a potentially serious pregnancy complication that requires timely medical assessment and appropriate management. Women should not begin aspirin, high-dose calcium, vitamin D or other supplements specifically for pre-eclampsia prevention without professional medical guidance.

Although adequate maternal nutrition supports a healthy pregnancy, nutritional supplements should not be considered substitutes for antenatal monitoring or prescribed treatment. Vitamin D supplementation has not been conclusively demonstrated to prevent pre-eclampsia.

Pregnant or recently postpartum women experiencing severe headaches, visual disturbances, upper abdominal pain, breathing difficulty or markedly elevated blood pressure should seek urgent medical  attention.