The association of preeclampsia with both high and low birth weight challenges the current belief that reduced uteroplacental perfusion is the unique pathophysiologic process in preeclampsia. Preeclampsia is thus presented from a new perspective, in the framework of maternal/fetal conflict. Interspecies comparisons encourage us to raise new questions concerning the potential for conflict among humans. The spectacular brain growth spurt during the second half of fetal life is a specifically human trait. A conflict between the demands expressed by the fetus and what the mother can do without depleting her body leads us to consider first the needs of the developing brain.
Al, M.D., Van Houwelingen, A.C., Badart-Smook, A., Hasaart, T.H., Roumen, F.J., & Hornstra, G. (1995). The essential fatty acid status of mother and child in pregnancy-induced hypertension: A prospective longitudinal study. Am J Obstet Gynecol. 172, 1605-1614.
Al, M.D., Van Houwelingen, A.C., & Hornstra, G. (1997). Relation between birth order and the maternal and neonatal docosahexaenoic acid status. Eur J Clin Nutr. 51, 548-553.
Appel, L.J., Miller, E.R., Seidler, A.J., & Whelton, P.K. (1993). Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled trials. Arch Intern Med. 153, 1429-1438.
Bucher, H.C., Guyatt, G.H., & Cook, R.J., et al. (1996). Effect of calcium supplementation on pregnancy-induced hypertension and pre-eclampsia. JAMA. 275, 1113-1117.
Caritis, S., Sibai, B., Thorn, C., & McLaughlin, S. (1995). Pregnancy effects of non-proteinuric gestational hypertension. SPO Abstracts. Am J Obstet Gynecol. 418, 376.
Carlson, E., & Salem, N. (1991). Essentiality of omega-3 fatty acids in growth and development in infants. In: Simopoulos, A.P., Kifer, R.R., Martin, R.E., & Barlow, S.M., eds. Effects of Polyunsaturated Fatty Acids in Seafoods. World Rev Nutr Diet. 66, 74-86.
Chappell, L.C., seed, P.T., Briley, A.L., Kelly, F.J., & Hunt, B.J., et al. (1999). Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: A randomised trial. Lancet. 354, 810-816.
Crawford, M.A., Hassam, A.C., Williams, G., & Whitehouse, W.L. (1976). Essential fatty acids and fetal brain growth. Lancet. I, 452-453.
De Groot, C.J.M., O'Brien, T. J., & Taylor, R.N. (1996). Biochemical evidence of impaired trophoblastic invasion of decidual stroma in women destined to have pre-eclampsia. Am J Obstet Gynecol. 175, 24-29.
Duley, L. (1994). Prophylactic fish oil in pregnancy. In: Pregnancy and Childbirth Module. Cochrane Database Systemic Reviews. Review No. 05941. Published through "Cochrane Updates on Disk."
Duley, L., Henderson-Smart, D., Knight, M., & King, J. (2001). Antiplatelet drugs for prevention of pre-eclampsia and its consequences: Systematic review. BMJ. 322, 329-333.
Eclampsia Trial Collaborative Group. (1995). Which anticonvulsant for women with eclampsia? Lancet. 345, 1455-1463.
Feeney, J.C., Tovey, L.A.D., & Scott, J.S. (1977). Influence of previous blood transfusion on incidence of pre-eclampsia. Lancet. II, 874-875.
Haig, D. (1993). Genetic conflicts in human pregnancy. Q Rev Biol. 68, 495-531.
Haig, D. (1996). Altercation of generations: genetics conflicts of pregnancy. Am J Reprod Immunol. 35, 226-236.
Kesmodel, U., Olsen, S.F., & Salvig, J.D. (1997). Marine n-3 fatty acid and calcium intake in relation to pregnancy induced hypertension, intrauterine growth retardation, and preterm delivery. Acta Obstet Gynecol Scand. 76, 38-44.
Kiilholma, P., Pakarinen, P., & Gronroos, M. (1984). Copper and zinc in pre-eclampsia. Acio Obstet Gynecol Scand. 63, 629-631.
Kilpatrick, S. (1995). Unlike pre-eclampsia, gestational hypertension is not associated with increased neonatal and maternal morbidity except abruptio. SPO abstracts. Am J Obstet Gynecol 419, 376.
Kurki, T., Hiilesmaa, V., Raitasalo, R., Mattila, H., & Ylikorkala, O. (2000). Depression and anxiety linked to pre-eclampsia. Obstet Gynecol. 95, 487-490.
Makrides, M., & Gibson, R.A. (2000). Long-chain polyunsaturated fatty acids requirements during pregnancy and lactation. Am J Clin Nutr. 71(suppl 1), 307S-311S.
Murphy, D.J., Sellers, S., MacKenzie, I.Z., Yudkin, P.L., & Johnson, A.M. (1995). Case-control study of antenatal and intrapartum risk factors for cerebral palsy in very preterm singleton babies. Lancet. 346, 1449-1454.
Naeye, B.M. (1981). Maternal blood pressure and fetal growth. Am J Obstet Gynecol. 141, 780-787.
Odent, M. (1995). The primary human disease: An evolutionary perspective. ReVision. 18, 19-21.
Odent, M. (2000). Pre-eclampsia as a maternal - fetal conflict: The link with fetal brain development. International Society for the Study of Fatty Acids and Lipids (ISSFAL) News. 7, 7-10.
Odent, M., McMillan, L., & Kimmel, T. (1996). Prenatal care and sea fish. Ear J Obstet Gynecol. 68, 49-51.
Olsen, S.F., & Secher, N.J. (1990). A possible preventive effect of low-dose fish oil on early delivery and pre-eclampsia: Indications from & 50-year-old controlled trial. Br J Nutr. 64, 599-609.
Olsen, S.F., Sorensen, J.D., & Secher, N.J., et al. (1997). Randomised controlled trial of effect of fish oil supplementation on pregnancy duration. Lancet. 339, 1003-1007.
Robillard, P.Y., Husley, T.C., & Perianiu, J., et al. (1994). Association of pregnancy-induced hypertension with duration of sexual cohabitation before conception. Lancet. 344, 973-975.
Ros, H.S., Cnattingius, S., & Lipworth, L. (1998). Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study. Am J Epidemiol. 147, 1062-1070.
Salvig, J.D., Olsen, S.F., & Secher, N.J. (1996). Effects offish oil supplementation in late pregnancy on blood pressure: A randomised controlled trial. Br J Obstet Gynaecol. 103, 529-533.
Sanders, T.A.B., & Younger, K.M. (1981). The effect of dietary supplements of n-3 polyunsaturated fatty acids on the fatty acid composition of platelets and plasma choline phosphoglycerides. Br J Nutr. 45, 613-616.
Sarhanis, P., & Pugh, D.H.O. (1992). Resolution of pre-eclampsia following intrauterine death of one twin. Br J Obstet Gynaecol. 99, 159-160.
Strickland, D.M., Guzik, O.S., Cox, K., Gant, N.F., & Rosenfeld, C.R. (1986). The relationship between abortion in the first trimester and development of pregnancy-induced hypertension in subsequent pregnancy. Am J Obstet Gynecol. 154, 146-148.
Symonds, E.M. (1980). Aetiology of pre-eclampsia: A review. J R Soc Med. 73, 871-875.
Velzing-Aarts, F.V., van der His, F.R., van der Dijs, F.P., & Muskiet, F.A. (1999). Umbilical vessels of preeclamptic women have low contents of both n-3 and n-6 long-chain polyunsaturated fatty acids. Am J Clin Nutr. 69, 293-298.
Wang, Y., Kay, H.H., & Killam, A.P. (1991). Decreased levels of polyunsaturated fatty acids in pre-eclampsia. Am J Obstet Gynecol. 164, 812-818.
Williams, M.A. (1995). Risk of pre-eclampsia in relation to elaidic acid (trans fatty acid) in maternal erythrocytes. SPO abstracts. Am J Obstet Gynecol. 436, 380.
Williams, M.A., Zingheim, R.W., King, I.B., & Zebelman, A.M. (1995). Omega-3 fatty acids in maternal erythrocytes and risk of pre-eclampsia. Epidemiology. 6, 232-237.
Xiong, X., Demianczuk, N.N., Buekens, P., & Saunders, L.D. (2000). Association of preeclampsia with high birth weight for age. Am J Obstet Gynecol. 183, 148-155.
Michel Odent, MD, Primal Health Research Centre, London, England
Editor's note: This essay is reprinted with the permission of Michel Odent, Director, Primal Health Research, published in North and South America by Birth Works, Ic., Medford, N.J. Free access to Primal Health Research Data Bank is provided at: www.Birthworks.org/primalhealth. Email address for Dr. Odent is: email@example.com