[Institution Title]
Preeclampsia is a common condition among pregnant women noted by an elevated blood pressure and the presence of significant amount of protein in the urine . In a survey conducted by the World Health Organization, it was reported that in 2011 pre-eclampsia affects approximately 2-8% of the population from a global perspective . Nevertheless, the prevalence may be insignificant but the impact of preeclampsia may be fatal for both the mother and her unborn child. In lieu with this, the proponent of this research would like to conduct a study that would establish the significant impact of prenatal vitamin supplementation (Vitamin C and E), among pregnant women who are at high risk for preeclampsia in population that has low nutritional status comparing the results from developing countries and developed countries.
The Population: Pregnant Women from Developing and Developed Countries
Defining the Population
In this study, the proponent draws 150 pregnant women who are in their third trimester from developing and developed countries classified to belong to the category that is of higher risk for preeclampsia. The population disregards several factors including the age and gravida. Nevertheless, the proponent shall consider the population’s socio-economic status and risk classification for preeclampsia.
Pre-eclampsia: A Priority Issue among Pregnant Women
Preeclampsia may not be prevalent, compared to other pregnancy-induced illnesses like gestational diabetes. Needless to say, the impact of preeclampsia can be life threatening—for the mother, her unborn child, and if successfully delivered, to the pre-eclampsia child. In fact, preeclampsia has been related to have caused fetal growth retardation , fetal morbidity , and even death for the mother .
Intervention
Defining the Intervention
There had been several studies which justifies that through prenatal vitamin supplementation, particularly Vitamin C and E, pregnant women who are high risk for developing preeclampsia, and those who are already classified as preeclampsia high risks mothers, the impact of preeclampsia can be attributably minimized or reduced. The proponent suggests that pregnant women, especially those who are classified as high risk of preeclampsia should be given prenatal vitamin supplements, especially Vitamins C and E.
Prevalence of the Issue
In 2011, the World Health Organization identified preeclampsia as a serious, life-threatening pregnancy-related medical condition. In fact, approximately 2 to 8% of the world’s population are perceived to be high risk for eclampsia and pre-eclampsia. Given this statistics, it has been significantly alarming in the nursing profession that a highly preventable or highly manageable condition can be life threatening and life debilitating.
Setting for Preeclampsia Patients
The proponent decided to make a comparative analysis among pregnant women from developing and developed countries. This setting has been selected to determine whether prenatal vitamin supplementation can actually help prevent preeclampsia. Furthermore, the proponent has also decided to discount gestation and age as a variable because it wants to assess the viability of the prenatal vitamin supplementation to high risk preeclampsia patients.
Urgency of the Problem
With more women getting pregnant every year, and the unhealthy lifestyle that affects pregnancy, it has become imperative to evaluate and analyze how women’s socio-economic capacity, especially in availing prenatal vitamin supplementation has significantly impacted their susceptibility of developing preeclampsia or being significantly affected by a consistently elevated high blood pressure. For the last couple of years, numerous studies had been conducted to determine the significant influence of prenatal vitamin supplements, particularly Vitamin C and E in managing the impact of preeclampsia .
Related Studies
There were several related studies connected to the correlation of prenatal vitamin supplementation to reducing the complications of preeclampsia . Specifically, important is a study conducted in 2006 by Alice R. Rumbold and associates which identified the usefulness of taking Vitamin C and E to prevent the complications of preeclampsia and perinatal complications. According to the author, the two vitamin supplement has no significant impact as far as reducing the complications of preeclampsia is concerned (Rumbold, Crowther, Haslam, & Dekker, 2006, p. 1805). Furthermore, the said vitamin supplement has also no significant impact to risk of intrauterine growth constraint and fetal death (Rumbold, Crowther, Haslam, & Dekker, 2006, p. 1804). Another significant study was conducted in 2002 entitled “Vitamin C and E supplementation in women at risk of preeclampsia is associated with changes in indices of oxidative stress and placental function” (Chappell, et al.). According to this study, the above mentioned vitamins helps reduced the oxidative stress which triggers premature delivery or stillbirth, which can be translated to a more viable placental function (Chappell, et al., 2002, p. 780).
Comparative Analysis
According to several studies, prenatal vitamin supplementation helps significantly reduce the adverse effect of preeclampsia . Nevertheless, there was also one study which overrides the report of the positive benefits of Vitamin C and E in reducing the adverse effects of preeclampsia . However, overall it can be assessed that the absence of continuous supplementation may alter the results. Among the identified barriers to getting this intervention is the lack of means to accessible source of prenatal vitamin supplement. Furthermore, it has been seen that pregnant women in from developed countries like the US, Australia and Europe who are appropriated with prenatal vitamin supplement have a lesser incidence of preeclampsia . In fact, accessibility to the supplements are made accessible through rural and community health centers in developed countries. Some are being accorded to them through their healthcare coverage. Unlike in developing countries where preeclampsia is usually the most prevalent, prenatal vitamin supplementation cannot be part of the government stipend. Poor pregnant women would preferably buy other important necessities than to buy the vitamin supplement .
Perceived Outcome
One specific outcome that interests the proponent of this study is how access to prenatal vitamin supplement can significantly impact the associated risks and complications of preeclampsia. If the intervention is readily available and accessible to the target population, the motivation for pregnant women to take the supplementation should be comparatively higher than those who have limited or no access to the proposed intervention.
Timeframe
Since the target population are pregnant women within the third trimester, this allows for three months or less, observation and trial period. During this duration it is expected that results can be visible. There should be significant management of patient’s blood pressure level, as well as protein in the patient’s urine. Similar to the trial period in de Souza Rugolo, Bentlin, and Trindade’s study (2011) and Roberts, et al.’s study (2010).
PICOT Statement
How does Prenatal Vitamin Supplement, i.e. Vitamin C and E, among pregnant women who are classified as high risk for preeclampsia in population that has low nutritional status results be compared from developing countries and developed countries?
References
Chappell, L., Seed, P., Kelly, F., Briley, A., Hunt, B., Charnock-Jones, S., & Mallet, ,. A. (2002). Vitamin C and E supplementation in women at risk of preeclampsia is associated with changes in indices of oxidative stress and placental function. American Journal of Obstetrics and Gynecology, 777–784.
de Souza Rugolo, L. M., Bentlin, M. R., & Trindade, C. E. (2011). Preeclampsia: Effect on the Fetus and Newborn. NeoReviews, e198-e206.
Eiland, E., Nzerue, C., & Faulkner, M. (2012). Preeclampsia 2012. Journal of Pregnancy, 1-7.
Lapidus, A. M. (2011, July 26). Effects of preeclampsia on the mother, fetus and child. Gynaecology Forum, p. n.p.
Roberts, J., Myatt, L., Spong, C., Thom, E., Hauth, J., & Leveno, K. (2010). Vitamins C and E to Prevent Complications of Pregnancy-Associated Hypertension. The New England Journal of Medicine, 1282-1291.
Rumbold, A., Crowther, C., Haslam, R., & Dekker, G. (2006). Vitamins C and E and the Risks of Preeclampsia and Perinatal Complications. The New England Journal of Medicine, 1796-1806.
World Health Organization. (2011). WHO recommendations for Prevention and treatment of pre-eclampsia and eclampsia. Retrieved from The World Health Organization: http://apps.who.int/iris/bitstream/10665/44703/1/9789241548335_eng.pdf
Xiong, X., Demianczuk, N., Saunders, D., Wang, F.-L., & Fraser, W. (2002). Impact of Preeclampsia and Gestational Hypertension on Birth Weight by Gestational Age. American Journal of Epidemiology, 203-209.
