摘要：This research sought to evaluate the preventive impact of a Biopsychosocial Model on the incidence of pregnancy-induced hytpertension and pre-eclampsia, and in the same way to evaluate the endocrine-immunological mechanism associated with psychosocial stress factors. The research turned out to be a prospective, randomized, double-blind, clinicaly controlled study. It was carried out in 12 health centers in Valle and Cauca Department, Colombia. It included 91 normotensive, first-time mothers with a high biopsychosocial risk (score ≥3 pts). They were randomly assigned to three groups: 43 (47.2%) to the nutritional intervention Group A: (calcium and linoleic acid, lateral rest), Group B: 24 (26.3 %), with psychosocial support both individual and in groups, placebo and lateral rest, and Group C 24 (26.3 %) with double placebo and lateral rest. A close follow up in their obstetric, nutritional, inmunological and bio-chemical aspects was made on these patients, including a prospective evaluation of the perinatal outcome (pre-post intervention). In Group A (nutritional), 2 (4.6%) patients developed pregnancy induced hytpertension and 2(4.6%) developed pre-eclampsia (RR= 0,22, i.c. 95% 0.08-0.64, p.= 0.001). In Group B, 4 (16.7%) patients developed pre-eclampsia (RR=0.38, i.c. 95% 0.04-0.95, p=0.03). In the Group C (control), 12 (50%) patients developed pre-eclampsia. Patients in Group A presented hypertension caused by pregnancy state, in contrast to the other two groups where pre-eclampsia was the only complication. The risk relatived (RR), with the development of the disease showed a protective effect in Groups A (nutritional) and Group B (psychosocial), with a RR of 0.22 and 0.38 respectively. The elemental Calcium and Linoleic Acid mixed, and in low dosages, taken during the third semester of the pregnancy period, reduced the incidence of pre-clampsia in patients with high risk, possibly through an increase in the Prostaglandin E2 levels. The nutritional and psicosocial interventions improved the balance of the vasoactive prostaglandin (P=0.001), which explains the protective effect observed once the intervention had been done. On the other hand, the psychosocial intervention showed a significant increase (P=0.01) of the relation TBXB2/Pg. 12, with the raise of prostacycline 12, which could explain that the psychosocial intervention had an additional protective effect.
