Background Maternal hypertriglyceridaemia is associated with an increase in the risk of pre-eclampsia. We evaluated the role of diet and lipid lowering interventions in pregnancy in preventing pre-eclampsia by a systematic review of evidence.

Methods The major electronic databases were searched (until November 2011) to find relevant citations for interventions. No search restrictions were applied. Interventions included diet control and fibre supplements, physical activity, statins and omega-3 fatty acids. Systematic review of effectiveness was carried out using methodology in line with current recommendations. Results were summarised as pooled relative risks (RR) with 95% confidence intervals (CI) for dichotomous data.

Results 19903 citations were identified. Of these 12 studied the effect of diet, 20 the effect of physical activity and 6 of omega-3 fatty acids on the incidence of pre-eclampsia. Weight management interventions including diet, physical activity and mixed approach (10 RCTs, 3072 women) overall, in pregnancy resulted in a significant reduction in the incidence of pre-eclampsia (RR 0.74, 95% CI 0.59, 0.92; p=0.008). Diet in pregnancy (6 RCTs, 2624 women) resulted in a significant decrease in the risk of pre-eclampsia (RR 0.67, 95% CI 0.53, 0.85; p=0.0009) compared to physical activity and mixed approach. The effect of other lipid lowering interventions like statins, fibre and omega-3 will be provided in detail if selected.

Conclusions Dietary interventions in pregnancy to manage weight resulted in significant reduction in the risk of pre-eclampsia compared to other interventions.