BEYOND THE PILL AND THE PLATE: HYDROTHERAPY AND ANTI-INFLAMMATORY DIET AS ADJUNCTIVE NATUROPATHIC INTERVENTIONS FOR HYPERTENSIVE DISORDERS OF PREGNANCY - A NARRATIVE REVIEW

Abstract

Background: Hypertensive disorders of pregnancy (HDP), including preeclampsia, contribute substantially to maternal and perinatal morbidity and mortality. Inflammation, endothelial dysfunction, oxidative stress, and altered cardiovascular regulation are central to their pathophysiology, creating interest in complementary interventions alongside conventional obstetric management. Objective: This narrative review evaluates the biological mechanisms, available clinical evidence, therapeutic potential, and safety considerations of hydrotherapy and anti-inflammatory dietary interventions as adjunctive approaches for HDP. Methods: Relevant literature was reviewed to examine hydrotherapy-related cardiovascular and autonomic responses, including blood pressure and heart rate variability, alongside the inflammatory, metabolic, and vascular effects of Mediterranean- and DASH-style dietary patterns. Evidence from pregnant and non-pregnant populations was considered, with emphasis on distinguishing pregnancy-specific findings from indirect physiological evidence. Results: Anti-inflammatory dietary patterns demonstrate comparatively stronger pregnancy-specific evidence, suggesting potential benefits for maternal metabolic health, inflammatory regulation, endothelial function, and selected pregnancy outcomes. Hydrotherapy may influence peripheral circulation, vascular reactivity, blood pressure, and autonomic regulation; however, supporting evidence is predominantly derived from healthy or non-pregnant populations. Direct evidence establishing its effectiveness and safety in women with HDP remains insufficient. Conclusion: Anti-inflammatory dietary interventions may offer supportive benefits when integrated with established obstetric care, whereas hydrotherapy remains investigational for HDP. Pregnancy-specific clinical trials with standardised intervention protocols and appropriate maternal-fetal monitoring are required before routine clinical implementation.