Chronic hypertension during gestation is associated with an increased risk of adverse pregnancy outcomes including pre-eclampsia, fetal growth restriction and preterm birth. Research into new chemotherapeutic regimes for the treatment of hypertension in pregnancy is limited due to concerns about fetal toxicity and teratogenicity, and new therapeutic avenues are being sought in alternative physiological pathways. Historically, generation of the vasodilator nitric oxide was believed to be solely from L-arginine by means of nitric oxide synthase enzymes. Recently, a novel pathway for the reduction of dietary inorganic nitrate to nitrite by the bacteria in the oral cavity and subsequently to vasodilatory nitric oxide within the body has been uncovered. Dietary nitrate is abundant in green leafy vegetables, including beetroot and spinach, and reduction of exogenous nitrate to nitrite by oral bacteria can increase nitric oxide in the vasculature, lessening hypertension. Supplements rich in nitrate may be an attractive choice for treatment due to fewer side effects than drugs that are currently used to treat hypertensive pregnancy disorders. Additionally, manipulation of the composition of the oral microbiota using pro- and prebiotics in tandem with additional dietary interventions to promote cardiovascular health during gestation may offer a safe and effective means of treating hypertensive pregnancy disorders including gestational hypertension and pre-eclampsia. The use of dietary inorganic nitrate as a supplement during pregnancy requires further exploration and large scale studies before it may be considered as part of a treatment regime. The aim of this article is to review the current evidence that oral microbiota plays a role in hypertensive pregnancies and whether it could be manipulated to improve patient outcomes.

妊娠期间的慢性高血压与不良妊娠结局（包括先兆子痫，胎儿生长受限和早产）的风险增加相关。由于对胎儿毒性和致畸性的关注，对用于治疗妊娠高血压的新化学疗法的研究受到了限制，并且在替代的生理途径中寻求新的治疗途径。历史上，血管扩张剂一氧化氮的产生被认为仅来自大号-精氨酸借助于一氧化氮合酶。最近，已经发现了一种新的途径，该途径可以通过饮食中的细菌将饮食中的无机硝酸盐还原为亚硝酸盐，然后再还原为体内的血管舒张性一氧化氮。饮食中的硝酸盐在甜菜根和菠菜等绿叶蔬菜中含量很高，口腔细菌将外源硝酸盐还原为亚硝酸盐可增加脉管系统中的一氧化氮，从而减轻高血压。富含硝酸盐的补充剂可能是一种有吸引力的治疗方法，因为其副作用比目前用于治疗高血压妊娠疾病的药物少。另外，结合使用益生元和益生元对口腔微生物群的组成进行操作，并通过其他饮食干预措施来促进妊娠期间的心血管健康，可能为治疗包括妊娠高血压和先兆子痫在内的高血压妊娠疾病提供安全有效的手段。在怀孕期间使用饮食中的无机硝酸盐作为补充剂需要进一步的探索和大规模的研究，然后才能将其视为治疗方案的一部分。本文的目的是回顾当前口腔微生物群在高血压妊娠中起作用的证据，以及是否可以对其进行操纵以改善患者预后的证据。在怀孕期间使用饮食中的无机硝酸盐作为补充剂需要进一步的探索和大规模的研究，然后才能将其视为治疗方案的一部分。本文的目的是回顾当前口腔微生物群在高血压妊娠中起作用的证据，以及是否可以对其进行操纵以改善患者预后的证据。在怀孕期间使用饮食中的无机硝酸盐作为补充剂需要进一步的探索和大规模的研究，然后才能将其视为治疗方案的一部分。本文的目的是回顾当前口腔微生物群在高血压妊娠中起作用的证据，以及是否可以对其进行操纵以改善患者预后的证据。