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Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems
A N Atallah1, G J Hofmeyr, L Duley
1(Director, Effective Care Research Unit, University of the Witwatersrand), Frere/Cecilia Makiwane Hospitals, Private Bag 9047, East London 5200, Eastern Cape, South Africa. gjh@global.co.za
Insights
Calcium supplementation during pregnancy can reduce the risk of high blood pressure and pre-eclampsia, especially for high-risk individuals. It may also reduce low birth weight babies.
Area of Science:
- Obstetrics and Gynecology
- Nutritional Science
- Maternal-Fetal Medicine
Background:
- Calcium supplementation is investigated for its potential to prevent pregnancy-related hypertension and preterm labor.
- Understanding calcium's role is crucial for managing hypertensive disorders of pregnancy.
Purpose of the Study:
- To evaluate the impact of calcium supplementation during pregnancy on hypertensive disorders.
- To assess related adverse maternal and child health outcomes.
Main Methods:
- Systematic review of randomized controlled trials comparing calcium (≥1g/day) with placebo.
- Searched Cochrane databases and contacted study authors (search up to February 2000).
- Assessed trial quality and extracted data.
Main Results:
- Calcium supplementation modestly reduced high blood pressure (RR 0.81) and pre-eclampsia (RR 0.70).
- Benefits were most pronounced in women at high risk for hypertension and with low baseline calcium intake.
- Reduced incidence of low birth weight (<2500g) babies (RR 0.83) and improved childhood systolic blood pressure were observed.
Conclusions:
- Calcium supplementation shows benefits for pregnant women at high risk of gestational hypertension and those with low dietary calcium intake.
- Further research is needed to determine optimal calcium dosage during pregnancy.
Background:
Calcium supplementation may prevent high blood pressure through a number of mechanisms and may help to prevent preterm labour.
Objectives:
The objective of this review was to assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child adverse outcomes.
Search Strategy:
We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register and we contacted study authors. Date of last search: February 2000.
Selection Criteria:
Randomised trials comparing at least one gram daily of calcium during pregnancy with placebo.
Data Collection And Analysis:
Eligibility and trial quality were assessed. Data extraction was carried out and double entered.
Main Results:
Ten studies were included, all of good quality. There was a modest reduction in high blood pressure with calcium supplementation (relative risk 0.81, 95% confidence interval 0.74 to 0.89). The effect was greatest for women at high risk of hypertension (relative risk 0.35, 95% confidence interval 0.21 to 0.57) and those with low baseline dietary calcium (relative risk 0.49, 95% confidence interval 0.38 to 0.62). There was also a modest reduction in the risk of pre-eclampsia with calcium supplementation (relative risk 0. 70, 95% confidence interval 0.58 to 0.83). The effect was greatest for women at high risk of hypertension (relative risk 0.22, 95% confidence interval 0.11 to 0.43) and those with low baseline calcium intake (relative risk 0.32, 95% confidence interval 0.21 to 0.49). There was no overall effect on the risk of preterm delivery, although there was a reduction in risk amongst women at high risk of hypertension (relative risk 0.43, 95% confidence interval 0.24 to 0. 79). There was no evidence of any effect of calcium supplementation on stillbirth or death before discharge from hospital. There were fewer babies with birthweight, <2500g (RR 0.83, 95% CI 0.71-0.98). In one study, childhood systolic blood pressure >95th percentile was reduced (RR0.59, 95% CI 0.39-0.91).
Reviewer'S Conclusions:
Calcium supplementation appears to be beneficial for women at high risk of gestational hypertension and in communities with low dietary calcium intake. Optimum dosage requires further investigation.