[Calcium-supplementation in pregnancy--is it a must?]

The pregnant woman's body provides daily doses between 50 and 330 mg to support the developing fetal skeleton. This high fetal demand for calcium in pregnancy is facilitated by profound physiological interactions between mother and fetus. The D-A-CH organization (which represents the German, Austrian and Swiss Nutrition Offices) and the Institute of Medicine (IOM) of the US recommend a daily consumption of 1000 mg calcium for pregnant and lactating women at an age over 19 years. The average consumption of calcium in western countries is about 800 mg in young women. Therefore calcium consumption in pregnancy should be encouraged, especially during the second and third trimester of pregnancy and during lactation. Proper calcium consumption can be attained by diet with healthy nourishment including 3-4 snacks of milk or milk-derived products such as yogurt and cheese and calcium-rich mineral waters. In these women calcium-supplementation in pregnancy is not necessary. In women with chronic autoimmunologic disorders, low-molecular-weight-heparin therapy during pregnancy, lactose intolerance or in women who prefer to skip milk and milk products due to personal preference the supplementation of 500 to 1000 mg calcium in addition to dietary measures is recommended. Calcium supplementation in pregnancy has been associated with a reduced risk of pregnancy-induced hypertension, but this effect is only seen in persons with a low basal calcium intake. There are reports in literature that calcium supplementation in pregnancy protects against low-birthweight in newborns, which is defined as a birthweight of < 2500 g or that calcium supplementation lowers offspring blood pressure thus helping to prevent hypertension in the next generation. These reports are either preliminary or are not applicable to the Swiss population or need confirmation. Therefore calcium supplementation is only recommended in order to achieve a daily uptake of at least 1000 mg/day in pregnant women.