National Adoption of World Health Organization Recommendations on Calcium Supplementation During Pregnancy

In several countries, pregnant women have suboptimal intakes of calcium and high rates of mortality due to maternal hypertensive disorders. Calcium supplementation during pregnancy reduces the risk of these disorders and is recommended for pregnant women with low dietary calcium intake to prevent preeclampsia. Our objective was to evaluate the global adoption of the World Health Organization (WHO) recommendation for calcium supplementation during pregnancy to prevent pre-eclampsia. Each WHO member state's Ministry of Health website, Google, and WHO databases were searched, between January and July 2024, to identify national antenatal care guidelines. We found pregnancy-related guidelines published between 2007 and 2024 in 92 countries of the 194 countries included in this review (47.4%), of which 58 (63%) included calcium intake recommendations, and 29 recommended calcium supplementation with doses varying from 0.5 to 2 g of elemental calcium per day. Most of these guidelines were from upper middle- or high-income countries (19, 65.5%), whereas in countries where this recommendation is most needed, there is a lack of published calcium supplementation recommendations during pregnancy.