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. 2014 Jul;121(8):951-7.
doi: 10.1111/1471-0528.12613. Epub 2014 Mar 13.

Low-dose calcium supplementation for preventing pre-eclampsia: a systematic review and commentary

G J Hofmeyr  1 , J M Belizán, P von Dadelszen; Calcium and Pre-eclampsia (CAP) Study Group
Affiliations
Free PMC article

Low-dose calcium supplementation for preventing pre-eclampsia: a systematic review and commentary

G J Hofmeyr et al. BJOG. 2014 Jul.
Free PMC article

Abstract

Background: Epidemiological data link low dietary calcium with pre-eclampsia. Current recommendations are for 1.5-2 g/day calcium supplementation for low-intake pregnant women, based on randomised controlled trials of ≥1 g/day calcium supplementation from 20 weeks of gestation. This is problematic logistically in low-resource settings; excessive calcium may be harmful; and 20 weeks may be too late to alter outcomes.

Objectives: To review the impact of lower dose calcium supplementation on pre-eclampsia risk.

Search strategy and selection criteria: We searched PubMed and the Cochrane Pregnancy and Childbirth Group trials register.

Data collection and analysis: Two authors extracted data from eligible randomised and quasi-randomised trials of low-dose calcium (LDC, <1 g/day), with or without other supplements.

Main results: Pre-eclampsia was reduced consistently with LDC with or without co-supplements (nine trials, 2234 women, relative risk [RR] 0.38; 95% confidence interval [95% CI] 0.28-0.52), as well as for subgroups: LDC alone (four trials, 980 women, RR 0.36; 95% CI 0.23-0.57]); LDC plus linoleic acid (two trials, 134 women, RR 0.23; 95% CI 0.09-0.60); LDC plus vitamin D (two trials, 1060 women, RR 0.49; 0.31-0.78) and a trend for LDC plus antioxidants (one trial, 60 women, RR 0.24; 95% CI 0.06-1.01). Overall results were consistent with the single quality trial of LDC alone (171 women, RR 0.30; 95% CI 0.06-1.38). LDC plus antioxidants commencing at 8-12 weeks tended to reduce miscarriage (one trial, 60 women, RR 0.06; 95% CI 0.00-1.04).

Conclusions: These limited data are consistent with LDC reducing the risk of pre-eclampsia; confirming this in sufficiently powered randomised controlled trials would have implications for current guidelines and their global implementation.

Keywords: Calcium replacement; calcium supplement; eclampsia; low-dose calcium; pre-eclampsia.

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Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
The effect of low-dose calcium supplementation in the second half of pregnancy with or without vitamin D, linoleic acid or antioxidants, on pre-eclampsia, including trials at low and high risk of bias.
See this image and copyright information in PMC

References

    1. Firoz T, Sanghvi H, Merialdi M, von Dadelszen P. Pre-eclampsia in low and middle income countries. Best Pract Res Clin Obstet Gynaecol. 2011;25:537–48. - PubMed
    1. Hamlin RH. The prevention of eclampsia and pre-eclampsia. Lancet. 1952;1:64–8. - PubMed
    1. Belizan JM, Villar J. The relationship between calcium intake and edema-, proteinuria-, and hypertension-getosis: an hypothesis. Am J Clin Nutr. 1980;33:2202–10. - PubMed
    1. von Dadelszen P, Firoz T, Donnay F, Gordon R, Hofmeyr GJ, Lalani S, et al. Preeclampsia in low and middle income countries—health services lessons learnt from the PRE-EMPT (PRE-eclampsia – Eclampsia Monitoring, Prevention & Treatment) project. J Obstet Gynaecol Can. 2012;34:917–26. - PubMed
    1. Currie S, de Graft-Johnson J, Galloway R, Sheehan C, Smith J. Asia Regional Meeting. 2012 May 3–6; Dhaka, Bangladesh; Meeting Report; Interventions for impact in essential obstetric and newborn care; [ www.mchip.net/sites/default/files/EONC_AsiaRegionalMeeting_web.pdf ] Accessed on 21 December 2012.

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