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

Hofmeyr, GJ; Belizán, JM; von Dadelszen, P; Calcium and Pre-eclampsia (CAP) Study Group, CAP (2014) Low-dose calcium supplementation for preventing pre-eclampsia: a systematic review and commentary. Bjog : An International Journal Of Obstetrics & Gynaecology, 121 (8). pp. 951-957. https://doi.org/10.1111/1471-0528.12613
SGUL Authors: von Dadelszen, Peter

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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.

Item Type: Article
Additional Information: © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: Calcium replacement, calcium supplement, eclampsia, low-dose calcium, pre-eclampsia, Calcium, Dietary, Dietary Supplements, Female, Humans, Hypertension, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Cardiovascular, Randomized Controlled Trials as Topic, Treatment Outcome, Calcium and Pre-eclampsia (CAP) Study Group, Humans, Pre-Eclampsia, Pregnancy Complications, Cardiovascular, Hypertension, Calcium, Dietary, Treatment Outcome, Pregnancy, Dietary Supplements, Female, Randomized Controlled Trials as Topic, Obstetrics & Reproductive Medicine, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Bjog : An International Journal Of Obstetrics & Gynaecology
Language: eng
Dates:
DateEvent
13 March 2014Published
Publisher License: Creative Commons: Attribution 3.0
PubMed ID: 24621141
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107506
Publisher's version: https://doi.org/10.1111/1471-0528.12613

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