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
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: |
Date | Event |
---|
13 March 2014 | Published |
|
Publisher License: |
Creative Commons: Attribution 3.0 |
PubMed ID: |
24621141 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
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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