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

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hofmeyr, G. J. Belizán, J. M. Von Dadelszen, P.
Description	Country affiliation: South Africa Author Affiliation: Hofmeyr GJ ( Effective Care Research Unit, East London Hospital Complex/University of the Witwatersrand/University of Fort Hare, East London, Eastern Cape, South Africa.)
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.
File Format	HTM / HTML
ISSN	14700328
e-ISSN	14710528
DOI	10.1111/1471-0528.12613
Journal	BJOG: An International Journal of Obstetrics & Gynaecology
Issue Number	8
Volume Number	121
Language	English
Publisher	Wiley
Publisher Date	2014-07-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Obstetrics Discipline Gynecology Calcium, Dietary Administration & Dosage Dietary Supplements Hypertension Prevention & Control Pre-eclampsia Pregnancy Complications, Cardiovascular Adverse Effects Pregnancy Randomized Controlled Trials As Topic Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology

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