Calcium supplementation during pregnancy to reduce the risk of pre-eclampsia
Hypertensive disorders* such as pre-eclampsia and eclampsia are among the main causes of maternal deaths and preterm births, especially in low-income countries. Preterm births are the leading cause of early neonatal deaths and infant mortality, and survivors are at higher risk of respiratory disease and long-term neurological morbidity.
Normally, during early pregnancy, blood pressure falls and then slowly rises until the end of pregnancy. However, obesity, diabetes, twin or teenage pregnancies and low calcium consumption alter this equilibrium and increase the risk of developing pre-eclampsia. Calcium supplementation improves calcium intake and consequently reduces the risk of hypertensive disorders during pregnancy.
*disorders in which blood pressure is elevated
WHO recommendations
In populations with low dietary calcium intake, daily calcium supplementation (1.5 g - 2.0 g oral elemental calcium) is recommended for pregnant women to reduce the risk of pre-eclampsia.*
* This recommendation is consistent with the recommendations in ‘WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia’ (2011) and supercedes the previous recommendation found in the WHO guideline ‘Calcium supplementation in pregnant women’ (2013).
Additional information for this recommendation can be found in the guidance summary and in the guideline, under 'WHO documents' below.
WHO documents
GRC-approved guidelines
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WHO recommendations on antenatal care for a positive pregnancy experience
Publication date: 2016
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WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia
Publication date: 2011
Evidence
Systematic reviews used to develop the guidelines
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Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes
Buppasiri P, Lumbiganon P, Thinkhamrop J, Ngamjarus C, Laopaiboon M, Medley N.
Cochrane Database of Systematic Reviews. 2015; Issue 2. Art. No.: CD007079. -
Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems
Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L.
Cochrane Database of Systematic Reviews. 2010; Issue 8. Art. No.: CD001059.
Related Cochrane reviews
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Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems
Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L, Torloni MR.
Cochrane Database of Systematic Reviews. 2014; Issue 6. Art. No.: CD001059. - Summary of this review
Other related systematic reviews
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Effects of Calcium Supplementation During Pregnancy on Maternal, Fetal and Birth Outcomes
Imdad A and Bhutta ZA.
Paediatric and Perinatal Epidemiology. 2012; 26 Suppl 1:138–152.