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Calcium supplementation for preventing pre-eclampsia/eclampsiaJustus Hofmeyr, for the Calcium and Pre-eclampsia (CAP) Study Group**Fernando Althabe, Sadiqua Allie, John Anthony, José Belizán, Eduardo Bergel, Ana Pilar Betran, Eckhart Buchmann,Sue Fawcus, Justus Hofmeyr, Anne Horak, Stephen Munjanja, Adegboyega Oyebajo, Diane Sawchuck, Mandisa Singata, Peter von Dadelszen
Population mortality estimates 150-580/100 000
Low incidence of pre-eclampsia noted in:
Ethiopia (Hamlin 1962)
Guatemala (Belizan 1980)
Postulated due to high calcium diets
Hamlin RHJ. Prevention of pre-eclampsia. Lancet 1962;1:864-5.
Belizan JM, Villar J. The relationship between calcium intake and edema, proteinuria, and hypertension-gestosis: an hypothesis. American Journal of Clinical Nutrition 1980;33:2202-10.
Hofmeyr GJ, Atallah ÁN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 1998
World Health organization randomized trial of calcium supplementation among low calcium intake women.
Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali M, Zavaleta N, Purwar M, Hofmeyr GJ, thi Nhu Ngoc N, Campódonico L, Landoulsi S, Carroli G, Lindheimer M et al.
Am J Obstet Gynecol
Hofmeyr GJ, Lawrie TA,
Atallah ÁN, Duley L.
Cochrane Database of
Syst Reviews 2010
Calcium supplementation in 2nd half of pregnancy:
↓ blood pressure (↓ vascular tone)
↓ serious complications related to hypertension
No effect on other organ dysfunction eg endothelial
↓ BP → ↓ early deliveries (induction/CS)
→ ↓ low birthweight
→ ↑ time to develop HELLP syndrome
To prevent multisystem dysfunction may need adequate calcium from before pregnancy
Hofmeyr GJ, Duley L, Atallah A. Dietary calcium supplementation for prevention of pre-eclampsia and related problems: a systematic review and commentary. BJOG. 2007; 114: 933-943
Daily provisional supply of calcium
per capita in developing and developed countries (FAO, 1990)