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Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems

  1. GJ Hofmeyr,
  2. AN Atallah,
  3. L Duley

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 21 JAN 2002

DOI: 10.1002/14651858.CD001059


How to Cite

Hofmeyr GJ, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. The Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD001059. DOI: 10.1002/14651858.CD001059.

Author Information

*Prof G Justus Hofmeyr, Director/Hon. Professor, Effective Care Research Unit, University of the Witwatersrand, University of Fort Hare, Eastern Cape Department of Health, Frere and Cecilia Makiwane Hospitals, Private Bag X 9047, East London, Eastern Cape, 5200, SOUTH AFRICA. gjh@global.co.za.

Publication History

  1. Published Online: 21 JAN 2002

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Belizan 1991{published and unpublished data}
  • Belizan JM. Prevention of hypertensive disorders of pregnancy with calcium supplementation. 8th World Congress on Hypertension in Pregnancy; 1992 November 8-12; Buenos Aires, 1992:93.
  • Belizan JM, Villar J, Bergel E, del Pino A, Di Fulvio S, Galliano SV, et al. Long term effect of calcium supplementation during pregnancy on the blood pressure of offspring: follow up of a randomised controlled trial. BMJ 1997;315:281-5.
  • Belizan JM, Villar J, Gonzalez L, Campodonico L, Bergel E. Calcium supplementation to prevent hypertensive disorders of pregnancy. New England Journal of Medicine 1991;325:1399-405.
  • Villar J, Belizan JM, Repke J. The effect of calcium supplementation on the incidence of hypertensive disorders of pregnancy and prematurity. 7th World Congress of Hypertension in Pregnancy; 1990; Perugia, Italy, 1990:54.
  • Villar J, Belizan JM, Repke JT. Does calcium supplementation reduce pregnancy-induced hypertension and prematurity? Proceedings of the International Symposium on advances in the prevention of low birthweight; 1988 May 8-11; Cape Cod, Massachusetts, 1988:187-95.
CPEP 1997{published data only}
  • Levine RJ, Esterlitz JR, Raymond EG, DerSimonian R, Hauth JC, Ben Curet L, et al. Trial of calcium for preeclampsia prevention (CPEP): rationale, design, and methods. Controlled Clinical Trials 1996;17:442-69.
  • Levine RJ, Hauth JC, Curet LB, Sibai BM, Catalano PM, Morris CD, et al. Trial of calcium to prevent preeclampsia. New England Journal of Medicine 1997;337(2):69-76.
  • Levine RJ for the CPEP Study Group. Calcium for preeclampsia prevention (CPEP): a double-blind, placebo-controlled trial in healthy nulliparas. American Journal of Obstetrics and Gynecology 1997;176:S2.
  • Levine RJ for the CPEP Study Group. The trial of calcium for preeclampsia prevention (CPEP). 8th World Congress on Hypertension in Pregnancy - Protagonists and Presentations; 1992 November 8-12; Buenos Aires, Argentina, 1992:94.
Crowther 1999{published data only}
  • Crowther CA, Hiller JE, Pridmore B, Bryce R, Duggan P, Hague WM, et al. Calcium supplementation in nulliparous women for the prevention of pregnancy-induced hypertension, preeclampsia and preterm birth: an Australian randomized trial. Australian and New Zealand Journal of Obstetrics and Gynaecology 1999;39(1):12-8.
L-Jaramillo 1989{published and unpublished data}
  • Lopez-Jaramillo P, Narvaez M, Weigel RM, Yepez R. Calcium supplementation reduces the risk of pregnancy-induced hypertension in an Andes population. British Journal of Obstetrics and Gynaecology 1989;96:648-55.
  • Lopez-Jaramillo P, Narvaez M, Yepez R. Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. American Journal of Obstetrics and Gynaecology 1987;156:261-2.
  • Narvaez M, Lopez-Jaramillo P, Weigel M. Calcium (Ca++) supplementation reduces the risk for pregnancy induced hypertension (PIH). World Contress of Gynecology and Obstetrics; 1988 October 23-28; Brazil 1988;180-1.
L-Jaramillo 1990{published data only}
  • Lopez-Jaramillo P, Narvaez M, Felix C, Lopez A. Dietary calcium supplementation and prevention of pregnancy hypertension. Lancet 1990;335:293.
  • Narvaez M, Lopez-Jaramillo P, Weigel M. Calcium (Ca++) supplementation reduces the risk for pregnancy induced hypertension (PIH). World Contress of Gynecology and Obstetrics; 1988 October 23-28; Brazil 1988;180-1.
L-Jaramillo 1997{published data only}
  • Lopez-Jaramillo P, Delgado F, Jacome P, Teran E, Ruano C, Rivera J. Calcium supplementation and the risk of preeclampsia in Ecuadorian pregnant teenagers. Obstetrics & Gynecology 1997;90:162-7.
Niromanesh 2001{published data only}
  • Niromanesh S, Laghaii S, Mosavi-Jarrahi A. Supplementary calcium in prevention of pre-eclampsia. International Journal of Gynecology and Obstetrics 2001;74:17-21.
Purwar 1996{published data only}
  • Purwar M, Kulkarni H, Motghare V, Dhole S. Calcium supplementation and prevention of pregnancy induced hypertension. Journal of Obstetrics and Gynaecology Research 1996;22(5):425-30.
S-Ramos 1994{published data only}
  • Sanchez-Ramos L, Briones DK, Kaunitz AM, Delvalle GO, Gaudier FL, Walker KD. Prevention of pregnancy-induced hypertension by calcium supplementation in angiotensin II-sensitive patients. Obstetrics & Gynecology 1994;84:349-53.
  • Sanchez-Ramos L, Delvalle GO, Briones D, Walker C, Delke I, Gaudier F. Prevention of preeclampsia by calcium supplementation in angiotensin-sensitive patients. American Journal of Obstetrics and Gynecology 1994;170:408.
Villar 1987{published and unpublished data}
  • Repke JT, Villar J, Anderson C, Pareja G, Dubin N, Belizan JM. Biochemical changes associated with blood pressure reduction induced by calcium supplementation during pregnancy. American Journal of Obstetrics and Gynecology 1989;160:684-90.
  • Villar J, Repke J, Belizan JM, Pareja G. Calcium supplementation reduces blood pressure during pregnancy: results of a randomized controlled clinical trial. Obstetrics & Gynecology 1987;70:317-22.
Villar 1990{published and unpublished data}
  • Villar J, Belizan JM, Repke J. The effect of calcium supplementation on the incidence of hypertensive disorders of pregnancy and prematurity. 7th World Congress of Hypertension in Pregnancy; 1990; Perugia, Italy, 1990:54.
  • Villar J, Belizan JM, Repke JT. Does calcium supplementation reduce pregnancy-induced hypertension and prematurity? Advances in the prevention of low birthweight; 1988 May 8-11; Cape Cod, Massachusetts, 1998:187-95.
  • Villar J, Repke JT. Calcium supplementation during pregnancy may reduce preterm delivery in high-risk populations. American Journal of Obstetrics and Gynecology 1990;163:1124-31.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Almirante 1998
  • Almirante CY. Calcium supplementation during pregnancy in the prevention of EPH gestosis. Prenatal and Neonatal Medicine 1998;3 Suppl 1:24.
Belizan 1983
  • Belizan JM, Villar J, Zalazar A, Rojas L, Chan D, Bryce GF. Preliminary evidence of the effect of calcium supplementation on blood pressure in normal pregnant women. American Journal of Obstetrics and Gynecology 1983;146:175-80.
Boggess 1997
  • Boggess KA, Samuel L, Schmuckler BC, Waters J, Easterling TR. A randomised controlled trial of the effect of third trimester calcium supplementation on maternal hemodynamic function. Obstetrics & Gynecology 1997;90:157-61.
Cong 1995
  • Cong KJ, Chi SL, Liu GR. Calcium and pregnancy induced hypertension. Chinese Journal of Obstetrics and Gynecology 1993;28:657-9.
  • Cong KJ, Chi SL, Liu GR. Calcium supplementation during pregnancy for reducing pregnancy induced hypertension. Chinese Medical Journal 1995;108:57-9.
  • Cong KJ, Chi SL, Liu GR. Calcium supplementation during pregnancy to reduce pregnancy induced hypertension. Beijing Medical Journal 1992;5:268.
Felix 1991
  • Felix C, Jacome P, Lopez A, Moya W, Narvaez M, Lopez-Jaramillo P. The hypotensive effect of calcium supplementation during normal pregnancy in Andean women is not related to vascular production of prostacyclin by umbilical arteries. Journal of Obstetrics and Gynaecology 1991;11(2):93-6.
Herrera 1998
  • Herrera JA, Arevalo-Herrera M, Herrera S. Prevention of preeclampsia by linoleic acid and calcium supplementation: a randomized controlled trial. Obstetrics & Gynecology 1998;91(4):585-90.
Kawasaki 1985
  • Kawasaki N, Matsui K, Ito M, Nakamura T, Yoshimura T, Ushijima H, et al. Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. American Journal of Obstetrics and Gynecology 1985;153:576-82.
Knight 1992
  • Knight KB, Keith RE. Calcium supplementation on normotensive and hypertensive pregnant women. American Journal of Clinical Nutrition 1992;55:891-5.
Lavin 1986
  • Lavin JP. The effect of calcium supplementation on pregnancy induced hypertension. Personal communication 1986.
Marya 1987
  • Marya RK, Rathee S, Manrow M. Effect of calcium and vitamin D supplementation on toxaemia of pregnancy. Gynecologic and Obstetric Investigation 1987;24:38-42.
Montanaro 1990
  • Montanaro D, Boscutti G, Antonucci F, Messa P, Mioni G, Driul P, et al. Prevention of pregnancy-induced hypertension (PIH) and pre-eclampsia (PE) by oral calcium supplementation. Proceedings of the 10th International Congress of Nephrology; 1987 July 26-31; London, 1987:281.
  • Montanaro D, Boscutti G, Mioni G, Driul P, Tosolini G. Calcium supplementation decreases the incidence of pregnancy-induced hypertension (PIH) and pre-eclampsia (PE). 7th World Congress of Hypertension in Pregnancy; 1990; Perugia, Italy, 1990:267.
Raman 1978
  • Raman L, Rajalakshmi K, Krishnamachari K, Gowrinath Sastry J. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of neonates. American Journal of Clinical Nutrition 1978;31:466-9.
Repke 1989
  • Repke J, Villar J, Bergel E, Belizan JM. The effect of iron absorption in patients receiving calcium supplementation. 9th Annual Meeting of the Society of Perinatal Obstetricians; 1989 February 1-4; New Orleans, Louisiana, USA, 1989:512.
Rogers 1999
  • Rogers MS, Fung HYM, Hung CY. Calcium and low-dose aspirin prophylaxis in women at high risk of pregnancy-induced hypertension. Hypertension in Pregnancy 1999;18(2):165-72.
S-Ramos 1995
  • Sanchez-Ramos L, Adair CD, Delvalle GO, Gaudier F, Delke I. Calcium supplementation in mild preeclampsia remote from term: a prospective randomized double-blind clinical trial. American Journal of Obstetrics and Gynecology 1993;168:385.
  • Sanchez-Ramos L, Adair D, Kaunitz AM, Briones DK, Delvalle GO, Delke I. Calcium supplementation in mild pre-eclampsia remote from term: a randomized double-blind clinical trial. Obstetrics & Gynecology 1995;85:915-8.
Suzuki 1996
  • Suzuki Y, Itoh Y, Hayashi Y, Murakami I, Yamaguchi K, Ohshima T, et al. Calcium supplementation to prevent gestational hypertension. 10th World Congress of the International Society for the Study of Hypertension in Pregnancy; 1996 August 4-8; Seattle, Washington, 1996:113.
Tamas 1997
  • Tamas P, Szabo I, Szekely J, Csermely T, Prievara FT, Nemeth L, et al. Effects of Doxium 500 (R) in gestational hypertension [A doxium 500 (R) Hatasanak vizsgalata terhessegi Hypertoniaban (kettos vak, placebo-kontrollalt tanulmany)]. Magyar Noorvosok Lapja 1997;60(3):181-7.
Wanchu 2001
  • Wanchu M, Malhotra S, Khullar M. Calcium supplementation in pre-eclampsia. Journal of the Association of Physicians of India 2001;49:795-8.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
August 2002
  • August P, Sison M, Helseth G. Identification of prognostic indices and impact of calcium supplementation in women at high risk for pre-eclampsia: data from a randomized clinical trial [abstract]. Hypertension in Pregnancy 2002;21(Suppl 1):44.
Chames 2002
  • Chames M, Bendich A, Bogden J, Sibai B, Prada J. A randomized trial of calcium supplementation effects on blood lead levels in pregnancy [abstract]. American Journal of Obstetrics and Gynecology 2002;187(6 Pt 2):S137.
Crowther 1998
  • Crowther C, Hiller J, Pridmore B, Bryce R, Duggan P, Hague W, et al. Calcium supplementation in nulliparous women for the prevention of pregnancy included hypertension, pre-eclampsia and preterm birth: an australian randomised trial. 4th Annual Congress of the Perinatal Society of Australia & New Zealand; 1998 March 30-April 4; Alice Springs, Australia 1998;101.
MacDonald 1986
  • MacDonald HN. Fetal and maternal benefits from calcium and vitamin D supplementation of pregnant Asians. Personal communication 1986.
Prada 2001
  • Prada J, Tsang R, Guo S. Reduction of blood pressure from calcium supplementation in adolescent pregnancy: a randomized trial [abstract]. American Journal of Hypertension 2001;14(4 Pt 2):179A.
Prada 2002
  • Prada JA, Sibai BM, Guo S. Effect of calcium supplementation on the maternal blood pressure of adolescents and twins [abstract]. American Journal of Obstetrics and Gynecology 2002;187(6 pt 2):S217.
Stephens 1998
  • Stephens IF. Effect of calcium supplementation during pregnancy on blood pressure of offspring. Authors cannot be sure of effect's generalisability to all children aged 5-9 [letter; comment]. BMJ 1998;316(7126):234.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Mahomed 1998
  • Mahomed K, Marume A, Hammond N, Madzima M. Calcium supplementation for the prevention of pregnancy induced hypertension and preterm labour in twin pregnancies: a randomised controlled trial.
WHO
  • WHO Collaborative Group. WHO multicentre randomised trial of calcium supplementation for the prevention of pre-eclampsia.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Belizan 1980
  • 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.
Belizan 1988
  • Belizan JM, Villar J, Repke J. The relationship between calcium intake and pregnancy-induced hypertension: up-to-date evidence. American Journal of Obstetrics and Gynecology 1988;158:898-902.
Belizan 1997
  • Belizan JM, Villar J, Bergel E, del Pino A, Di Fulvio S, Galliano SV, et al. Long term effect of calcium supplementation during pregnancy on the blood pressure of offspring: follow up of a randomised controlled trial. BMJ 1997;315:281-5.
Bucher 1996
  • Bucher HC, Guyatt GH, Cook RJ. Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: a meta-analysis of randomized controlled trials. JAMA 1996;275:1113-7.
Carroli 1994
  • Carroli G, Duley L, Belizan JM, Villar J. Calcium supplementation during pregnancy: a systematic review of randomised controlled trials. British Journal of Obstetrics and Gynaecology 1994;101(9):753-8.
CLASP 1994
  • CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant woman. Lancet 1994;343:619-29.
Early Breast Ca 1990
  • Early Breast Cancer Trialists' Collaborative Statistical methods. Treatment of early breast cancer: Vol 1. Worldwide evidence 1985-1990. Oxford: Oxford University Press, 1990:13-8.
ECCPA 1996
  • ECPPA (Estudo Collaborativo para Prevenção da Pre-eclampsia com Aspirina) Collaborative Group. ECPPA: randomised trial of low dose aspirin for the prevention of maternal and fetal complications in high risk pregnant woman. British Journal of Obstetrics and Gynaecology 1996;103:39-47.
Greenland 1994
  • Greenland S. Invited commentary: A critical look at some popular meta-analytic methods. American Journal of Epidemiology 1994;140:290-6.
Hamlin 1952
  • Hamlin RHJ. The prevention of eclampsia and pre-eclampsia. Lancet 1952;i:64-8.
Hamlin 1962
  • Hamlin RHJ. Prevention of pre-eclampsia. Lancet 1962;1:864-5.
HMSO 1994
  • HMSO. Report on confidential enquiries into maternal deaths in the United Kingdom 1988-1990. Department of Health Welsh Office, Scottish Office Home and Health Department, Department of Health and Social Security, Northern Ireland. London: HMSO, 1994.
Johnson 1993
  • Johnson A, Townshend P, Yudkin P, Bull D, Wilkinson AR. Functional abilities at age 4 years of children born before 29 weeks gestation. BMJ 1993;306:1715-8.
NHMRC 1993
  • NHMRC Report on maternal deaths in Australia 1988-1990. Canberra: Government Publishing Service, 1993.
Repke 1991
  • Repke JT, Villar J. Pregnancy-induced hypertension and low birth weight: the role of calcium. American Journal of Clinical Nutrition 1991;54:237-41S.
Villar 1989
  • Villar J, Repke J, Markush L, Calvert W, Rhoads G. The measuring of blood pressure during pregnancy. American Journal of Obstetrics and Gynecology 1989;161:1019-24.
Villar 1993
  • Villar J, Belizan JM, Fisher PJ. Epidemiologic observation on the relationship between calcium intake and eclampsia. International Journal of Gynecology and Obstetrics 1993;21:271-8.
Villar 1994
  • Villar J, Ezcurra EJ, Gurtner de la Fuente V, et al. Preterm delivery syndrome-the unmet need. Research Clinical Forums 1994;16:9-39.
Villar 1995
  • Villar J, Carroli G, Belizan JM. Predictive ability of meta-analysis of randomised control trials. Lancet 1995;345:772-6.
Villar 1998
  • Villar J, Gulmezoglu AM, de Onis M. Nutritional and antimicrobial interventions to prevent preterm birth: an overview of randomized controlled trials. Obstetrical and Gynecological Survey 1998;53(9):575-85.

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Duley 1995
  • Duley L. Routine calcium supplementation in pregnancy. [revised 23 June 1993] In: Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database [database on disk and CDROM]. The Cochrane Collaboration; Issue 2, Oxford: Update Software; 1995.