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Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes

  1. Pranom Buppasiri1,*,
  2. Pisake Lumbiganon1,
  3. Jadsada Thinkhamrop1,
  4. Chetta Ngamjarus2,
  5. Malinee Laopaiboon3

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 5 OCT 2011

Assessed as up-to-date: 22 JUN 2011

DOI: 10.1002/14651858.CD007079.pub2


How to Cite

Buppasiri P, Lumbiganon P, Thinkhamrop J, Ngamjarus C, Laopaiboon M. Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD007079. DOI: 10.1002/14651858.CD007079.pub2.

Author Information

  1. 1

    Khon Kaen University, Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen, Khon Kaen, Thailand

  2. 2

    Faculty of Public Health, Khon Kaen University, Department of Biostatistics and Demography, Khon Kaen, Thailand

  3. 3

    Khon Kaen University, Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen, Thailand

*Pranom Buppasiri, Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Faculty of Medicine, Khon Kaen, Khon Kaen, 40002, Thailand. bprano@kku.ac.th.

Publication History

  1. Publication Status: New
  2. Published Online: 5 OCT 2011

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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. Additional references
Belizan 1983 {published data only}
  • 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.
Belizan 1991 {published data only}
  • 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 randomized 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.
  • Bergel E, Gibbons L, Rasines MG, Luetich A, Belizan JM. Maternal calcium supplementation during pregnancy and dental caries of children at 12 years of age: follow-up of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica 2010;89(11):1396-402.
  • 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.
  • Villar J, Belizan JM, Repke JT. Does calcium supplementation reduce pregnancy-induced hypertension and prematurely?. Proceedings of International Symposium on Advances in the Prevention of Low Birthweight; 1988 May 8-11; Cape Cod, Massachusetts, USA. 1988.
Boggess 1997 {published data only}
Chan 2006 {published data only}
  • Chan GM. The effects of dietary milk on adolescent pregnant mothers and their newborn [abstract]. Pediatric Academic Societies Annual Meeting; 2006 April 29-May 2; San Francisco, CA, USA. 2006.
  • Chan GM, McElllgot K, McNaught T, Gill G. Effects of dietary calcium intervention on adolescent mothers and newborns. Obstetrics & Gynecology 2006;108:565-71.
Crowther 1999 {published data only}
  • 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. 2nd Annual Congress of the Perinatal Society of Australia & New Zealand; 1998 March 30-April 4; Alice Springs, Australia. 1998:101.
  • 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 Fracog and the ACT study group. Australian and New Zealand Journal of Obstetrics and Gynaecology 1999;39(1):12-8.
  • Griffith EC, Crowther CA, Hiller JE, Wilson KJ, ACT Study Group. Leg cramps in pregnancy: ineffectiveness of calcium supplementation. 2nd Annual Congress of the Perinatal Society of Australia & New Zealand; 1998 March 30-April 4; Alice Springs, Australia. 1998:99.
  • Hiller JE, Crowther CA, Moore VA, Willson K, Robinson JS. Calcium supplementation in pregnancy and its impact on blood pressure in children and women: follow up of a randomised controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology 2007;47(2):115-21.
Ettinger 2009 {published data only}
  • Ettinger AS, Lamadrid-Figueroa H, Tellez-Rojo MM, Mercado-Garcia A, Peterson KE, Schwartz J, et al. Effect of calcium supplementation on blood lead levels in pregnancy: a randomized placebo-controlled trial. Environmental Health Perspectives 2009;117(1):26-31.
Jarjou 2006 {published data only}
  • Hawkesworth S, Sawo Y, Fulford AJ, Goldberg GR, Jarjou LM, Prentice A, et al. Effect of maternal calcium supplementation on offspring blood pressure in 5- to 10-y-old rural Gambian children. American Journal of Clinical Nutrition 2010;92(4):741-7.
  • Jarjou L, Prentice A, Sawo Y, Laskey MA, Bennett J, Goldberg GR, et al. Randomized, placebo-controlled, calcium supplementation study in pregnant Gambian women: effects on breast-milk calcium concentrations and infant birth weight, growth, and bone mineral accretion in the first year of life. American Journal of Clinical Nutrition 2006;83(3):657-66.
  • Jarjou LM, Laskey MA, Sawo Y, Goldberg GR, Cole TJ, Prentice A. Effect of calcium supplementation in pregnancy on maternal bone outcomes in women with a low calcium intake. American Journal of Clinical Nutrition 2010;92(2):450-7.
  • Jarjou LM, Prentice A, Bennett J. Impact of calcium supplementation in the preceding pregnancy on the human milk calcium concentration of Gambian women. Advances in Experimental Medicine and Biology 2004;54:347-9.
  • Jarjou LMA, Bennett J, Laidlow A, Goldberg GR, Prentice A. Changes in bone turnover and calciotropic hormones in lactating Gambian women supplemented with calcium during pregnancy. Journal of Human Lactation 2007;23:86-7.
  • Prentice A, Jarjou LM, Goldberg GR, Bennett J, Cole TJ, Schoenmakers I. Maternal plasma 25-hydroxyvitamin D concentration and birthweight, growth and bone mineral accretion of Gambian infants. Acta Paediatrica 2009;98(8):1360-2.
Karandish 2003 {published data only}
  • Karandish M, Djazayery A, Mahmoudi M, Behrooz A. The effect of calcium supplementation during pregnancy on birth weight. Medical Journal of Reproduction and Infertility 2003;4(3):184.
Levine 1997 {published data only}
  • Harrison-Hohner J, Coste S, Dorato V, Curet LB, McCarron D, Hatton D. Prenatal calcium supplementation and postpartum depression: an ancillary study to a randomized trial of calcium for prevention of preeclampsia. Archives of Women's Mental Health 2001;3:141-6.
  • Hatton DC, Harrison-Hohner J, Coste S, Reller M, McCarron D. Gestational calcium supplementation and blood pressure in the offspring. American Journal of Hypertension 2003;16:801-5.
  • Koo WWK, Walters JC, Esterlitz J, Levine RJ, Bush AJ, Sibai B. Maternal calcium supplementation and fetal bone mineralization. Obstetrics & Gynecology 1999;94:577-82.
  • Levine RJ. Calcium for preeclampsia prevention (CPEP): a double-blind, placebo-controlled trial in healthy nulliparas. American Journal of Obstetrics and Gynecology 1997;176(1 Pt 2):S2.
  • Levine RJ, CPEP Study Group. The trial of calcium for preeclampsia prevention (CPEP). 8th World Congress of the International Society for the Study of Hypertension in Pregnancy; 1992 November 8-12; Buenos Aires, Argentina. 1992:94.
  • Levine RJ, Esterlitz JR, Raymond EG, DerSimonian R, Hauth JC, Ben Curet L. Trial of calcium for preeclampsia prevention (CPEP): rationale, design, and methods. Controlled Clinical Trials 1996;17(5):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;337:69-76.
Lopez-Jaramillo 1989 {published data only}
  • 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 Gynecology 1987;156:261-2.
  • Navaez M, Lopez-Jaramillo P, Weigel M. Calcium (Ca++) supplementation reduces the risk for pregnancy induced hypertension (PIH). 12th FIGO World Congress of Gynecology and Obstetrics; 1988 October 23-28; Brazil. 1988:180-1.
Lopez-Jaramillo 1997 {published data only}
  • Lopez-Jaramillo P, Delgado F, Jacome P, Teran E, Ruano C, Rivera J. Calcium supplementation and risk of preeclampsia in Ecuadorian pregnancy teenagers. Obstetrics & Gynecology 1997;90:162-7.
Niromanesh 2001 {published data only}
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;22:425-30.
  • Purwar M, Motghare V, Kulkarni H. Calcium supplementation and prevention of pregnancy induced hypertension: randomized double blind controlled trial [abstract]. Journal of Clinical Epidemiology 1996;49 Suppl 1:28S.
Raman 1978 {published data only}
  • Raman L, Rajalakshmi K. Effect of calcium supplementation to undernourished mothers during pregnancy on bone density of the neonates. American Journal of Clinical Nutrition 1978;31:466-9.
Rogers 1999 {published data only}
Sanchez-Ramos 1994 {published data only}
  • Sanchez-Ramos L, Briones DK, Kaunitz AM, Delvalle GO, Gaudier FL, Walker CD. Prevention of pregnancy induced hypertension by calcium supplementation in angiotensin II sensitive patients. Obstetrics & Gynecology 1994;84:349-53.
  • Sanchez-Ramos L, Del Valle GO, Briones D, Walker RN, Delke I, Gaudier F. Prevention of preeclampsia by calcium supplementation in angiotensin-sensitive patients. American Journal of Obstetrics and Gynecology 1994;170:408.
Sanchez-Ramos 1995 {published data only}
  • 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 CD, Kaunitz AM, Briones DK, Del Valle GO, Delke I. Calcium supplementation in mild preeclampsia remote from term: a randomized double clinical trial. Obstetrics & Gynecology 1995;85:915-8.
Taherian 2002 {published data only}
  • Taherin AA, Taherian A, Shirvani A. Prevention of preeclampsia with low-dose aspirin or calcium supplementation. Archives of Iranian Medicine 2002;5:151-6.
Villar 1987 {published data only}
  • 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 control clinical trial. Obstetrics & Gynecology 1987;70:317-22.
Villar 1990 {published data only}
  • Villar J, Belizan JM, Repke J. The effect of calcium supplementation on the incidence of hypertensive disorders of pregnancy and prematurity (Study 1). 7th World Congress of Hypertension in Pregnancy; 1990 October; Perugia, Italy. 1990:54.
  • Villar J, Repke JT. Calcium supplementation during pregnancy may reduce preterm in high-risk populations. American Journal of Obstetrics and Gynecology 1990;163:1124-31.
Villar 2006 {published data only}
  • Abalos E, Merialdi M, Wojdyla D, Carroli G, Campodonico L, Yao SE, et al. Effects of calcium supplementation on fetal growth in mothers with deficient calcium intake: a randomised controlled trial. Paediatric and Perinatal Epidemiology 2010;24(1):53-62.
  • Abdel-Aleem H, Merialdi M, Elsnosy ED, Elsedfy GO, Abdel-Aleem MA, Villar J. The effect of calcium supplementation during pregnancy on fetal and infant growth: a nested randomized controlled trial within WHO calcium supplementation trial. Journal of Maternal-Fetal & Neonatal Medicine 2009;22(2):94-100.
  • Carroli G, Merialdi M, Wojdyla D, Abalos E, Campodonico L, Yao SE, et al. Effects of calcium supplementation on uteroplacental and fetoplacental blood flow in low-calcium-intake mothers: a randomized controlled trial. American Journal of Obstetrics and Gynecology 2010; Vol. 202, issue 1:45.e1-9.
  • Hofmeyr GJ, Mlokoti Z, Nikodem VC, Mangesi L, Ferreira S, Singata M, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders is not associated with changes in platelet count, urate, and urinary protein: a randomized control trial. Hypertension in Pregnancy 2008;27(3):299-304.
  • Villar J, Abdel-Aleem, Merialdi M, Mathai M, Ali MM, Zavaleta N, et al. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. American Journal of Obstetrics and Gynecology 2006;194(3):639-49.
  • Villar J, Aleem HA, Merialdi M, Mathai M, Ali M, Zavaleta N, et al. WHO randomized trial of calcium supplementation among low calcium intake pregnant women [abstract]. American Journal of Obstetrics and Gynecology 2005;193(6 Suppl):S2.
  • Zhang J, Villar J, Sun W, Merialdi M, Abdel-Aleem H, Mathai M, et al. Blood pressure dynamics during pregnancy and spontaneous preterm birth. American Journal of Obstetrics and Gynecology 2007;197(2):162.e1-6.
Wanchu 2001 {published data only}
  • Wanchu M, Malhotra S, Khular M. Calcium supplementation in pre-eclampsia. Journal of the Association of Physician of India 2001;49:795-8.

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. Additional references
Duggin 1974 {published data only}
  • Duggin GG, Dale NE, Lyneham RC, Evans RA, Tiller DJ. Calcium balance in pregnancy. Lancet 1974;2:926-7.
Felix 1991 {published data only}
  • 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;11:93-6.
Hammar 1981 {published data only}
  • Hammar M, Larsson L, Tegler L. Calcium treatment of leg cramps in pregnancy. Effect on clinical symptoms and total serum and ionized serum calcium concentration. Acta Obstetricia et Gynecologica Scandinavica 1981;60(4):345-7.
Janakiraman 2003 {published data only}
  • Janakiraman V, Eittinger A, Mercado-Garcia A, Hu H, Hernandez-Avila M. Calcium supplementations and bone resorption in pregnancy; a randomized cross over trial. American Journal of Preventive Medicine 2003;24:260-4.
Kalkwarf 1997 {published data only}
Kent 1995 {published data only}
  • Kent GN, Price RI, Gutteridge DH, May KD, Allen JR, Smith M, et al. Site specific reduction in bone loss by calcium supplementations in normal lactation. Osteoporosis International 1995;5:315.
Liu 2011 {published data only}
  • Liu Z, Qiu L, Chen YM, Su YX. Effect of milk and calcium supplementation on bone density and bone turnover in pregnant Chinese women: a randomized controlled trial. Archives of Gynecology and Obstetrics 2011;283:205-11.
Lopez-Jaramillo 1990 {published data only}
Mahomed 2000 {unpublished data only}
  • Mahomed K, Marume A, Hammond N, Madzima M. Calcium supplementation for the prevention of pregnancy induced hypertension and preterm labour in twin pregnancy: a randomised controlled trial. Personal communication 1998.
Mukherjee 1997 {published data only}
Odendaal 1974 {published data only}
Prentice 1995 {published data only}
  • Prentice A, Jarjou LM, Cole TJ, Stirling DM, Dibba B, Fairweather-Tait S. Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breast-milk calcium concentration, maternal bone mineral content, and urinary calcium excretion. American Journal of Clinical Nutrition 1995;62:58-67.
Qui 1999 {published data only}
  • Qiu L, Su Y, Peng Y. Effects of different levels of calcium intake on bone of pregnant women. Chung-Hua Yu Fang i Hsueh Tsa Chih [Chinese Journal of Preventive Medicine] 1999;33:369-71.
Robinson 1947 {published data only}
  • Robinson M. Cramps in pregnancy. Journal of Obstetrics and Gynaecology of the British Commonwealth 1947;54:826-9.

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. Additional references
Almirante 1998 {published data only}
  • Almirante CY. Calcium supplementation during pregnancy in prevention of EPH gestosis. Prenatal and Neonatal Medicine 1998;3 Suppl 1:24.
Chames 2002 {published data only}
  • Chames M, Liu H, Bendich A, Bogden J, Sibai B, Prada J. A randomised trial of calcium supplementation effects on blood lead levels in pregnancy. American Journal of Obstetrics and Gynecology 2002;187(6 Pt 2):S137.
Galimberti 2001 {published data only}
  • Galimberti D, Joao M, Bernacchi S, Gimenez S, Carames V. IGF-1 and bone turnover in pregnant women with low calcium intake [abstract]. Journal of Perinatal  Medicine 2001;29 Suppl 1(Pt 1):17.
Repke 1989a {published data only}
  • Repke J, Villar J, Bergel E, Belizan JM. The effect of iron absorption in patients receiving calcium supplementation. Proceedings of 9th Annual Meeting of the Society of Perinatal Obstetricians; 1989 Feb 1-4; New Orleans, Louisiana, USA. 1989:512.

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. Additional references
Carroli 1994
Chang 2003
  • Chang SC, O'Brien KO, Nathanson MS, Caulfield LE, Mancini J, Witter FR. Fetal femur length is influenced by maternal dairy intake in pregnant African American adolescents. American Journal of Clinical Nutrition 2003;77:1248-54.
Cross 1995
  • Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE. Calcium homeostasis and bone metabolism during pregnancy, lactation and postweaning: a longitudinal study. American Journal of Clinical Nutrition 1995;61:514-23.
Egger 1997
  • Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629-34.
Hallberg 1992
  • Hallberg L, Rossander-Hulten L, Brune M, Gleerup A. Calcium and iron absorption: mechanism of action and nutritional importance. European Journal of Clinical Nutrition 1992;46:317-27.
Harbord 2006
Heaney 2002
  • Heaney RP, Davies KM, Barger-Lux J. Calcium and weight: clinical studies. Journal of the American of Nutrition 2002;21:152S-155S.
Higgins 2011
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Hofmeyr 2006
Inzucchi 1999
  • Inzucchi SE, Burrow GN. Endocrine disorder in pregnancy. Medicine of the Fetus and Mother. 2nd Edition. Lippincott Williams & Wilkins, 1999.
Koo 1999
Laskey 1999
Luke 1994
McGuire 2007
  • McGuire M, Beeman KA. Nutritional Sciences, from Fundamentals to Food. Australia: Thomson Wardworth, 2007.
Prentice 1994
RevMan 2011
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Ritchie 1998
  • Ritchie LD, Fung EB, Halloran BP, Turnlund JR, Van Loan MD, Cann CE, et al. A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses. American Journal of Clinical Nutrition 1998;67:693-701.
Sampath 2008
Sowers 1993
  • Sowers MF, Corton G, Shapiro B, Jannausch ML, Crutchfield M, Smith ML, et al. Changes in bone density with lactation. JAMA 1993;269:3130-5.
Sowers 1995
Susser 1991
Trichopoulou 1990
  • Trichopoulou A, Vassilakou T. Recommended dietary intakes in the European community member state: an overview. European Journal of Clinical Nutrition 1990;44(Suppl 2):51-125.
Trowman 2006
Villar 1998
  • Villar J, Gulmezoglu M, De Onis M. Nutritional and antimicrobial interventions to prevent preterm birth: an overview of randomized controlled trials. Obstetrical & Gynecological Survey 1998;53:575-85.
Williams 1962
Yanovski 2009
  • Yanovski JA, Parikh SJ, Yanoff LB, Benkinger BI, Calis KA, Reynolds JC, et al. Effects of calcium supplementation on boy weight and adiposity in overweight and obese adult: a randomized clinical trial. Annual Internal Medicine 2009;150:821-W146.