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Meta-Analysis
. 2018 Oct 1;10(10):CD001059.
doi: 10.1002/14651858.CD001059.pub5.

Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems

G Justus Hofmeyr  1 , Theresa A Lawrie, Álvaro N Atallah, Maria Regina Torloni
Affiliations
Meta-Analysis

Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems

G Justus Hofmeyr et al. Cochrane Database Syst Rev. .

Abstract

Background: Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia, and may help to prevent preterm birth. This is an update of a review last published in 2014.

Objectives: To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes.

Search methods: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (18 September 2017), and reference lists of retrieved studies.

Selection criteria: We included randomised controlled trials (RCTs), including cluster-randomised trials, comparing high-dose calcium supplementation (at least 1 g daily of calcium) during pregnancy with placebo. For low-dose calcium we included quasi-randomised trials, trials without placebo, trials with cointerventions and dose comparison trials.

Data collection and analysis: Two researchers independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two researchers assessed the evidence using the GRADE approach.

Main results: We included 27 studies (18,064 women). We assessed the included studies as being at low risk of bias, although bias was frequently difficult to assess due to poor reporting and inadequate information on methods.High-dose calcium supplementation (≥ 1 g/day) versus placeboFourteen studies examined this comparison, however one study contributed no data. The 13 studies contributed data from 15,730 women to our meta-analyses. The average risk of high blood pressure (BP) was reduced with calcium supplementation compared with placebo (12 trials, 15,470 women: risk ratio (RR) 0.65, 95% confidence interval (CI) 0.53 to 0.81; I² = 74%). There was also a reduction in the risk of pre-eclampsia associated with calcium supplementation (13 trials, 15,730 women: average RR 0.45, 95% CI 0.31 to 0.65; I² = 70%; low-quality evidence). This effect was clear for women with low calcium diets (eight trials, 10,678 women: average RR 0.36, 95% CI 0.20 to 0.65; I² = 76%) but not those with adequate calcium diets. The effect appeared to be greater for women at higher risk of pre-eclampsia, though this may be due to small-study effects (five trials, 587 women: average RR 0.22, 95% CI 0.12 to 0.42). These data should be interpreted with caution because of the possibility of small-study effects or publication bias. In the largest trial, the reduction in pre-eclampsia was modest (8%) and the CI included the possibility of no effect.The composite outcome maternal death or serious morbidity was reduced with calcium supplementation (four trials, 9732 women; RR 0.80, 95% CI 0.66 to 0.98). Maternal deaths were no different (one trial of 8312 women: one death in the calcium group versus six in the placebo group). There was an anomalous increase in the risk of HELLP syndrome in the calcium group (two trials, 12,901 women: RR 2.67, 95% CI 1.05 to 6.82, high-quality evidence), however, the absolute number of events was low (16 versus six).The average risk of preterm birth was reduced in the calcium supplementation group (11 trials, 15,275 women: RR 0.76, 95% CI 0.60 to 0.97; I² = 60%; low-quality evidence); this reduction was greatest amongst women at higher risk of developing pre-eclampsia (four trials, 568 women: average RR 0.45, 95% CI 0.24 to 0.83; I² = 60%). Again, these data should be interpreted with caution because of the possibility of small-study effects or publication bias. There was no clear effect on admission to neonatal intensive care. There was also no clear effect on the risk of stillbirth or infant death before discharge from hospital (11 trials, 15,665 babies: RR 0.90, 95% CI 0.74 to 1.09).One study showed a reduction in childhood systolic BP greater than 95th percentile among children exposed to calcium supplementation in utero (514 children: RR 0.59, 95% CI 0.39 to 0.91). In a subset of these children, dental caries at 12 years old was also reduced (195 children, RR 0.73, 95% CI 0.62 to 0.87).Low-dose calcium supplementation (< 1 g/day) versus placebo or no treatmentTwelve trials (2334 women) evaluated low-dose (usually 500 mg daily) supplementation with calcium alone (four trials) or in association with vitamin D (five trials), linoleic acid (two trials), or antioxidants (one trial). Most studies recruited women at high risk for pre-eclampsia, and were at high risk of bias, thus the results should be interpreted with caution. Supplementation with low doses of calcium reduced the risk of pre-eclampsia (nine trials, 2234 women: RR 0.38, 95% CI 0.28 to 0.52). There was also a reduction in high BP (five trials, 665 women: RR 0.53, 95% CI 0.38 to 0.74), admission to neonatal intensive care unit (one trial, 422 women, RR 0.44, 95% CI 0.20 to 0.99), but not preterm birth (six trials, 1290 women, average RR 0.83, 95% CI 0.34 to 2.03), or stillbirth or death before discharge (five trials, 1025 babies, RR 0.48, 95% CI 0.14 to 1.67).High-dose (=/> 1 g) versus low-dose (< 1 g) calcium supplementationWe included one trial with 262 women, the results of which should be interpreted with caution due to unclear risk of bias. Risk of pre-eclampsia appeared to be reduced in the high-dose group (RR 0.42, 95% CI 0.18 to 0.96). No other differences were found (preterm birth: RR 0.31, 95% CI 0.09 to 1.08; eclampsia: RR 0.32, 95% CI 0.07 to 1.53; stillbirth: RR 0.48, 95% CI 0.13 to 1.83).

Authors' conclusions: High-dose calcium supplementation (≥ 1 g/day) may reduce the risk of pre-eclampsia and preterm birth, particularly for women with low calcium diets (low-quality evidence). The treatment effect may be overestimated due to small-study effects or publication bias. It reduces the occurrence of the composite outcome 'maternal death or serious morbidity', but not stillbirth or neonatal high care admission. There was an increased risk of HELLP syndrome with calcium supplementation, which was small in absolute numbers.The limited evidence on low-dose calcium supplementation suggests a reduction in pre-eclampsia, hypertension and admission to neonatal high care, but needs to be confirmed by larger, high-quality trials.

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Conflict of interest statement

G Justus Hofmeyr: Justus Hofmeyr was a collaborator in the WHO Calcium Trial (WHO 2006), which was included in this review and did not participate in the decision on inclusion and data extraction for this study

Theresa A Lawrie: none known.

Álvaro N Atallah: none known.

Maria Regina Torloni: Maria Regina Torloni is investigator for an ongoing study (Torloni 2015) which may potentially be included in future updates of this review

Figures

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1
Study flow diagram.
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'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
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3
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Funnel plot of comparison: 2 Routine high‐dose calcium supplementation in pregnancy by hypertension risk, outcome: 2.1 High blood pressure (with or without proteinuria).
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Funnel plot of comparison: 1 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium, outcome: 1.1 High blood pressure (with or without proteinuria).
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Funnel plot of comparison: 3 Routine high‐dose calcium supplementation in pregnancy by study sample size, outcome: 3.1 High blood pressure (with or without proteinuria).
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Funnel plot of comparison: 1 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium, outcome: 1.2 Pre‐eclampsia.
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Funnel plot of comparison: 2 Routine high‐dose calcium supplementation in pregnancy by hypertension risk, outcome: 2.2 Pre‐eclampsia.
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Funnel plot of comparison: 4 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium and study sample size (not pre‐specified), outcome: 4.1 Pre‐eclampsia.
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Funnel plot of comparison: 1 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium, outcome: 1.3 Preterm birth.
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Funnel plot of comparison: 2 Routine high‐dose calcium supplementation in pregnancy by hypertension risk, outcome: 2.3 Preterm birth.
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Funnel plot of comparison: 3 Routine high‐dose calcium supplementation in pregnancy by study sample size, outcome: 3.3 Preterm birth.
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References

References to studies included in this review

Almirante 1998 {published data only}
    1. Almirante CY. Calcium supplementation during pregnancy in the prevention of EPH gestosis. Prenatal and Neonatal Medicine 1998;3 Suppl 1:24.
Asemi 2012 {published data only}
    1. Asemi Z, IRCT201212105623N3. Comparison of effectiveness of multivitamin, multivitamin‐mineral supplements, probiotic and normal Gaz on pregnancy outcomes in pregnant women. en.search.irct.ir/view/11730 (first received 26 December 2012).
    1. Asemi Z, Tabassi Z, Heidarzadeh Z, Khorammian H, Sabihi SS, Samimi M. Effect of calcium‐vitamin D supplementation on metabolic profiles in pregnant women at risk for pre‐eclampsia: a randomized placebo‐controlled trial. Pakistan Journal of Biological Sciences 2012;15(7):316‐24. - PubMed
Asemi 2016 {published data only}
    1. Asemi Z, Samimi M, Siavashani MA, Mazloomi M, Tabassi Z, Karamali M, et al. Calcium‐vitamin D co‐supplementation affects metabolic profiles, but not pregnancy outcomes, in healthy pregnant women. International Journal of Preventive Medicine 2016;7:49. - PMC - PubMed
Bassaw 1998 {published data only}
    1. Bassaw B, Roopnarinesingh S, Roopnarinesingh A, Homer H. Prevention of hypertensive disorders of pregnancy. Journal of Obstetrics and Gynaecology 1998;18(2):123‐6. - PubMed
Belizan 1991 {published and unpublished data}
    1. 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.
    1. Belizan JM, Villar J, Bergel E, Pino A, 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. - PMC - PubMed
    1. 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. - PubMed
    1. 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. - PubMed
    1. 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. - PMC - PubMed
Cong 1995 {published data only}
    1. Cong KJ, Chi SL, Liu GR. Calcium and pregnancy induced hypertension. Chinese Journal of Obstetrics and Gynecology 1993;28:657‐9. - PubMed
    1. Cong KJ, Chi SL, Liu GR. Calcium supplementation during pregnancy for reducing pregnancy induced hypertension. Chinese Medical Journal 1995;108:57‐9. - PubMed
    1. Cong KJ, Chi SL, Liu GR. Calcium supplementation during pregnancy to reduce pregnancy induced hypertension. Beijing Medical Journal 1992;5:268. - PubMed
CPEP 1997 {published data only}
    1. Habli M, Levine RJ, Qian C, Sibai B. Neonatal outcomes in pregnancies with preeclampsia or gestational hypertension and in normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation. American Journal of Obstetrics and Gynecology 2007;197(4):406.e1‐406.e7. - PubMed
    1. 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. - PubMed
    1. 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. - PubMed
    1. 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.
    1. 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. - PubMed
Crowther 1999 {published data only}
    1. 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.
    1. 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. - PubMed
    1. 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. - PubMed
Herrera 1998 {published data only}
    1. 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. - PubMed
Herrera 2006 {published data only}
    1. Herrera JA, Arevalo‐Herrera M, Shahabuddin AK, Ersheng G, Herrera S, Garcia RG, et al. Calcium and conjugated linoleic acid reduces pregnancy‐induced hypertension and decreases intracellular calcium in lymphocytes. American Journal of Hypertension 2006;19(4):381‐7. - PubMed
    1. Herrera JA, Shahabuddin AK, Ersheng G, Wei Y, Garcia RG, Lopez‐Jaramillo P. Calcium plus linoleic acid therapy for pregnancy‐induced hypertension. International Journal of Gynecology & Obstetrics 2005;91(3):221‐7. - PubMed
    1. Herrera JA, Shahabuddin AKM, Faisal M, Ersheng G, Wei Y, Lixia D, et al. Effects of supplementation with oral calcium and linoleic acid in primigravidas at high risk [Efectos de la supplementacion oral con calcio y acido linoleico conjugado en primigravidas de alto riesgo]. Colombia Medica 2004;35(1):31‐7.
Jarjou 2004 {published data only}
    1. Goldberg G, Yin J, Jarjou L, Prentice A. Maternal calcium supplementation during pregnancy and blood pressure in rural Gambian children at 3 and 9 years old. Annals of Nutrition & Metabolism 2013;63(Suppl 1):728, Abstract no: PO982.
    1. Goldberg GR, Jarjou LM, Cole TJ, Prentice A. Randomized, placebo‐controlled, calcium supplementation trial in pregnant Gambian women accustomed to a low calcium intake: effects on maternal blood pressure and infant growth. American Journal of Clinical Nutrition 2013;98(4):972‐82. - PMC - PubMed
    1. 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. - PMC - PubMed
    1. Hawkesworth S, Walker CG, Sawo Y, Fulford AJ, Jarjou LM, Goldberg GR, et al. Nutritional supplementation during pregnancy and offspring cardiovascular disease risk in The Gambia. American Journal of Clinical Nutrition 2011;94(6 Suppl):1853S‐1860S. - PubMed
    1. 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. - PMC - PubMed
Khan 2013 {published data only}
    1. Khan A, Mandal SK, Pal A. Role of high dose calcium in the prevention of preeclampsia. Bangladesh Journal of Obstetrics and Gynecology 2013;28(2):66‐70.
Kumar 2009 {published and unpublished data}
    1. Kumar A, Devi SG, Batra S, Singh C, Shukla DK. Calcium supplementation for the prevention of pre‐eclampsia. International Journal of Gynecology & Obstetrics 2009;104(1):32‐6. - PubMed
Li 2000 {published data only}
    1. Li X, Gou W. Study on prevention of pregnancy induced hypertension and effect of platelet intracellular free ca˜(2+) by calcium supplementation. Journal of Xi'an Medical University 2000;21(1):46‐8.
L‐Jaramillo 1989 {published and unpublished data}
    1. 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. - PubMed
    1. 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. - PubMed
    1. Narvaez M, Lopez‐Jaramillo P, Weigel M. Calcium (Ca++) supplementation reduces the risk for pregnancy induced hypertension (PIH). World Congress of Gynecology and Obstetrics; 1988 October 23‐28; Brazil. 1988:180‐1.
L‐Jaramillo 1990 {published data only}
    1. Lopez‐Jaramillo P, Narvaez M, Felix C, Lopez A. Dietary calcium supplementation and prevention of pregnancy hypertension. Lancet 1990;335:293. - PubMed
    1. Narvaez M, Lopez‐Jaramillo P, Weigel M. Calcium (Ca++) supplementation reduces the risk for pregnancy induced hypertension (PIH). World Congress of Gynecology and Obstetrics; 1988 October 23‐28; Brazil. 1988:180‐1.
L‐Jaramillo 1997 {published data only}
    1. 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. - PubMed
Marya 1987 {published and unpublished data}
    1. 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. - PubMed
Niromanesh 2001 {published data only}
    1. Niromanesh S, Laghaii S, Mosavi‐Jarrahi A. Supplementary calcium in prevention of pre‐eclampsia. International Journal of Gynecology & Obstetrics 2001;74:17‐21. - PubMed
Purwar 1996 {published data only}
    1. 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. - PubMed
    1. Purwar M, Motghare V, Kulkarni H. Calcium supplementation and prevention of pregnancy induced hypertension: randomized double blind controlled trial. Journal of Clinical Epidemiology 1996; Vol. 49, issue Suppl 1:28S. - PubMed
Rogers 1999 {published data only}
    1. 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. - PubMed
Rumiris 2006 {published data only}
    1. Rumiris D, Purwosunu Y, Wibowo N, Farina A, Sekizawa A. Lower rate of preeclampsia after antioxidant supplementation in pregnant women with low antioxidant status. Hypertension in Pregnancy 2006;25:241–53. - PubMed
S‐Ramos 1994 {published data only}
    1. 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. - PubMed
    1. 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. - PubMed
Taherian 2002 {published data only}
    1. Taherian AA, Taherian A, Shirvani A. Prevention of pre‐eclampsia with low‐dose aspirin or calcium supplementation. Archives of Iranian Medicine 2002;5(3):151‐6.
Villar 1987 {published and unpublished data}
    1. 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. - PubMed
    1. 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. - PubMed
Villar 1990 {published and unpublished data}
    1. 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.
    1. 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.
    1. 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. - PubMed
WHO 2006 {published and unpublished data}
    1. Abalos E, Merialdi M, Wojdyla D, Carroli G, Campodónico 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. - PubMed
    1. 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. - PubMed
    1. 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;202(1):45.e1‐45.e9. - PubMed
    1. 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. - PubMed
    1. Villar J, Abdel‐Aleem H, Merialdi M, Mathai M, Ali M, 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;194:639‐49. - PubMed

References to studies excluded from this review

Aghamohammady 2010 {published data only}
    1. Aghamohammadi A, Rajabi A. The effect of calcium supplementation during pregnancy on preterm delivery and preeclampsia in nulliparous beyond age 35. Acta Obstetricia et Gynecologica Scandinavica 2012;91 (Suppl 159):60.
    1. Aghamohammady A. The effect of calcium supplementation during pregnancy on preterm delivery in primiparous beyond age 35. Journal of Maternal‐Fetal and Neonatal Medicine 2010;23(S1):100.
Anu 2017 {published data only}
    1. Anu MS, CTRI/2017/03/008259. Ayurvedic management in preventing intra uterine growth retardation. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=18028 (first received 30 March 2017).
Anumba 2006 {published data only}
    1. Anumba D, ISRCTN25268811. Randomised double blind placebo controlled trial of calcium supplements in teenage pregnancy. isrctn.com/ISRCTN25268811 (first received 29 September 2006).
Asemi 2017 {published data only}
    1. Asemi Z, IRCT201704225623N109. Clinical trial of the effect of multi mineral‐vitamin D supplementation compared with the placebo on pregnancy outcomes in women with gestational diabetes. en.search.irct.ir/view/37291 (first received 25 April 2017).
August 2002 {published data only}
    1. 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.
    1. August P, Sison MC, Helseth G. Clinical outcomes of African Americans with chronic hypertension during pregnancy. Hypertension in Pregnancy 2002; Vol. 21, issue Suppl 1:55.
Azami 2017 {published data only}
    1. Azami M, Azadi T, Farhang S, Rahmati S, Pourtaghi K. The effects of multi mineral‐vitamin D and vitamins (C+E) supplementation in the prevention of preeclampsia: an RCT. International Journal of Reproductive Biomedicine 2017; Vol. 15, issue 5:273‐8. - PMC - PubMed
    1. Azami M, IRCT2016062528617N1. The effects of multi minerals (Zn, Mg and Ca) and vitamins (C and E) supplementation in the prevention of preeclampsia. en.search.irct.ir/view/31125 (first received 24 September 2016).
Belizan 1983 {published data only}
    1. 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. - PubMed
Bhatia 2010 {published data only}
    1. Bhatia V, CTRI/2010/091/000499. Vitamin D and calcium nutrition: deficiency and evaluation of supplementation. http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=1674 (first received 19 May 2010).
Boggess 1997 {published data only}
    1. 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. - PubMed
Chames 2002 {published data only}
    1. 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.
Chan 2006 {published data only}
    1. Chan G, NCT00320125. Effects of dairy foods on adolescent pregnant mothers and their newborns. https://clinicaltrials.gov/ct2/show/record/NCT00320125 (first received 28 April 2006). [NCT00320125]
de Souza 2006 {published data only}
    1. Souza EV. Aspirin and calcium to prevent preeclampsia in chronic hypertensive women with abnormal uterine artery Doppler ultrasound [abstract] [Acido acetilalicilico associado ao calcio na prevencao da pre‐eclampsia em gestantes hipertensas cronicas selecionadas pela dopplervelocimetria das arterias uterinas]. Revista Brasileira de Ginecologia y Obstetricia 2006;28(2):136.
    1. Souza EV, Sass N, Atallah AN, Kular L Jr. Aspirin and calcium to prevent pre eclampsia in chronic hypertension women with abnormal uterine artery doppler ultrasound [abstract]. Hypertension in Pregnancy 2006;25(Suppl 1):152.
Diogenes 2011 {published data only}
    1. Bezerra FF, NCT01732328. Calcium plus vitamin D supplementation during pregnancy of adolescent mothers: effects on maternal and infant bone mass, calcium and bone metabolism and breast milk composition. clinicaltrials.gov/show/NCT01732328 (first received 19 November 2012).
    1. Diogenes ME, Bezerra FF, Rezende EP, Donangelo CM. Calcium plus vitamin D supplementation during third trimester of pregnancy in adolescents accustomed to low calcium diets did not affect infant bone mass at early lactation in a randomized controlled trial. Journal of Nutrition 2015;145:1515‐23. - PubMed
    1. Diogenes ME, Bezerra FF, Rezende EP, Taveira MF, Pinhal I, Donangelo CM. Effect of calcium plus vitamin D supplementation during pregnancy in Brazilian adolescent mothers: a randomized, placebo‐controlled trial. American Journal of Clinical Nutrition 2013;98(1):82‐91. - PubMed
    1. Diogenes MEL, Bezerra FF, Rezende EP, Taveira MF, Pinhal I, Donangelo CM. Maternal vitamin D status of adolescent mothers at mid‐pregnancy influence bone mineral content of their newborns. FASEB Journal 2011;25:603.19.
    1. Normando P, Diogenes ME, Cabello PH, Cabello GM, Donangelo CM, Bezerra FF. Calcium plus vitamin D supplementation during pregnancy interacts with polymorphisms in the promoter region of the VDR gene to affect postpartum bone mass of Brazilian adolescent mothers: a randomized controlled trial. Nutrition 2016;32(10):1068‐74. - PubMed
Dizavandy 1998 {published data only}
    1. Dizavandy EB, Alavi GS, Cordi M. The effect of calcium supplementation in the prevention of hypertensive disorders of pregnancy in nulliparous women. Medical Journal of the Islamic Republic of Iran 1998;12(1):11‐4.
Ettinger 2011 {published data only}
    1. Ettinger AS, Lamadrid H, Mercado A, Kordas K, Peterson K, Hu H, et al. Effect of calcium on bone resorption and bone mineral density in pregnancy: A randomized control trial. American Journal of Epidemiology 2011;173(Suppl):S236.
    1. Hu H, Hernandez‐Avila M, NCT00558623. Controlled trial in pregnancy of dietary supplements for suppression of bone resorption and mobilization of lead into plasma. clinicaltrials.gov/show/NCT00558623 (first received 14 November 2007).
Felix 1991 {published data only}
    1. 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.
Fung 2010 {published data only}
    1. Fung E, NCT01145573. Testing the calcium DRI during pregnancy: a study of bone health in black and white women. clinicaltrials.gov/show/NCT01145573 (first received 11 June 2010). [NCT01145573]
Herrera 2006a {published data only}
    1. Herrera JA, Arevalo‐Herrera M, Villegas A, Herrera S, Villalba M, Bromet A. Calcium oral supplementation in adolescent pregnant women. Colombia Medica 2006;37(2 Suppl 1):15‐20.
Hofmeyr 2015 {published data only}
    1. Hofmeyr GJ, PACTR201105000267371. WHO randomized trial of calcium supplementation before pregnancy to reduce recurrent pre‐eclampsia. pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR2011050002... (first received 6 December 2010).
    1. Hofmeyr GJ, Seuc AH, Betran AP, Purnat TD, Ciganda A, Munjanja SP, et al. The effect of calcium supplementation on blood pressure in non‐pregnant women with previous pre‐eclampsia: an exploratory, randomized placebo controlled study. Pregnancy Hypertension 2015;5(4):273‐9. - PubMed
Karamali 2016 {published data only}
    1. Karamali M, Asemi Z, Ahmadi‐Dastjerdi M, Esmaillzadeh A. Calcium plus vitamin D supplementation affects pregnancy outcomes in gestational diabetes: randomized, double‐blind, placebo‐controlled trial. Public Health Nutrition 2016;19(1):156‐63. - PMC - PubMed
    1. Karamali M, IRCT201407115623N23. Effect of vitamin D plus calcium co‐supplementation on pregnancy outcomes in gestational diabetes. en.search.irct.ir/view/19118 (first received 21 July 2014).
Karandish 2003 {published data only}
    1. 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.
Kawasaki 1985 {published data only}
    1. 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. - PubMed
Knight 1992 {published data only}
    1. Knight KB, Keith RE. Calcium supplementation on normotensive and hypertensive pregnant women. American Journal of Clinical Nutrition 1992;55:891‐5. - PubMed
Lavin 1986 {unpublished data only}
    1. Lavin JP. The effect of calcium supplementation on pregnancy induced hypertension. Personal communication 1986.
MacDonald 1986 {unpublished data only}
    1. MacDonald HN. Fetal and maternal benefits from calcium and vitamin D supplementation of pregnant Asians. Personal communication 1986.
Martin 2017 {published data only}
    1. Dickin K. A cluster‐randomized, non‐inferiority open‐label trial of the impact of supplementation regimen on consumption of prenatal calcium and iron/folic acid supplements and adherence to related recommendations. clinicaltrials.gov/ct2/show/record/NCT02238704 (first received 5 September 2014). [NCT02238704]
    1. Martin SL, Omotayo MO, Pelto GH, Chapleau GM, Stoltzfus RJ, Dickin KL. Adherence‐specific social support enhances adherence to calcium supplementation regimens among pregnant women. Journal of Nutrition 2017;147(4):688‐96. - PubMed
    1. Omotayo M, Stoltzfus R, Martin S, Kung'u J, Dickin K. WHO guidelines on calcium supplementation for prevention of preeclampsia: adoption, feasibility and acceptability in rural Kenya. FASEB Journal 2016;30:[abstract no: 1149.29].
    1. Omotayo MO, Dickin KL, Chapleau GM, Martin SL, Chang C, Mwanga EO, et al. Cluster‐randomized non‐inferiority trial to compare supplement consumption and adherence to different dosing regimens for antenatal calcium and iron‐folic acid supplementation to prevent preeclampsia and anaemia: rationale and design of the micronutrient initiative study. Journal of Public Health Research 2015;4(3):582. - PMC - PubMed
    1. Omotayo MO, Dickin KL, Pelletier DL, Mwanga EO, Kung'u JK, Stoltzfus RJ. A simplified regimen compared with who guidelines decreases antenatal calcium supplement intake for prevention of preeclampsia in a cluster‐randomized noninferiority trial in rural kenya. Journal of Nutrition 2017 [epub ahead print]. - PubMed
Montanaro 1990 {published data only}
    1. 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, UK. 1987:281.
    1. 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.
Mosalanejad 2016 {published data only}
    1. Mosalanejad N, IRCT2016121430612N2. Compare the effect of vitamin D and calcium plus vitamin D on pregnancy outcomes in pregnant women. en.search.irct.ir/view/34642 (first received 26 December 2016).
NCT00000543 {published data only}
    1. NCT00000543. Oral calcium in pregnant women with hypertension. clinicaltrials.gov/ct2/show/record/NCT00000543 (first received 27 October 1999).
Nooripour 2016 {published data only}
    1. Nooripour S, IRCT2015041321736N1. Clinical trial on the evaluation of calcium and vitamin d in the cord serum of neonates, whose mothers were under vitamin d treatment during their pregnancy. en.search.irct.ir/view/22976 (first received 1 February 2016).
Prada 2001 {published data only}
    1. 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 {published data only}
    1. 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.
Raman 1978 {published data only}
    1. 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. - PubMed
Repke 1989 {published data only}
    1. 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.
Roth 2014 {published data only}
    1. Roth D, Zlotkin S, NCT01678079. Bioavailability and acceptability of enteric‐coated microencapsulated calcium during pregnancy: a randomized crossover trial in Bangladesh (Encapsulated Calcium Absorption in Pregnancy). clinicaltrials.gov/show/NCT01678079 (first received 30 August 2012).
    1. Roth DE, Pezzack B, Al Mahmud A, Abrams SA, Islam M, Aimone Phillips A, et al. Bioavailability of enteric‐coated microencapsulated calcium during pregnancy: a randomized crossover trial in Bangladesh. American Journal of Clinical Nutrition 2014;100(6):1587‐95. - PubMed
Salzano 2001 {published data only}
    1. Salzano P, Felicetti M, Laboccetta A, Borrelli P, Domenico A, Borrelli A. Prevention of gestational hypertension with calcium, linoleic acid, mono and polyunsaturated fatty acid supplements. Minerva Ginecologica 2001;53(4):235‐8. - PubMed
Samimi 2016 {published data only}
    1. Samimi M, IRCT201102135444N3. Effects of calcium and vitamin D co‐supplementation on pre‐eclampsia parameters, metabolic status and biomarkers of oxidative stress in pregnant women at risk for pre‐eclampsia. en.search.irct.ir/view/5288 (first received 31 January 2015).
    1. Samimi M, Kashi M, Foroozanfard F, Karamali M, Bahmani F, Asemi Z, et al. The effects of vitamin D plus calcium supplementation on metabolic profiles, biomarkers of inflammation, oxidative stress and pregnancy outcomes in pregnant women at risk for pre‐eclampsia. Journal of Human Nutrition and Dietetics 2016;29(4):505‐16. - PubMed
Souza 2014 {published data only}
    1. Souza EV, Torloni MR, Atallah AN, Dos Santos GM, Kulay Jr L, Sass N. Aspirin plus calcium supplementation to prevent superimposed preeclampsia: a randomized trial. Brazilian Journal of Medical and Biological Research 2014;47(5):419‐25. - PMC - PubMed
S‐Ramos 1995 {published data only}
    1. 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. - PubMed
    1. 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. - PubMed
Subprabha 2017 {published data only}
    1. Subprabha K, CTRI/2016/10/007373. Role of madhuraushadha siddha avaleha as garbhini rasayana in the 6th and 7th month of pregnancy. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=15659 (first received 22 May 2017).
Suzuki 1996 {published data only}
    1. 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 {published data only}
    1. 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 {published data only}
    1. Wanchu M, Malhotra S, Khullar M. Calcium supplementation in pre‐eclampsia. Journal of the Association of Physicians of India 2001;49:795‐8. - PubMed
Zheng 2000 {published data only}
    1. Zheng QS, Zhang YP. Clinical experience with calcium supplementation in pregnancy. Journal of Practical Obstetrics and Gynecology 2000;16(2):102‐3.

References to studies awaiting assessment

Liu 2013 {published data only}
    1. Liu X, NCT01806454. Calcium supplementation to prevent preeclampsia in sichuan province of china: a multi‐center, prospective random trial. https://clinicaltrials.gov/ct2/show/NCT01806454. NCT01806454 (first received 1 March 2013) 2013.

References to ongoing studies

Chaiarach 2017 {published data only}
    1. Chaiarach S, TCTR20170629006. Combined therapy with low dose aspirin and calcium supplements during second trimester to reduce the risk of superimposed preeclampsia in pregnant women with chronic hypertension: a randomized‐controlled trial. http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&.... TCTR20170629006 (first received 21 June 2017) 2017.
Mahomed 1998 {unpublished data only}
    1. 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. Personal communication 1998.
Sulovic 2013 {published data only}
    1. Sulovic N, Kontic‐Vucinic O, Relic G, Sulovic L. Did calcium management prevent preeclampsia?. Pregnancy Hypertension 2011;1:287. - PubMed
    1. Sulovic N, Kontic‐Vucinic O, Sulovic L, Relic G, Nebojsa R. Did calcium management prevent preeclampsia?. Journal of Perinatal Medicine 2013;41(Suppl 1):Abstract no:454.
Torloni 2015 {published data only}
    1. Torloni MR, NCT02338687. Low dose calcium supplementation to prevent preeclampsia: a cluster randomized study. clinicaltrials.gov/show/NCT02338687 (first received 11 January 2015).

Additional references

Belizan 1980
    1. 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. - PubMed
Belizan 1988
    1. 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. - PubMed
Belizan 1997
    1. Belizan JM, Villar J, Bergel E, Pino A, 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. - PMC - PubMed
Bergel 2002
    1. Bergel E, Belizan JM. A deficient maternal calcium intake during pregnancy increases blood pressure of the offspring in adult rats. BJOG: an international journal of obstetrics and gynaecology 2002;109:540‐5. - PubMed
Betrán 2005
    1. Betrán AP, Wojdyla D, Posner SF, Gülmezoglu AM. National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity. BMC Public Health 2005;5:131. - PMC - PubMed
Bucher 1996
    1. 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. - PubMed
Carroli 1994
    1. 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. - PubMed
Carroli 2010
    1. 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. 202:45.e1‐45.e9. - PubMed
Clark 2008
    1. Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. American Journal of Obstetrics and Gynecology 2008;199(1):36.e1‐e5. - PubMed
CLASP 1994
    1. 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. - PubMed
De‐Regil 2012
    1. De‐Regil LM, Palacios C, Ansary A, Kulier R, Peña‐Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2012, Issue 2. [DOI: 10.1002/14651858.CD008873.pub2] - DOI - PMC - PubMed
Duvekot 2002
    1. Duvekot EJ, Groot CJ, Bloemenkamp KW, Oei SG. Pregnant women with a low milk intake have an increased risk of developing preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology 2002;105:11‐4. - PubMed
ECCPA 1996
    1. 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. - PubMed
Hamlin 1952
    1. Hamlin RHJ. The prevention of eclampsia and pre‐eclampsia. Lancet 1952;i:64‐8. - PubMed
Hamlin 1962
    1. Hamlin RHJ. Prevention of pre‐eclampsia. Lancet 1962;1:864‐5.
Hatton 2003
    1. 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. - PubMed
Higgins 2011
    1. 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.
Hiller 2007
    1. 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. - PubMed
HMSO 1994
    1. 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.
Hofmeyr 2007
    1. Hofmeyr G, Duley L, Atallah A. Dietary calcium supplementation for prevention of pre‐eclampsia and related problems: a systematic review and commentary. BJOG: an international journal of obstetrics and gynaecology 2007;114(8):933‐43. - PubMed
Hofmeyr 2008
    1. 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. - PubMed
Hofmeyr 2017
    1. Hofmeyr GJ, Manyame S. Calcium supplementation commencing before or early in pregnancy, or food fortification with calcium, for preventing hypertensive disorders of pregnancy. Cochrane Database of Systematic Reviews 2017, Issue 9. [DOI: 10.1002/14651858.CD011192.pub2] - DOI - PMC - PubMed
Isezuo 2004
    1. Isezuo SA, Ekele BA. Eclampsia and abnormal QTc. West African Journal of Medicine 2004;23:123‐7. - PubMed
Johnson 1993
    1. 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. - PMC - PubMed
Kazerooni 2003
    1. Kazerooni T, Hamze‐Nejadi S, Kazerooni T, Hamze‐Nejadi S. Calcium to creatinine ratio in a spot sample of urine for early prediction of pre‐eclampsia. International Journal of Gynecology & Obstetrics 2003;80:279‐83. - PubMed
Khan 2006
    1. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066–74. - PubMed
Kisters 2000
    1. Kisters K, Barenbrock M, Louwen F, Hausberg M, Rahn KH, Kosch M. Membrane, intracellular, and plasma magnesium and calcium concentrations in preeclampsia. American Journal of Hypertension 2000;13:765‐9. - PubMed
Kumru 2003
    1. Kumru S, Aydin S, Simsek M, Sahin K, Yaman M, Ay G. Comparison of serum copper, zinc, calcium, and magnesium levels in preeclamptic and healthy pregnant women. Biological Trace Element Research 2003;94:105‐12. - PubMed
Langenveld 2011
    1. Langenveld J, Ravelli AC, Kaam AH, Ham DP, Pampus MG, Porath M, et al. Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation: a 7 year retrospective analysis of a national registry. American Journal of Obstetrics and Gynecology 2011;205(6):540.e1‐540.e7. - PubMed
Li 2012
    1. Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC‐Heidelberg). Heart 2012;98(12):920‐5. - PubMed
McGarvey 1991
    1. McGarvey ST, Zinner SH, Willett WC, Rosner B. Maternal prenatal dietary potassium, calcium, magnesium and infant blood pressure. Hypertension 1991;17:218‐24. - PubMed
NHBPEP 2000
    1. National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. American Journal of Obstetrics and Gynecology 2000;183:S1‐S22. - PubMed
NHMRC 1993
    1. NHMRC. NHMRC Report on Maternal Deaths in Australia 1988‐1990. Canberra: Government Publishing Service, 1993.
Ozkan 2011
    1. Ozkan H, Cetinkaya M, Koksal N, Ozmen A, Yıldız M. Maternal preeclampsia is associated with an increased risk of retinopathy of prematurity. Journal of Perinatal Medicine 2011;39(5):523‐7. - PubMed
Repke 1991
    1. Repke JT, Villar J. Pregnancy‐induced hypertension and low birth weight: the role of calcium. American Journal of Clinical Nutrition 1991;54:237S‐241S. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rumbold 2008
    1. Rumbold A, Duley L, Crowther CA, Haslam RR. Antioxidants for preventing pre‐eclampsia. Cochrane Database of Systematic Reviews 2008, Issue 1. [DOI: 10.1002/14651858.CD004227.pub3] - DOI - PMC - PubMed
Segovia 2004
    1. Segovia BL, Vega IT, Villarreal EC, Licona NA. Hypocalciuria during pregnancy as a risk factor of preeclampsia. Ginecologia y Obstetricia de Mexico 2004;72:570‐4. - PubMed
Villar 1983
    1. Villar J, Belizan JM, Fischer PJ. Epidemiologic observations on the relationship between calcium intake and eclampsia. International Journal of Gynecology & Obstetrics 1983;21:271‐8. - PubMed
Villar 1989
    1. 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. - PubMed
Villar 1993
    1. Villar J, Belizan JM, Fisher PJ. Epidemiologic observation on the relationship between calcium intake and eclampsia. International Journal of Gynecology & Obstetrics 1993;21:271‐8. - PubMed
Villar 1994
    1. Villar J, Ezcurra EJ, Gurtner de la Fuente V, Campodonico L. Preterm delivery syndrome: the unmet need. Research and Clinical Forums 1994;16:9‐39.
Villar 1998
    1. Villar J, Gulmezoglu AM, 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. - PubMed
Villar 2000
    1. Villar J, Belizan JM. Same nutrient, different hypotheses: disparities in trials of calcium supplementation during pregnancy. American Journal of Clinical Nutrition 2000;71 Suppl:1375S‐1379S. - PubMed
Villar 2004
    1. Villar J, Say L, Shennan A, Lindheimer M, Duley L, Conde‐Agudelo A, et al. Methodological and technical issues related to the diagnosis, screening, prevention and treatment of pre‐eclampsia and eclampsia. International Journal of Gynecology & Obstetrics 2004;85(Suppl 1):S28‐S41. - PubMed
von Dadelszen 2004
    1. Dadelszen P, Magee LA, Devarakonda RM, Hamilton T, Ainsworth LM, Yin R, et al. The prediction of adverse maternal outcomes in pre‐eclampsia. Journal of Obstetrics and Gynaecology Canada: JOGC 2004;26:871‐9. - PubMed
WHO 2011
    1. World Health Organization. WHO recommendations for prevention and treatment of pre‐eclampsia and eclampsia. whqlibdoc.who.int/publications/2011/9789241548335_eng.pdf 2011. - PubMed
Yamasmit 2004
    1. Yamasmit W, Chaithongwongwatthana S, Charoenvidhya D, Uerpairojkit B, Tolosa J. Random urinary protein‐to‐creatinine ratio for prediction of significant proteinuria in women with preeclampsia. Journal of Maternal‐Fetal & Neonatal Medicine 2004;16:275‐9. - PubMed
Zhang 2007
    1. 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. - PMC - PubMed

References to other published versions of this review

Duley 1995
    1. 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.
Hofmeyr 2002
    1. Hofmeyr GJ, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 2002, Issue 1. [DOI: 10.1002/14651858.CD001059] - DOI - PubMed
Hofmeyr 2006
    1. Hofmeyr GJ, Atallah ÁN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD001059.pub2] - DOI - PubMed
Hofmeyr 2010
    1. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 2010, Issue 8. [DOI: 10.1002/14651858.CD001059.pub3] - DOI - PubMed
Hofmeyr 2014
    1. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 2014, Issue 6. [DOI: 10.1002/14651858.CD001059.pub4] - DOI - PubMed

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