Background:
Maternal nutrition during pregnancy is known to have an effect on fetal
growth and development. It is recommended that women increase their
calcium intake during pregnancy and lactation, although the
recommended dosage varies among professionals. Currently, there is no
consensus on the role of routine calcium supplementation for pregnant
women other than for preventing or treating hypertension.
Objectives:
To determine the effect of calcium supplementation on maternal, fetal
and neonatal outcomes (other than for preventing or treating
hypertension) as well as any possible side effects.
Search methods:
We searched the Cochrane Pregnancy and Childbirth Group's Trials
Register (17 March 2011).
Selection criteria:
We considered all published, unpublished and ongoing randomised
controlled trials (RCTs) comparing maternal, fetal and neonatal
outcomes in pregnant women who received calcium supplementation
versus placebo or no treatment. We excluded quasi- and pseudo-RCTs.
Data collection and analysis:
Two review authors identified studies for inclusion and extracted the
BOROMARAJONANI
COLLEGE OF NURSING
SARABURI
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data. Two review authors performed data analysis.
Main results:
This review includes data from 21 studies (involving 16,602 women).
There were no statistically significant differences between women who
received calcium supplementation and those who did not in terms of
reducing preterm births (less than 37 weeks' gestation) (risk ratio (RR)
0.90; 95% confidence interval (CI) 0.73 to 1.11; 12 studies, 15615
women; random-effects model) and also in less than 34 weeks' gestation
(RR 1.11; 95% CI 0.84 to 1.46; three trials, 5145 women). There was no
significant difference in infant low birth weight between the two groups
(RR 0.91; 95% CI 0.72 to 1.16; four trials, 13449 infants; randomeffects).
However, compared to the control group, women in the calcium
supplementation group gave birth to slightly heavier birth weight infants
(mean difference (MD) 64.66 g; 95% CI 15.75 to 113.58; 19 trials, 8287
women; random-effects).
Authors' conclusions:
Calcium supplementation is associated with a significant protective
benefit in the prevention of pre-eclampsia, and should be used for this
indication according to a previous review. This review indicates that
there are no additional benefits for calcium supplementation in
prevention of preterm birth or low infant birth weight. While there was a
statistically significant difference of 80 g identified in mean infant birth
weight, there was significant heterogeneity identified, and the clinical
significance of this difference is uncertain.
[CINAHL Note: The Cochrane Collaboration systematic reviews contain
interactive software that allows various calculations in the MetaView.]