Role of High Dose Calcium Supplementation in Pre-eclampsia: A Pilot Study

Abstract

Introduction: Pre-eclampsia is a serious condition complicating pregnancy. It is a multisystem disorder responsible for significant maternal and perinatal morbidity and mortality. Thus, prevention of pre-eclampsia may improve both maternal and foetal outcomes. It has been found that reduced serum calcium level may cause high blood pressure by stimulating parathyroid hormone, rennin release and also by producing vasoconstriction in smooth muscle. Aim: To evaluate the role of high dose (2000 mg/day) calcium compared to normal dose (1000 mg/day) calcium in preventing the incidence and severity of pre-eclampsia. Materials and Methods: This was a pilot study and this prospective interventional study conducted from January 2017 to June 2018 in Kolkata, India with 200 primigravidas. About 100 women were given 1000 mg calcium and 100 women were given 2000 mg (high dose) calcium in a day. Incidence of gestational hypertension, pre-eclampsia, severe pre-eclampsia, neonatal outcome etc were assessed in both the groups. Normally distributed data were compared with Student’s unpaired t-test. p-value was considered statistically significant when ≤0.05. Results: There was a significant reduction in the incidence of pre-eclampsia (p-value=0.03) among the cases receiving high dose calcium, without any statistically significant reduction in severity of it. There was no reduction in incidence of gestational hypertension with high dose calcium. In neonatal outcome, there was better APGAR score in the high dose group compared to control group (16% in cases and 7% in control group, p-value=0.04). Conclusion: This pilot study paves the way for larger studies to study the role of high dose of calcium which may have a significant role in reduction of pre-eclampsia.

Keywords

• eclampsia
• hypertension in pregnancy
• morbidity
• prevention