Hypertension in pregnancy alone or with proteinuria is one of the leading causes of maternal mortality and morbidity in the world. Research demonstrates calcium supplementation is associated with a decrease in the development of gestational hypertension and preeclampsia. Although there are reports that serum calcium levels have no effect on preventing these diseases, many physicians and institutions are promoting the use of calcium to all pregnant women.
Gestational hypertension is the development of new hypertension, blood pressure greater than 140/90 mm Hg, in a pregnant woman after 20 weeks gestation without the presence of protein in the urine or other signs of preeclampsia. Pre-eclampsia is gestational hypertension plus proteinuria >300 mg of protein in a 24-hour urine sample and is one of the most common causes of death due to pregnancy. Blood pressure in preeclampsia can progress to greater than 160/110 mm Hg, along with additional medical signs and symptoms. HELLP syndrome is a type of preeclampsia presenting with hemolytic anemia, elevated liver enzymes and a low platelet count.
Calcium is known to reduce the risk of gestational hypertension and preeclampsia, however, the mechanism of its protective effect remains unclear. The expression of proinflamatory markers were significantly reduced following exposure of endothelial cells to trophoblastic debris from preeclamptic placenta or from first-trimester placentae treated with preeclamptic sera in the presence of calcium compared with treatment without calcium. This decrease in inflamatory markers is believed to reduce the risk of gestational hypertension and the development of preeclampsia.
Ninety nine percent of the total body calcium is in the bones and the remaining 1% is in the extracellular space. During pregnancy there is an increase in the demand for calcium, as is the case for many other vitamins and minerals. The recommended dietary allowance (RDA) is 1,200 mg/day for pregnant women. Calcium is regulated by a complex mechanism coordinated by a variety of hormones, the chief among them being vitamin D and parathyroid hormone. Along with the risk for gestational hypertension and preeclampsia, other complications of low calcium levels during pregnancy include poor bone formation in the mother, and fetal complications such as low birth weight, increased neonatal mortality, and high blood pressure in the child.
Prevention is the goal of medicine. For this reason calcium supplementation recomendation is increasing throughout the world. If you are pregnant ask your doctor about the benefits of calcium supplementation.
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- Desousa, J., Tong, M., Wei, J., Chamley, L., Stone, P., & Chen, Q. (2016). The anti-inflammatory effect of calcium for preventing endothelial cell activation in preeclampsia. Journal of Human Hypertension, 30(5), 303-308. doi: http://dx.doi.org/10.1038/jhh.2015.73
- Gupta, A., Kant, S., Pandav, C., Gupta, S., Rai, S., & Misra, P. (2016). Dietary calcium intake, serum calcium level, and their association with preeclampsia in rural north india. Indian Journal of Community Medicine, 41(3) doi:http://dx.doi.org/10.4103/0970-0218.183591
- Gestational hypertension. (2016, November 18). In Wikipedia, The Free Encyclopedia. Retrieved 09:48, February 27, 2017, from https://en.wikipedia.org/w/index.php?title=Gestational_hypertension&oldid=750261328
- Imdad, A., Jabeen, A., & Bhutta, Z. A. (2011). Role of calcium supplementation during pregnancy in reducing risk of developing gestational hypertensive disorders: A meta-analysis of studies from developing countries. BMC Public Health, 11doi:http://dx.doi.org/10.1186/1471-2458-11-S3-S18