G J Hofmeyr1, A H Seuc2, A P Betrán3, T D Purnat4, A Ciganda5, S P Munjanja6, S Manyame7, M Singata8, S Fawcus9, K Frank10, D R Hall11, G Cormick12, J M Roberts13, E F Bergel14, S K Drebit15, P Von Dadelszen16, J M Belizan17. 1. Department of Obstetrics and Gynaecology, East London Hospital Complex, University of the Witwatersrand, South Africa; University of Fort Hare, Eastern Cape Department of Health, East London, South Africa. Electronic address: justhof@gmail.com. 2. Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. Electronic address: seuca@who.int. 3. Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. Electronic address: betrana@who.int. 4. World Health Organization Regional Office for Europe, Marmorvej 51, Copenhagen, Denmark. Electronic address: tina.purnat@gmail.com. 5. Institute for Clinical Effectiveness and Health Policy (IECS), Emilio Ravignani 2024, Buenos Aires, Argentina. Electronic address: alvaro@ciganda.com. 6. University of Zimbabwe, Harare, Zimbabwe. Electronic address: spmunjanja@gmail.com. 7. University of Zimbabwe, Harare, Zimbabwe. Electronic address: smanyame79@gmail.com. 8. Department of Nursing Sciences, Fort Hare University, South Africa. Electronic address: mandisa.singata@gmail.com. 9. Department of Obstetrics and Gynaecology, University of Cape Town, South Africa; Head, Obstetric Services, Mowbray Maternity Hospital, Cape Town, South Africa. Electronic address: fawcus@mweb.co.za. 10. Department of Obstetrics and Gynaecology, University of the Witwatersrand, South Africa. Electronic address: kafrank@mweb.co.za. 11. Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa. Electronic address: drh@sun.ac.za. 12. Institute for Clinical Effectiveness and Health Policy (IECS), Emilio Ravignani 2024, Buenos Aires, Argentina. Electronic address: gcormick@iecs.org.ar. 13. Magee-Womens Research Institute, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, USA. Electronic address: jroberts@mwri.magee.edu. 14. Institute for Clinical Effectiveness and Health Policy (IECS), Emilio Ravignani 2024, Buenos Aires, Argentina. Electronic address: bergel@gmail.com. 15. Department of Obstetrics and Gynaecology, University of British Columbia, Room V3-339, 950 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada. Electronic address: Sharla.Drebit@phsa.ca. 16. Department of Obstetrics and Gynaecology, University of British Columbia, Room V3-339, 950 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada. Electronic address: pvd@cw.bc.ca. 17. Institute for Clinical Effectiveness and Health Policy (IECS), Emilio Ravignani 2024, Buenos Aires, Argentina. Electronic address: belizanj@gmail.com.
Abstract
BACKGROUND: Epidemiological findings suggest that the link between poverty and pre-eclampsia might be dietary calcium deficiency. Calcium supplementation has been associated with a modest reduction in pre-eclampsia, and also in blood pressure (BP). METHODS: This exploratory sub-study of the WHO Calcium and Pre-eclampsia (CAP) trial aims to determine the effect of 500mg/day elemental calcium on the blood pressure of non-pregnant women with previous pre-eclampsia. Non-pregnant women with at least one subsequent follow-up trial visit at approximately 12 or 24weeks after randomization were included. RESULTS: Of 836 women randomized by 9 September 2014, 1st visit data were available in 367 women of whom 217 had previously had severe pre-eclampsia, 2nd visit data were available in 201 women. There was an overall trend to reduced BP in the calcium supplementation group (1-2.5mmHg) although differences were small and not statistically significant. In the subgroup with previous severe pre-eclampsia, the mean diastolic BP change in the calcium group (-2.6mmHg) was statistically larger than in the placebo group (+0.8mmHg), (mean difference -3.4, 95% CI -0.4 to -6.4; p=0.025). The effect of calcium on diastolic BP at 12weeks was greater than in those with non-severe pre-eclampsia (p=0.020, ANOVA analysis). CONCLUSIONS: There is an overall trend to reduced BP but only statistically significant in the diastolic BP of women with previous severe pre-eclampsia. This is consistent with our hypothesis that this group is more sensitive to calcium supplementation, however results need to be interpreted with caution.
BACKGROUND: Epidemiological findings suggest that the link between poverty and pre-eclampsia might be dietary calcium deficiency. Calcium supplementation has been associated with a modest reduction in pre-eclampsia, and also in blood pressure (BP). METHODS: This exploratory sub-study of the WHO Calcium and Pre-eclampsia (CAP) trial aims to determine the effect of 500mg/day elemental calcium on the blood pressure of non-pregnant women with previous pre-eclampsia. Non-pregnant women with at least one subsequent follow-up trial visit at approximately 12 or 24weeks after randomization were included. RESULTS: Of 836 women randomized by 9 September 2014, 1st visit data were available in 367 women of whom 217 had previously had severe pre-eclampsia, 2nd visit data were available in 201 women. There was an overall trend to reduced BP in the calcium supplementation group (1-2.5mmHg) although differences were small and not statistically significant. In the subgroup with previous severe pre-eclampsia, the mean diastolic BP change in the calcium group (-2.6mmHg) was statistically larger than in the placebo group (+0.8mmHg), (mean difference -3.4, 95% CI -0.4 to -6.4; p=0.025). The effect of calcium on diastolic BP at 12weeks was greater than in those with non-severe pre-eclampsia (p=0.020, ANOVA analysis). CONCLUSIONS: There is an overall trend to reduced BP but only statistically significant in the diastolic BP of women with previous severe pre-eclampsia. This is consistent with our hypothesis that this group is more sensitive to calcium supplementation, however results need to be interpreted with caution.
Authors: J P Beckman; J J Camp; B D Lahr; K R Bailey; A E Kearns; V D Garovic; M Jayachandran; V M Miller; D R Holmes Journal: Climacteric Date: 2017-11-30 Impact factor: 3.005
Authors: Gabriela Cormick; Agustín Ciapponi; María Luisa Cafferata; María Sol Cormick; José M Belizán Journal: Cochrane Database Syst Rev Date: 2022-01-11
Authors: Gabriela Cormick; Agustín Ciapponi; María Luisa Cafferata; María Sol Cormick; José M Belizán Journal: Cochrane Database Syst Rev Date: 2021-08-10