METHODS: A systematic literature search was performed in electronic databases from inception to 15th July 2023, including only randomized controlled trials. Odds ratio (OR) were, and their corresponding 95% confidence interval (95% CI).
RESULTS: A total of 26 studies with 20,038 patients (10,003 patients with calcium supplements and 10,035 patients with placebo group) were included in the analysis. The Pooled analysis of primary outcome shows that calcium supplements reduce the risk of preeclampsia by 49% (OR, 0.51(95%CI: 0.40-0.66), P<0.001), and reduce the risk of gestational hypertension by 30% (OR, 0.70 (95%CI: 0.58-0.85)), P<0.001) compared to placebo. There was a trend of lower incidence of preterm delivery (OR, 0.88 (95%CI: 0.71-1.09), P=0.23), labor induction (OR, 0.90 (95%CI: 0.78-1.03), P=0.13), small for gestational age (OR, 0.70 (95% CI:0.37-1.32), P = 0.27), low birth weight (OR, 0.96 (95%CI: 0.86-1.08), P=0.53), perinatal mortality (OR, 0.88 (95%CI: 0.72-1.09), P=0.24), and maternal mortality (OR, 0.48 (95%CI: 0.12-1.84), P=0.28) among calcium supplementation group compared with the placebo group, however, statistical signifance was not achieved.
CONCLUSIONS: This study shows that calcium supplements are associated with a significant reduction in the risk of preeclampsia and gestational hypertension and a trend toward better maternal and fetal-related outcomes.
方法:从开始到2023年7月15日,在电子数据库中进行了系统的文献检索,仅包括随机对照试验。赔率比(OR)为,及其相应的95%置信区间(95%CI)。
结果:总共26项研究纳入了19969名患者(9,968名患者使用钙补充剂,10,001名患者使用安慰剂组)的分析。对主要结局的汇总分析表明,钙补充剂可将先兆子痫的风险降低44%(OR,0.56(95CI:0.45-0.70),P<0.001),并将妊娠期高血压的风险降低20%(OR,0.80(95CI:0.70-0.91),P<0.001)与安慰剂相比。早产发生率有降低的趋势(OR,0.88(95CI:0.71-1.09),P=0.23),引产(或,0.90(95CI:0.78-1.03),P=0.13),小胎龄(或,0.70(95%CI:0.37,1.32),P=0.27),低出生体重(或,0.90(95CI:0.78-1.03),P=0.13),围产期死亡率(OR,0.88(95CI:0.71-1.08),P=0.22),和孕产妇死亡率(或,0.48(95CI:0.12-1.84),与安慰剂组相比,补钙组的P=0.28),然而,无法达到统计学意义。
结论:这项研究表明,补充钙与显著降低先兆子痫和妊娠期高血压的风险相关,并有改善母婴结局的趋势。