关键词: Pregnancies calcium supplements gestational hypertension mortality preeclampsia

Mesh : Humans Pregnancy Female Pre-Eclampsia / prevention & control epidemiology Dietary Supplements Randomized Controlled Trials as Topic Hypertension, Pregnancy-Induced / epidemiology prevention & control Calcium, Dietary / administration & dosage therapeutic use Calcium / therapeutic use

来  源:   DOI:10.1016/j.cpcardiol.2023.102217

Abstract:
BACKGROUND: Pre-eclampsia and eclampsia are common causes of morbidity and mortality, especially in low-income countries. Reducing adverse outcomes associated with hypertensive disorders of pregnancy has been the ultimate priority in recent years. We aim to evaluate the association between calcium supplementation and preeclampsia and gestational hypertension risk among pregnant women.
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.
摘要:
背景:先兆子痫和子痫是发病率和死亡率的常见原因,特别是在低收入国家。近年来,减少与妊娠高血压疾病相关的不良结局一直是当务之急。我们的目的是评估孕妇钙补充剂与先兆子痫和妊娠期高血压风险之间的关系。
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。
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