Patrelli Tito Silvio, Dall'asta Andrea, Gizzo Salvatore, Pedrazzi Giuseppe, Piantelli Giovanni, Jasonni Valerio Maria, Modena Alberto Bacchi
Department of Obstetrics, Gynecology and Neonatology, University of Parma, Parma, Italy.
J Matern Fetal Neonatal Med. 2012 Dec;25(12):2570-4. doi: 10.3109/14767058.2012.715220. Epub 2012 Aug 24.
Since the early 1980s, epidemiological evidence has suggested a connection between low calcium intake and preeclampsia The purpose of this meta-analysis is to summarize current evidence regarding calcium supplementation during pregnancy in predicting preeclampsia and associated maternal-fetal complications.
Literature revision of all RCT (random allocation of calcium versus placebo) available in MEDLINE/PUBMED up to 2/29/2012 regarding calcium supplementation during pregnancy for preventing preeclampsia. We used the Mantel-Haenszel's Method for four subgroup of patients: Adequate calcium intake; Low calcium intake; Low risk of preeclampsia; High risk of preeclampsia. We considered p < 0.05 as significant.
There is no consensus in Literature about: (1) the efficacy of calcium supplementation in the prevention of preeclampsia, (2) other/adverse/long-term effects of calcium supplementation in pregnancy.
Preeclampsia is likely to be a multifactorial disease. However, inadequate calcium intake represents a factor associated with an increased incidence of hypertensive disease. The results of our meta-analysis demonstrate that the additional intake of calcium during pregnancy is an effective measure to reduce the incidence of preeclampsia, especially in populations at high risk of preeclampsia due to ethnicity, gender, age, high BMI and in those with low baseline calcium intake.
自20世纪80年代初以来,流行病学证据表明钙摄入量低与先兆子痫之间存在关联。本荟萃分析的目的是总结目前关于孕期补钙在预测先兆子痫及相关母婴并发症方面的证据。
对截至2012年2月29日MEDLINE/PUBMED上所有关于孕期补钙预防先兆子痫的随机对照试验(钙与安慰剂随机分配)进行文献综述。我们对四组患者采用Mantel-Haenszel方法:钙摄入量充足;钙摄入量低;先兆子痫低风险;先兆子痫高风险。我们将p<0.05视为具有统计学意义。
文献中对于以下方面尚无共识:(1)补钙预防先兆子痫的疗效,(2)孕期补钙的其他/不良/长期影响。
先兆子痫可能是一种多因素疾病。然而,钙摄入不足是与高血压疾病发病率增加相关的一个因素。我们的荟萃分析结果表明,孕期额外补钙是降低先兆子痫发病率的有效措施,尤其是在因种族、性别、年龄、高体重指数以及基线钙摄入量低而处于先兆子痫高风险的人群中。