Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Department of Obstetrics and Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Matern Child Nutr. 2018 Jan;14(1). doi: 10.1111/mcn.12479. Epub 2017 Jun 18.
Adequate calcium intake during pregnancy is important in the prevention of pre-eclampsia. A substantial proportion of pregnant women do not meet the recommended daily calcium intake, even in developed countries. Nonetheless, calcium supplementation is not routinely advised to pregnant women in most countries. We aimed to predict the impact of advising pregnant women to use calcium supplements (1,000 mg/day) on the number of cases of pre-eclampsia prevented and related health care costs. By use of a decision-analytic model, we assessed the expected impact of advising calcium supplementation to either (1) all pregnant women, (2) women at high risk of developing pre-eclampsia, or (3) women with a low dietary calcium intake compared with current care. Calculations were performed for a hypothetical cohort of 100,000 pregnant women living in a high-income country, although input parameters of the model can be adjusted so as to fit other settings. The incidence of pre-eclampsia could be reduced by 25%, 8%, or 13% when advising calcium supplementation to all pregnant women, women at high risk of pre-eclampsia, or women with a low dietary calcium intake, respectively. Expected net financial benefits of the three scenarios were of €4,621,465, €2,059,165, or €2,822,115 per 100,000 pregnant women, respectively. Advising pregnant women to use calcium supplements can be expected to cause substantial reductions in the incidence of pre-eclampsia as well as related health care costs. It appears most efficient to advise calcium supplementation to all pregnant women, not subgroups only.
怀孕期间摄入足够的钙对于预防子痫前期很重要。即使在发达国家，仍有相当一部分孕妇未达到推荐的每日钙摄入量。尽管如此，大多数国家并未常规建议孕妇补充钙。我们旨在预测建议孕妇使用钙补充剂（1000 毫克/天）对预防子痫前期病例数和相关医疗保健费用的影响。通过使用决策分析模型，我们评估了建议孕妇补充钙（1）所有孕妇，（2）子痫前期高危孕妇，或（3）与当前护理相比钙摄入量低的孕妇对预期影响。对生活在高收入国家的 100,000 名孕妇的假设队列进行了计算，尽管可以调整模型的输入参数以适应其他环境。当建议所有孕妇、子痫前期高危孕妇或钙摄入量低的孕妇补充钙时，子痫前期的发病率可分别降低 25%、8%或 13%。这三种情况下的预期净财务收益分别为每 100,000 名孕妇 4621465 欧元、2059165 欧元或 2822115 欧元。建议孕妇使用钙补充剂有望显著降低子痫前期的发病率和相关医疗保健费用。建议所有孕妇而不是仅建议某些亚组补充钙似乎效率最高。
