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每日补充 500 毫克钙与孟加拉国妊娠高血压风险降低之间的关联。

The association between daily 500 mg calcium supplementation and lower pregnancy-induced hypertension risk in Bangladesh.

机构信息

Research and Evaluation Division, BRAC Center, Dhaka, 1212, Bangladesh.

Department of Public Health, North South University, Dhaka, Bangladesh.

出版信息

BMC Pregnancy Childbirth. 2018 Oct 17;18(1):406. doi: 10.1186/s12884-018-2046-0.

Abstract

BACKGROUND

Evidence suggests that daily supplementation of 1500 to 2000 mg of calcium during pregnancy reduces pregnancy-induced hypertension (PIH). However, the evidence on the efficacy of low-dose calcium supplementation on PIH is limited. This paper assesses the longitudinal correlation between low-dose calcium intake (500 mg daily) and change in blood pressure during pregnancy among a homogeneous population in terms of hypertension and pre-eclampsia.

METHODS

The study followed a retrospective cohort study design, and was carried out among 11,387 pregnant women from 10 rural upazilas (sub-districts) of Bangladesh where maternal nutrition initiative (MNI), implemented by Building Resources Across Communities (BRAC), was ongoing. The modified Poisson regression model was used to estimate the association (risk ratio) between consumption of calcium tablets and PIH.

RESULTS

The present research found that women who consumed 500 mg/d calcium tablets for more than 6 months during their pregnancy had a 45% lower risk of developing hypertension compared to those who consumed less calcium (RR = 0.55, 95% CI = 0.33-0.93).

CONCLUSIONS

Daily supplementation of 500 mg oral calcium during pregnancy for at least 180 tablets is associated with a considerably reduced risk of PIH, but this study is unable to confirm whether this association is causal. The causal relationship needs to be confirmed through a large scale randomized controlled trial.

摘要

背景

有证据表明,怀孕期间每天补充 1500 至 2000 毫克钙可降低妊娠高血压(PIH)的发生率。然而,低剂量钙补充对 PIH 的疗效的证据有限。本文评估了在高血压和子痫前期发病率相似的同质人群中,低剂量钙摄入(每天 500 毫克)与怀孕期间血压变化之间的纵向相关性。

方法

该研究采用回顾性队列研究设计,在孟加拉国 10 个农村分区(sub-districts)的 11387 名孕妇中进行,这些地区正在开展由社区资源建设组织(BRAC)实施的孕产妇营养倡议(MNI)。采用修正泊松回归模型来估计钙补充与 PIH 之间的关联(风险比)。

结果

本研究发现,与钙摄入量较低的孕妇相比,每天摄入 500 毫克钙片超过 6 个月的孕妇发生高血压的风险降低了 45%(RR=0.55,95%CI=0.33-0.93)。

结论

怀孕期间每天至少补充 500 毫克口服钙与 PIH 风险显著降低有关,但本研究无法确定这种关联是否具有因果关系。需要通过大规模随机对照试验来确认这种因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/072d/6192122/808e058941a9/12884_2018_2046_Fig1_HTML.jpg

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