全球孕期膳食钙摄入量的不平等：系统评价和荟萃分析。
Global inequities in dietary calcium intake during pregnancy: a systematic review and meta-analysis.
机构信息
Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina.
Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
出版信息
BJOG. 2019 Mar;126(4):444-456. doi: 10.1111/1471-0528.15512. Epub 2018 Nov 27.
BACKGROUND
Evidence shows that adequate calcium intake during pregnancy reduces the risk of hypertensive disorders of pregnancy. In most low- and middle-income countries (LMICs) the daily calcium intake is well below recommendations. Mapping calcium intake during pregnancy worldwide and identifying populations with low calcium intake will provide the evidence base for more targeted actions to improve calcium intake.
OBJECTIVE
To assess dietary calcium intake during pregnancy worldwide.
SEARCH STRATEGY
MEDLINE and EMBASE (from July 2004 to November 2017).
SELECTION CRITERIA
Cross-sectional, cohort, and intervention studies reporting calcium intake during pregnancy.
DATA COLLECTION AND ANALYSIS
Five reviewers working in pairs independently performed screening, extraction, and quality assessment. We reported summary measures of calcium intake and calculated the weighted arithmetic mean for high-income countries (HICs) and LMICs independently, and for geographic regions, among studies reporting country of recruitment, mean intake, and total number of participants. When available, inadequate intakes were reported.
MAIN RESULTS
From 1880 citations 105 works met the inclusion criteria, providing data for 73 958 women in 37 countries. The mean calcium intake was 948.3 mg/day (95% CI 872.1-1024.4 mg/day) for HICs and 647.6 mg/day (95% CI 568.7-726.5 mg/day) for LMICs. Calcium intakes below 800 mg/day were reported in five (29%) countries from HICs and in 14 (82%) countries from LMICs.
CONCLUSION
These results are consistent with a lack of improvement in calcium dietary intake during pregnancy and confirm the gap between HICs and LMICs, with alarmingly low intakes recorded for pregnant women in LMICs. From the public health perspective, in the absence of specific local data, calcium supplementation of pregnant women in these countries should be universal.
TWEETABLE ABSTRACT
Despite dietary recommendations, women in LMICs face pregnancy with diets low in calcium.
背景
有证据表明，孕期摄入足够的钙可降低妊娠高血压疾病的风险。在大多数低收入和中等收入国家（LMICs），每日钙摄入量远低于建议量。绘制全球孕期钙摄入量图并确定钙摄入量低的人群，可为改善钙摄入量提供更有针对性的行动依据。
目的
评估全球孕期膳食钙摄入量。
检索策略
MEDLINE 和 EMBASE（2004 年 7 月至 2017 年 11 月）。
选择标准
报告孕期钙摄入量的横断面、队列和干预研究。
数据收集和分析
5 名审查员两两合作，独立进行筛选、提取和质量评估。我们报告了钙摄入量的汇总指标，并分别为高收入国家（HICs）和中低收入国家（LMICs）以及报告招募国家、平均摄入量和总参与者数的地理区域计算了加权算术平均值。在有数据的情况下，报告了摄入量不足的情况。
主要结果
从 1880 条引文中共纳入 105 项研究，共纳入 37 个国家的 73958 名妇女。HIC 组的平均钙摄入量为 948.3mg/天（95%CI 872.1-1024.4mg/天），LMIC 组为 647.6mg/天（95%CI 568.7-726.5mg/天）。在 5 个（29%）HIC 国家和 14 个（82%）LMIC 国家报告了钙摄入量低于 800mg/天的情况。
结论
这些结果与孕期膳食钙摄入量没有改善的情况一致，并证实了 HICs 和 LMICs 之间的差距，令人震惊的是，LMIC 国家的孕妇钙摄入量很低。从公共卫生的角度来看，在缺乏具体当地数据的情况下，这些国家的孕妇应普遍补充钙。
推文摘要
尽管有饮食建议，但中低收入国家的妇女在妊娠期间的饮食中钙含量较低。
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