Trial of Calcium to Prevent Preeclampsia
Open accessAbstract
BACKGROUND: Previous trials have suggested that calcium supplementation during pregnancy may reduce the risk of preeclampsia. However, differences in study design and a low dietary calcium intake in the populations studied limit acceptance of the data. METHODS: We randomly assigned 4589 healthy nulliparous women who were 13 to 21 weeks pregnant to receive daily treatment with either 2 g of elemental calcium or placebo for the remainder of their pregnancies. Surveillance for preeclampsia was conducted by personnel unaware of treatment-group assignments, using standardized measurements of blood pressure and urinary protein excretion at uniformly scheduled prenatal visits, protocols for monitoring these measurements during the hospitalization for delivery, and reviews of medical records of unscheduled outpatient visits and all hospitalizations. RESULTS: Calcium supplementation did not significantly reduce the incidence or severity of preeclampsia or delay its onset. Preeclampsia occurred in 158 of the 2295 women in the calcium group (6.9 percent) and 168 of the 2294 women in the placebo group (7.3 percent) (relative risk, 0.94; 95 percent confidence interval, 0.76 to 1.16). There were no significant differences between the two groups in the prevalence of pregnancy-associated hypertension without preeclampsia (15.3 percent vs. 17.3 percent) or of all hypertensive disorders (22.2 percent vs. 24.6 percent). The mean systolic and diastolic blood pressures during pregnancy were similar in both groups. Calcium did not reduce the numbers of preterm deliveries, small-for-gestational-age births, or fetal and neonatal deaths; nor did it increase urolithiasis during pregnancy. CONCLUSIONS: Calcium supplementation during pregnancy did not prevent preeclampsia, pregnancy-associated hypertension, or adverse perinatal outcomes in healthy nulliparous women.
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The incidence of hypertensive disorders of pregnancy ranges from 4% to 25%.
“The incidence of HDP ranges from 4 to 25 %, [4, 5]”
From Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study (2021) · cites this paper as [5]
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- Authors
- Levine, R. J., Hauth, J. C., Curet, L. B., Sibai, B. M., Catalano, P. M., Morris, C. D., DerSimonian, R., Esterlitz, J. R., Raymond, E. G., Bild, D. E., Clemens, J. D., Cutler, J. A., Ewell, M. G., Friedman, S. A., Goldenberg, R. L., Jacobson, S.-L., Joffe, G. M., Klebanoff, M. A., & Petrulis, A. S.
- Affiliations
- National Institutes of Health (US)
- University of Alabama at Birmingham (US)
- University of New Mexico (US)
- University of Tennessee Health Science Center (US)
- MetroHealth Medical Center (US)
- Oregon Health & Science University (US)
- National Heart, Lung, and Blood Institute (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1997-07-10
- Volume
- 337
- Issue
- 2
- Pages
- 69-77
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2084688828
- Cited by
- 634
- References
- 33
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 11 · 2022: 14 · 2021: 17 · 2020: 13 · 2019: 11 · 2018: 19 · 2017: 12 · 2016: 11 · 2015: 16 · 2014: 26 · 2013: 22 · 2012: 34
- FWCI
- 45.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (N01-HD-5-3122, N01-HD-5-3121, N01-HD-5-3123)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- calcium supplementation, preeclampsia prevention, pregnancy, nulliparous women, gestational hypertension, hypertensive disorders of pregnancy, blood pressure in pregnancy, urinary protein excretion, urolithiasis, perinatal outcomes, preterm birth, small for gestational age
- MeSH terms
- Adult, Calcium, Female, Humans, Hypertension, Parity, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Cardiovascular, Pregnancy Outcome, Proteinuria, United States, Urinary Calculi, Incidence, Case-Control Studies
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