Calcium supplementation during pregnancy and long‐term offspring outcome: a systematic literature review and meta‐analysis
What this study found
Maternal calcium supplementation during pregnancy showed a possible benefit for offspring blood pressure, but the overall evidence was inconclusive and did not show consistent long-term effects on growth or most other outcomes. In the Argentine trial, high systolic blood pressure in offspring aged 5 to 9 years was lower with calcium than placebo (RR 0.59, 95% CI 0.39 to 0.90), while mean systolic blood pressure was not clearly different (MD -1.4 mmHg, 95% CI -3.3 to 0.5). Height and length outcomes were also not meaningfully changed in that trial (MD -0.71 cm, 95% CI -2.38 to 0.95). The…
- Study & population
- Systematic review and meta-analysis of randomized trials in pregnant women, with offspring followed from infancy to childhood in Argentina, the United States, Australia, Egypt, The Gambia, and Brazil.
- Intervention
- Pregnant participants received oral calcium supplementation, most commonly calcium carbonate at 1500 to 2000 mg/day, started at about 13 to 21 weeks or 20 weeks' gestation and continued during pregnancy.
- Key limitation
- The evidence was limited by conflicting trial results, high attrition bias, and incomplete follow-up into later childhood.
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Open PDFOriginal abstract
The World Health Organization currently recommends calcium supplementation for pregnant women, especially those with low calcium intakes, to reduce the risk of hypertension and preeclampsia. We aimed to evaluate the effect of this intervention on selected offspring outcomes. A systematic search was conducted in 11 databases for published randomized controlled trials (RCTs) on the effect of maternal calcium supplementation with or without vitamin D during pregnancy on selected offspring cardiovascular, growth, and metabolic and neurodevelopmental outcomes. Screening of titles and abstracts of 3555 records and full texts of 31 records yielded six RCTs (nine reports, n = 1616). Forest plot analyses were performed if at least two studies presented comparable data on the same outcome. In one study (n = 591), high‐dose calcium supplementation during pregnancy was associated with a decreased risk of offspring high systolic blood pressure at 5–7 years of age (risk ratio = 0.59; 95% confidence interval: 0.39–0.90). The effects of the intervention on offspring growth, metabolic, and neurodevelopmental outcomes remain unknown because of conflicting or insufficient data. High risk of attrition bias decreased the quality of the evidence. Limited available data from RCTs do not provide sufficient evidence to conclude that prenatal calcium supplementation influences offspring health outcomes beyond the newborn period.