e-Library of Evidence for Nutrition Actions (eLENA)


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Calcium supplementation during pregnancy to reduce the risk of pre-eclampsia

Intervention | Last updated: 20 June 2023

Hypertensive disorders* such as pre-eclampsia and eclampsia are among the main causes of maternal deaths and preterm births, especially in low-income countries. Preterm births are the leading cause of early neonatal deaths and infant mortality, and survivors are at higher risk of respiratory disease and long-term neurological morbidity.

Normally, during early pregnancy, blood pressure falls and then slowly rises until the end of pregnancy. However, obesity, diabetes, twin or teenage pregnancies and low calcium consumption alter this equilibrium and increase the risk of developing pre-eclampsia. Calcium supplementation improves calcium intake and consequently reduces the risk of hypertensive disorders during pregnancy.

*disorders in which blood pressure is elevated

WHO Recommendations

In populations with low dietary calcium intake, daily calcium supplementation (1.5 g–2.0 g oral elemental calcium) is recommended for pregnant women to reduce the risk of pre-eclampsia.*

* This recommendation is consistent with the recommendations in WHO recommendations on antenatal care for a positive pregnancy experience (2016) and supercedes the previous recommendation found in the WHO guideline Calcium supplementation in pregnant women (2013).



    Evidence

    Systematic reviews used to develop the guidelines

    Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems

    Hofmeyr GJ, Lawrie TA, Atallah ÁN, Torloni MR. Cochrane Database of Systematic Reviews. 2018; Issue 10. Art. No.: CD001059.

    Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems

    Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L. Cochrane Database of Systematic Reviews. 2010; Issue 8. Art. No.: CD001059.

    Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes

    Buppasiri P, Lumbiganon P, Thinkhamrop J, Ngamjarus C, Laopaiboon M, Medley N. Cochrane Database of Systematic Reviews. 2015; Issue 2. Art. No.: CD007079.

    Summary of this review Alternate Text

    Related Cochrane reviews

    Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy

    Hofmeyr GJ, Manyame S, Medley N, Williams MJ. Cochrane Database of Systematic Reviews. 2019; Issue 9. Art. No.: CD011192.

    Other related systematic reviews

    Effects of Calcium Supplementation During Pregnancy on Maternal, Fetal and Birth Outcomes

    Imdad A and Bhutta ZA. Paediatric and Perinatal Epidemiology. 2012; 26 Suppl 1:138–152.

    Category 1 intervention

    Guidelines have been recently approved by the WHO Guidelines Review Committee

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    Essential Nutrition Actions

    This intervention is an Essential Nutrition Action targeting the first 1000 days of life.

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