 |
| Calcium supplements |
Out of
various agents used for prevention of preeclampsia calcium supplementation has
got the highest likelihood of being successful in bringing down its incidence and
perinatal mortality as per a study presented by Sanchez-Ramos
L. et al. at the pregnancy meeting, SMFM 2017, Las Vegas.
Preeclampsia
complicates approximately 3-5% of pregnancies, accounting for 10-15% of
maternal deaths and 3% of perinatal deaths.
Numerous
agents have been studied for their ability to prevent preeclampsia and conventional
studies have gauged the effectiveness of these agents. But these have been
small, single center trials.
This was a
systematic review and network meta-analysis of large RCTs comparing the
effectiveness of multiple treatment options in preventing preeclampsia. Only
data from meta-analysis of large RCTs with more than 450 subjects were
included.
The study
was registered under PROSPERO,[1]
an international prospective register of systematic reviews in areas of healthcare
all around the world and guided by PRISMA guidelines.[2]
A search of
electronic databases from 1966 through July15, 2016 picked up 27 large
multicenter trials with total of 60, 425 pregnant women. This large cohort was
used to compare various exposures against Placebo or no treatment for the
development of preeclampsia. The secondary outcome studied were severity of
preeclampsia and maternal and neonatal morbidity and mortality. The various agents
studied were:
- Low-dose aspirin: aspirin given at low doses (50-100mg) during pregnancy
- Calcium supplementation: given at doses of 500-2000mg
- Low molecular weight heparin: anticoagulant
- Vitamin E/C: vitamin supplements in varying doses as defined by the study
- Fish oil: supplement derived from fatty tissue of fish containing omega-3 fatty acids
Direct and
indirect pairwise comparison was done using STATA for multivariate random
effect models.
It was seen
that women who regularly received Calcium supplementation had a 61% and 74%
less odds of developing preeclampsia in direct and indirect comparison.
Women receiving
calcium supplementation has 68% less likelihood of developing preeclampsia as
compared to women receiving fish oil.
Taking Calcium
was also associated with less chances of perinatal mortality as compared to low-dose
aspirin, vitamins C & E, and placebo.
