{"title":"补钙预防妊娠期高血压的有效性：随机对照试验的系统回顾和荟萃分析","authors":"Qing Zhu, Qin Yu, Mengyao Liu, Yongqing Wei","doi":"10.1016/j.preghy.2024.101174","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Gestational hypertension and related disorders, such as preeclampsia, pose significant risks to maternal and foetal health. Calcium supplementation has been proposed as a preventive measure, but its effectiveness remains debated. This review assess the impact of calcium supplementation in prevention of gestational hypertension.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across multiple databases, including Scopus, EMBASE, PubMed, Web of Science, CINAHL, Cochrane CENTRAL, from inception to July 2024. Eligibility criteria included studies involving pregnant women at risk of gestational hypertension, comparing calcium supplementation to control group, and reporting on outcomes such as preeclampsia, pregnancy-induced hypertension, HELLP syndrome, preterm birth, and maternal mortality. Data were analysed using a random-effects inverse-variance model to calculate pooled risk ratios (RRs) and assess heterogeneity using Cochran’s Q and I2 statistics. Publication bias was evaluated using funnel plots and Egger’s test.</div></div><div><h3>Results</h3><div>22 studies with 39,270 individuals were included. Most studies had higher risk of bias. Calcium supplementation significantly reduced the risk of preeclampsia (pooled RR = 0.606, 95 %CI: 0.483–0.761, p < 0.001) and pregnancy-induced hypertension (pooled RR = 0.870, 95 %CI: 0.759–0.996, p = 0.044). However, it showed no significant effect on HELLP syndrome, preterm birth, or mortality. Heterogeneity was moderate to substantial across outcomes, and publication bias was detected for preterm birth and pregnancy-induced hypertension.</div></div><div><h3>Conclusion</h3><div>Calcium supplementation during pregnancy significantly reduces the risk of preeclampsia and pregnancy-induced hypertension, highlighting its value as a cost-effective intervention for improving maternal health. These findings support integrating calcium supplementation into prenatal care strategies, particularly for populations with low dietary calcium intake.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101174"},"PeriodicalIF":2.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of calcium supplementation in the prevention of gestational hypertension: A systematic review and meta-analysis of randomised controlled trials\",\"authors\":\"Qing Zhu, Qin Yu, Mengyao Liu, Yongqing Wei\",\"doi\":\"10.1016/j.preghy.2024.101174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Gestational hypertension and related disorders, such as preeclampsia, pose significant risks to maternal and foetal health. Calcium supplementation has been proposed as a preventive measure, but its effectiveness remains debated. This review assess the impact of calcium supplementation in prevention of gestational hypertension.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across multiple databases, including Scopus, EMBASE, PubMed, Web of Science, CINAHL, Cochrane CENTRAL, from inception to July 2024. Eligibility criteria included studies involving pregnant women at risk of gestational hypertension, comparing calcium supplementation to control group, and reporting on outcomes such as preeclampsia, pregnancy-induced hypertension, HELLP syndrome, preterm birth, and maternal mortality. Data were analysed using a random-effects inverse-variance model to calculate pooled risk ratios (RRs) and assess heterogeneity using Cochran’s Q and I2 statistics. Publication bias was evaluated using funnel plots and Egger’s test.</div></div><div><h3>Results</h3><div>22 studies with 39,270 individuals were included. Most studies had higher risk of bias. Calcium supplementation significantly reduced the risk of preeclampsia (pooled RR = 0.606, 95 %CI: 0.483–0.761, p < 0.001) and pregnancy-induced hypertension (pooled RR = 0.870, 95 %CI: 0.759–0.996, p = 0.044). However, it showed no significant effect on HELLP syndrome, preterm birth, or mortality. Heterogeneity was moderate to substantial across outcomes, and publication bias was detected for preterm birth and pregnancy-induced hypertension.</div></div><div><h3>Conclusion</h3><div>Calcium supplementation during pregnancy significantly reduces the risk of preeclampsia and pregnancy-induced hypertension, highlighting its value as a cost-effective intervention for improving maternal health. These findings support integrating calcium supplementation into prenatal care strategies, particularly for populations with low dietary calcium intake.</div></div>\",\"PeriodicalId\":48697,\"journal\":{\"name\":\"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health\",\"volume\":\"38 \",\"pages\":\"Article 101174\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2210778924002010\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2210778924002010","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：妊娠期高血压及相关疾病，如先兆子痫，对母婴健康构成重大风险。补钙作为一种预防措施已被提出，但其有效性仍存在争议。本综述评估补钙对预防妊娠期高血压的影响。方法对Scopus、EMBASE、PubMed、Web of Science、CINAHL、Cochrane CENTRAL等数据库自成立至2024年7月进行综合文献检索。入选标准包括有妊娠高血压风险的孕妇，比较补钙与对照组的差异，报告子痫前期、妊娠高血压、HELLP综合征、早产和孕产妇死亡率等结局。数据分析采用随机效应反方差模型计算合并风险比（rr），并采用Cochran’s Q和I2统计量评估异质性。采用漏斗图和Egger检验评价发表偏倚。结果共纳入22项研究，共39,270人。大多数研究有较高的偏倚风险。补钙显著降低先兆子痫的风险(合并RR = 0.606, 95% CI: 0.483-0.761, p <；0.001)和妊娠高血压（合并RR = 0.870, 95% CI: 0.759-0.996, p = 0.044）。然而，它对HELLP综合征、早产或死亡率没有显著影响。结果的异质性为中度至重度，在早产和妊娠高血压中发现了发表偏倚。结论妊娠期补钙可显著降低子痫前期和妊高征的发生风险，是改善孕产妇健康的一种经济有效的干预措施。这些发现支持将钙补充纳入产前护理策略，特别是对于饮食钙摄入量低的人群。
Effectiveness of calcium supplementation in the prevention of gestational hypertension: A systematic review and meta-analysis of randomised controlled trials
Background
Gestational hypertension and related disorders, such as preeclampsia, pose significant risks to maternal and foetal health. Calcium supplementation has been proposed as a preventive measure, but its effectiveness remains debated. This review assess the impact of calcium supplementation in prevention of gestational hypertension.
Methods
A comprehensive literature search was conducted across multiple databases, including Scopus, EMBASE, PubMed, Web of Science, CINAHL, Cochrane CENTRAL, from inception to July 2024. Eligibility criteria included studies involving pregnant women at risk of gestational hypertension, comparing calcium supplementation to control group, and reporting on outcomes such as preeclampsia, pregnancy-induced hypertension, HELLP syndrome, preterm birth, and maternal mortality. Data were analysed using a random-effects inverse-variance model to calculate pooled risk ratios (RRs) and assess heterogeneity using Cochran’s Q and I2 statistics. Publication bias was evaluated using funnel plots and Egger’s test.
Results
22 studies with 39,270 individuals were included. Most studies had higher risk of bias. Calcium supplementation significantly reduced the risk of preeclampsia (pooled RR = 0.606, 95 %CI: 0.483–0.761, p < 0.001) and pregnancy-induced hypertension (pooled RR = 0.870, 95 %CI: 0.759–0.996, p = 0.044). However, it showed no significant effect on HELLP syndrome, preterm birth, or mortality. Heterogeneity was moderate to substantial across outcomes, and publication bias was detected for preterm birth and pregnancy-induced hypertension.
Conclusion
Calcium supplementation during pregnancy significantly reduces the risk of preeclampsia and pregnancy-induced hypertension, highlighting its value as a cost-effective intervention for improving maternal health. These findings support integrating calcium supplementation into prenatal care strategies, particularly for populations with low dietary calcium intake.
期刊介绍：
Pregnancy Hypertension: An International Journal of Women''s Cardiovascular Health aims to stimulate research in the field of hypertension in pregnancy, disseminate the useful results of such research, and advance education in the field.
We publish articles pertaining to human and animal blood pressure during gestation, hypertension during gestation including physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy. The subtitle reflects the wider aspects of studying hypertension in pregnancy thus we also publish articles on in utero programming, nutrition, long term effects of hypertension in pregnancy on cardiovascular health and other research that helps our understanding of the etiology or consequences of hypertension in pregnancy. Case reports are not published unless of exceptional/outstanding importance to the field.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
