Calcium and

Preeclampsia
Preeclampsia

HYPERTENSION IN PREGNANCY USUALLY OCCURS IN SECOND HALF DEFINITIVE CAUSE IS UNKNOWN –

ACCOMPANIED BY EXCESS OF PREGNANCY (>32 WEEKS MOST THOUGHT TO BE RELATED TO
PROTEIN IN THE URINE COMMONLY) PLACENTAL MALFORMATION
Signs and
Symptoms

• Swelling of the hands, feet, and face

• Headaches
• Shortness of breath
• Decreased urine output
• Weight gain due to water retention (3-
5 lbs/week)
• Headache
• Blurred vision
• Nausea/vomiting
 Obesity

Chronic hypertension
Risk
Factors Advanced maternal age (>35
years of age)

Diabetes mellitus or gestational

diabetes
 Baby:

• IUGR due to restricted blood supply

• Preterm delivery

Mother:

Concerns • Eclampsia – seizures than may result in

coma
• HELLP – hemolysis, elevated liver enzymes,
low platelets
• Associated with increased morbidity and
mortality
• Cardiovascular complications –
hypertension, ischemic heart disease,
kidney disease; stroke, VTE
 SMOKING CESSATION WEIGHT LOSS PRIOR TO
PREGNANCY IF
OVERWEIGHT

Prevention

APPROPRIATE WEIGHT MANAGEMENT OF

GAIN DURING PREGNANCY CHRONIC DISEASES (HTN,
DM)
 Encouragement of dietary calcium is
primary goal

In populations with low calcium intake,

WHO recommends daily supplementation
Calcium of 1.5-2.0 grams of elemental calcium.
• Current RDA: 1000-1300mg

Studies showed a 64% risk reduction in at-

risk populations
 Where to find
•calcium
Fortified OJ: 300 mg/8 oz
• Soybeans: 260 mg/cup
• Kale: 100 mg/cup
• Dairy
• Milk: 300 mg/8 oz
• Plain yogurt: 300 mg/6 oz
• Cheese: 200 mg/1 oz
Calcium Supplementation:
Who and When

• Women at higher risk for preeclampsia

• Calcium-deficient diets
• WIC packages provides about 500 mg calcium daily,
assuming pregnant woman is consuming entire package
• Supplements should contain no more than 500 mg/serving
• Should be taken several hours apart with meals but not with
excessive iron or with prenatal vitamin
• Prenatal vitamins contain about 300mg of calcium
• Total daily calcium should not exceed 2.5g
 • WHO recommendations on antenatal care for a
positive pregnancy experience. Geneva: World
Health Organization; 2016
(https://www.who.int/reproductivehealth/publ
ications/maternal_perinatal_health/anc-
positive-pregnancy-experience/en/).
References • Imdad A, Jabeen A, Bhutta ZA. Role of calcium
supplementation during pregnancy in reducing
risk of developing gestational hypertensive
disorders: a meta-analysis of studies from
developing countries. BMC Public Health.
2011;11 Suppl 3(Suppl 3):S18. Published 2011
Apr 13. doi:10.1186/1471-2458-11-S3-S18