แคลเซียมเสริมและความดันโลหิตสูงระหว่างตั้งครรภ์

บทคัดย่อ

     Objectives : To assess effects of calcium supplementation during pregnancy for prevention and reduction of severity of Hypertensive disorders in pregnancy.

     Materials and Method : A Prospective Randomized Controlled trial was conducted in 464 normal pregnant women, up to 34 gestational weeks, who attended to antenatal clinic and delivered in Prachubkirikhan Hospital during September 1, 2006 - April 30, 2007. Pregnant women who had similar risks (age, gravidity, gestational age, past and familial history) were matched and randomly assigned to study group (take calcium carbonate 1500 mg/day, ferrous fumerate 600 mg./day, folic acid 5 mg/day) or control group (take ferrous fumerate 600 mg./day, folic acid 5 mg/day). Every pregnants were managed and follow up in the same standard until delivered.

     Main outcomes measurement : incidence and severity of Hypertensive disorders in pregnancy.

     Results : There were 227 pregnant women in study group and 237 women in control group. Both groups had similar age, gravidity, gestational age (when recmited), demographic characteristics, amount of milk consumed per day, risk history excepts for education and body mass index (before pregnant). Thirty six women developed Hypertensive disorders in pregnancy (12 from study group, 24 from controlled group). Calcium supplementation was associated with a non-statistically significant reduction in Hypertensive disorders in pregnancy. Subgroups analysis showed that calcium supplementation in multipara, high incomes women or whom started calcium before 20 gestational weeks can statistically reduced Hypertensive disorders in pregnancy. Other subgroups had no significant benefits from calcium supplementation. Calcium supplementation had no significant effects on severity of Hypertensive disorders in pregnancy.

     Conclusion : Calcium supplementation prevented Hypertensive disorders in pregnancy in multipara, high incomes women or whom started calcium before 20 gestational weeks but did not reducethe severity.