Abstract
An estimated 20 to 30 g of calcium are needed for the fetal skeleton to mineralize properly. This randomized, crossover trial evaluated the effects of calcium supplementation on a new marker of bone resorption, cross-linked N-telopeptides (NTX) of type I collagen. The NTX crosslink is unique to type I collagen in bone so that the urinary NTX level is a specific marker of bone breakdown. Thirty-one Mexican women at 25 to 35 weeks gestation received, in random order, a 1200-mg calcium supplement for 10 consecutive days and a multivitamin lacking calcium for 10 days. Daily urine samples from each subject were pooled and analyzed for NTX. Initially, 55% of the women took less than the recommended daily allowance of calcium during pregnancy (1300 mg at ages 14-18 years, 1000 mg for older women). All but 4 of the 31 women (87%) had lower NTX levels when taking calcium. Urinary NTX levels were significantly higher, indicating greater bone mobilization, during supplementation days than during placebo days, and the difference was fairly consistent across individuals. On multivariate analysis adjusting for age and dietary calcium intake, separately and together, neither of these factors significantly predicted the effect of supplementation. These findings indicate that a 1200-mg calcium supplement, taken at bedtime during the third trimester of pregnancy, reduces maternal bone turnover. Measurements of biochemical markers and simultaneous ultrasound estimates of bone mineral density during pregnancy should clarify the influence of calcium supplementation on the maternal skeleton.
Published Version
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