Serum calcium level among pregnant women and its association with pre-eclampsia and delivery outcomes: A cross-sectional study from North India

Shashi Kant,Partha Haldar,Ayush Lohiya,Anant Gupta

doi:10.3126/nje.v9i4.23150

Abstract

Background:Calcium requirement increases during pregnancy, thereby increasing the chances of developing hypocalcaemia. Hypocalcaemia may be associated with pregnancy-related complications. Therefore, we planned this study to estimate the prevalence of hypocalcaemia among pregnant women attending secondary care hospital, and to study the association between hypocalcaemia and pregnancy outcomes.Materials and Methods:This study was conducted in a secondary level hospital at Ballabgarh, district Faridabad, Haryana, India. Consecutive pregnant women with gestation period more than 28 weeks were enrolled. Dietary calcium intake was ascertained using 24-hour dietary recall method. Serum calcium estimation was done by Biolis 24i auto analyser. Outcome of pregnancy (preterm delivery, low birth weight (LBW) babies, and neonatal mortality) was assessed telephonically 3 months after the enrolment.Results:A total of 696 pregnant women were enrolled in the study. Mean (SD) dietary calcium intake and serum calcium level was 796.4 (360.4) mg/day and 9.56 (0.94) mg/dl respectively. Prevalence (95% CI) of hypocalcaemia was 23.9% (20.8 – 27.2%). Serum total calcium level was not associated with dietary calcium intake (p-value = 0.36). Mean serum calcium level was significantly lower in mothers who had LBW babies. Pre-eclampsia, preterm delivery, and neonatal mortality were not associated with serum calcium level.Conclusion:Serum calcium level may not be related to dietary calcium level. Hence, the current recommendation of calcium supplementation during antenatal period appears to be inconclusive among our study population.

Highlights

There is an increasing evidence of lower than the recommended daily allowances dietary calcium intake in Indian population [1]
Association of delivery outcomes with serum calcium levels in study population We explored the association of serum calcium levels and daily dietary calcium intake with pre-eclampsia and adverse birth outcomes
We conclude that the serum calcium level was adequate among pregnant women attending antenatal clinic of secondary care hospital though their daily dietary calcium intake was inadequate

Summary

Introduction

There is an increasing evidence of lower than the recommended daily allowances dietary calcium intake in Indian population [1]. Calcium requirement in non-pregnant state is 600 mg/day which increases to 1,200 mg/day during pregnancy [3] This increased amount of calcium is required for the growth and development of bones and teeth of fetus. We tried to estimate the prevalence of hypocalcaemia among pregnant women attending antenatal clinic of a secondary level hospital. Secondary objective was to explore the association of serum calcium level with pre-eclampsia, birth weight of the baby, preterm delivery, and neonatal mortality. We planned this study to estimate the prevalence of hypocalcaemia among pregnant women attending secondary care hospital, and to study the association between hypocalcaemia and pregnancy outcomes. Outcome of pregnancy (preterm delivery, low birth weight (LBW) babies, and neonatal mortality) was assessed telephonically 3 months after the enrolment. The current recommendation of calcium supplementation during antenatal period appears to be inconclusive among our study population

Methods

Results

Discussion

Conclusion