Bibliographic Info
GuidelineWHO recommendation: calcium supplementation during pregnancy for prevention of pre-eclampsia and its complications
Year of Publication2018
Issuing InstitutionWorld Health Organization
Recommendation
Status
Updated
Context specific recommendation
Only in specific contexts
Certainty of evidence
Moderate
In populations with low dietary calcium intake, daily calcium supplementation (1.5 g–2.0 g oral elemental calcium) is recommended for pregnant women to reduce the risk of pre-eclampsia
Notes and Remarks
- 1.This recommendation is consistent with the 2016 WHO recommendations on antenatal care for a positive pregnancy experience
- 2.Dietary counselling of pregnant women should promote adequate calcium intake through locally available, calcium-rich foods.
- 3.Dividing the dose of calcium may improve acceptability. The suggested scheme for calcium supplementation is 1.5-2.0g daily, with the total dose divided into three doses, preferably taken at mealtimes.
- 4.Negative interactions between iron and calcium supplements may occur. Therefore, the two micronutrients should preferably be administered several hours apart rather than concomitantly.
- 5.As there is no clear evidence on the timing of initiation of calcium supplementation, stakeholders may wish to commence supplementation at the first antenatal care contact, in order to improve compliance to the regimen.
- 6.To reach the most vulnerable populations and ensure a timely and continuous supply of supplements, stakeholders may wish to consider task shifting the provision of calcium supplementation in community settings with poor access to healthcare professionals (4).
- 7.The implementation and impact of this recommendation should be monitored at the health service, regional and country levels based on clearly defined criteria and indicators associated with locally agreed targets. Barriers, enablers and pathways should be evaluated to inform integration of this recommendation into the antenatal care package.