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Low-Dose Calcium Supplementation in Pregnancy

preterm birth

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Hypertensive disorders of pregnancy, which include preeclampsia, complicate 2 to 8 percent of pregnancies and are estimated to cause 45,000 maternal deaths annually worldwide. These disorders are also associated with an increased risk of preterm birth, the leading cause of death among children worldwide. 

Calcium supplementation of 1500 to 2000 mg per day, divided into three doses, during pregnancy has been recommended by the World Health Organization (WHO) since 2011 to reduce the risk of preeclampsia in populations with low dietary calcium intake. Previous trials of high-dose calcium supplementation of at least 1000 mg per day reduced the risk of preeclampsia by more than half and the risk of preterm birth by 24 percent. However, only a few countries have implemented routine high-dose calcium supplementation in pregnancy due to adherence concerns and high cost. 

The findings of two independent, randomized trials conducted in India and Tanzania to compare the efficacy of low-dose calcium supplementation (500 mg per day) to high-dose calcium supplementation (1500 mg per day) in reducing the risk of preeclampsia and preterm birth was recently published in The New England Journal of Medicine. In each trial, 11,000 first-time pregnant women were enrolled. The results indicate that low-dose calcium supplementation was as effective as the high-dose in terms of the risk of preeclampsia. The trial in India, but not the one in Tanzania, showed that the low-dose calcium supplement was as effective as the high-dose with respect to preterm birth.

In-Print National Content Global and Health Briefs Health Brief May 2024
Tick Talk

Spring officially sprung on March 21. We have turned our clocks ahead. We are looking forward to warm winds, sunny skies and the smell of fresh cut grass. The daffodils and tulips have recently bloomed and we are just starting with the yard work that comes with the warmer weather.  Sadly, another season has started ramping up.  Tick season.

•             The best form of protection is prevention. Educating oneself about tick activity and how our behaviors overlap with tick habitats is the first step.

•             According to the NJ DOH, in 2022 Hunterdon County led the state with a Lyme disease incidence rate of 426 cases per 100,000 people. The fact is ticks spend approximately 90% of their lives not on a host but aggressively searching for one, molting to their next stage or over-wintering. This is why a tick remediation program should be implemented on school grounds where NJ DOH deems high risk for tick exposure and subsequent attachment to human hosts.

•             Governor Murphy has signed a bill that mandates tick education in NJ public schools. See this for the details.  Tick education must now be incorporated into K-12 school curriculum. See link:

https://www.nj.gov/education/broadcasts/2023/sept/27/TicksandTick-BorneIllnessEducation.pdf

•             May is a great month to remind the public that tick activity is in full swing. In New Jersey, there are many tickborne diseases that affect residents, including Anaplasmosis, Babesiosis, Ehrlichiosis, Lyme disease, Powassan, and Spotted Fever Group Rickettsiosis.

•             For years, the focus has mainly been about protecting ourselves from Lyme disease. But other tick-borne diseases are on the rise in Central Jersey. An increase of incidence of Babesia and Anaplasma are sidelining people too. These two pathogens are scary because they effect our blood cells. Babesia affects the red blood cells and Anaplasma effects the white blood cells.

•             Ticks can be infected with more than one pathogen. When you contract Lyme it is possible to contract more than just that one disease. This is called a co-infection. It is super important to pay attention to your symptoms. See link.

https://twp.freehold.nj.us/480/Disease-Co-Infection

A good resource from the State:

https://www.nj.gov/health/cd/topics/tickborne.shtml

 

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