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Original Rrticle

Thongchai Meelurkan IWD.

Department of Obstetric and Gynecology

Phrae Hospital

Phrae

Sawanpracharak wtedical fournal

VoLo Nor ]anuary-April zooe

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continuing oral calcium Plus Magnesium supplementation untilDelivery Affect Incidence of pIH and perinatal Outcomes

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(OR = 0.39; 95% Cl 0.22-0.68; P = 0.001) tu:cti'u:ull:.1 (severe

pre-eclampsia) fouar 0.8 uns 2.8 (OR=0 .26; 9}o/o Cl 0.1 Z-0.56;

P<0.001 ; neiruuJiuurfi sufi nrrnaanriounhmun 6a arqn::ririasn,jrgz filnrd' urnn'jrn{ufinur 1oR=1.44;9so/o ct 1.16-1.79; p=0.01)

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L!:n naan, R1?c?1 naonfrtouzrucnaaFt

Abstract

Obiective

Setting

Design

Subiects

Method

To assess the incidence of pregnancy induced hypertension (plH)

and perinatal outcomes of pregnant women who took calcium plus

magnesium supplementation in Phrae Hospital.

Department of Obstetrics and Gynecology, Phrae Hospital

Randomized clinical trial

2,120 pregnant women who fulfil the inclusion criteria during Oetober,

2006 and September, 2008.

The population were randomly divided into two groups. Study group

were pregnant \,vomen who tmk calcium plus rnagnesium supplementatinn

and standard antenatal medication until delivery and control group

received only strandard antenatal medication. Maternal age, body weight

and hight, numbers of previous pregnancies, history of PlH, gestational

age at delivery, fetal birth weight and APGAFI at 1't and 5h minute

score were collected and ana[tzed using SPSS for window programs.

Comparing between study group and control group, the incidence ofResults

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nanrrlfirnnriolua:ulnfiriudursu'rnr:rirunnoadonr:r6nnrr;a:rldilafing.runnr:d,ra::riuardorn:nu:nnaan

C-ontinuing Oral Cabirm plus lrfagnesium Sxpplerxnration Uotil Delivery

imAlOurcom

Conclusion

mild pre - eclampsia (1.6% vs 4.0%) (oR = 0.89; 9s% cr 0.22-0.68;

P = 0.001), severe pre - eclampsia (0.9% vs 2.9%) (OR = 0.26; gS%

Cl 0.12 - 0.56; P<0.001) and preterm labor (16.90lo vs 22.60l") (OR

1-44i 95o/" cl 1.16 - 1.79; p = 0.01) were significanily lower, and

the numbers of fetal birth weight greater than 2,s00 grams were

significantly higher in study group (47o/o vs 4g7yo) (oR 2.23; 9so/o

Cl = 1.64 - 3.05; P = 0.001). There were no significantly difference

in birth asphyxia.

I continuing oral calcium plus magnesium supplementation until delivery

was beneficial in lowering the incidence of plH and preterm delivery,

resulting in higher birth weight infant.

i calcium, magnesium, PlH, fetal body weight, birth asphp<iaKey words

Uild1

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62::nil:st1:n1*t?16117

ronmrdr{a.r1. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia.

Obstet Gynecol 2OO2;99: 159-67.,ouolarydorasa

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2.

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4. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC lll, Wenstrom KD.

Williams Obstetrics. 22nd ed. New York: Mc Graw-Hill; 2005: p.761-808.A A V d UI A & d O A A V I A A A5. aytEtl 6i51?{Uf,'. n?1iJnuLafinq.:?6usn\:nT;f,i. [lJ : ?Ylg1 ng1?IUE, ?UAT'ITT6U dFlenAn,

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rr5rafru 'irn'ru 2s44. fifi1 293-318.

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o,daray

Llmliln:: 1,{ LO AThii 2543. Y\1 423-48.

B. ejulo naariumna. fl1?snarruriulafin4.::sa'jr.one.:n::Ji.'[u: rnrfisy fiuot:t, $firu'r qun:#o,

ffirrmBn'n. afinTani. d,,r?61: 6ruu:rurainr:firuv{; 2546. fifl1 73-83.{9. Durland J, Pages N, Bac P, Borra M, Guiet-Bara A. New data on the importance of

gestational Mg deficiency. Magness Res 2OO4; 17(2): 116-25.

10. Levin RJ, Heuth JC, Curet LB, Sibai BM, Catalano PM, Morris CD, et al. Trial of

calcium to prevent preeclampsia. N Engl J Med 1997; 337: 69-76.

11. Bucher HC, Guyatt GH, Cook RJ. Effect of calcium supplementation on

pregnancy-induced hypertension and preeclampsia: a meta-analysis of randomized

controlled trials. JAMA 1996; 275: 1113-7.

12. Belizan JM, Villar J, Gonzalez L, Campodomico L, Bergel E. Calcium supplementation

to prevent hypertension disorders of pregnancy. , =ngl J Med 1991;325: 1399-405.

13. Robert Jm. Prevention or early treatment of preeclampsia. N Engl J Med 1997; 337:

124-25.

14. Villar J, Repke JT. Calcium supplementation during pregnancy may reduce preterm

delivery in high-risk populations. Am J Obstet Gynecol 1990; 163: 1124-31.

H6n1:lriunor*uxuo&uunfi4udunqrim::lirunnoaionr:rfianr:za:udulnf,ngrtrnnr:#.rn::#Iacnall r5nurnnaon

4) e d C-ontinuingoralCalcirmPlusMagmiunsupplercntatimUntilDeliverytrfi o qu.-ufi 1 x.a.-H.g 2552 Affat Ircidme of pIH 8rd ftrinaral outcomes I

15. Sanchez-Ramos L, Brienes DK, Kaunity AM. Prevention of pregnancy-induced

hypertension by calcium supplementation in angiotensin ll sensitive patieints. Obstet

Gynecol 1994; 84:349.

16. Kurzel RB. Serum magnesium levels in pregnancy and preterm labor. Am J Perinatol

1991;8: 119-27.

17. Hofmeyr GJ, Roodt A, Atallah AN, Duley L. Calcium supplementation to prevent

pre-eclampsia: a systemic review. S Afr Med J 2003; 93(3) 224-8.

18. Sukonpan K, Phupong V. Serum calcium and serum magnesium in normal and

preeclamptic pregnancy. Arch Gynecol Obstet 2005; 273: 12-6.

19. Prentice A. Maternal calcium requirements during pregnancy and lactation. Am J Clin

Nutr 1994; 59 supp: s477-82.a a I dAI t o U O .ad20. nnn n:{[n:Lv{t:. l$JniltdErilu5f,1n6l1n6una:1{n1u. Lu : umnrril?1u{1uq?n1y{4ilqfl

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21. Merialdi M, Carroli G, Villar J, Abalos E, Gulmezoglu A, Kulier R, et al. Nutritional

interventions during pregnancy for the prevention or treatment of impaired fetal

growth. J Nutr 2003; 133 suppl 5: s1626-31.

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