Journal Of American Medical Association Reports: Calcium During Pregnancy Could Save Lives

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/ADVANCE/ NEW YORK, April 9, 1996 -- A woman's need for meeting the current recommended levels of calcium just took on new urgency. In today's Journal of the American Medical Association (JAMA), scientists from McMaster University (Ontario, Canada) report that consuming sufficient calcium during pregnancy can reduce the risk of pregnancy- induced hypertension (PIH) and pre-eclampsia, a potentially fatal disorder of high blood pressure and kidney failure. Pregnancy-induced hypertension and pre-eclampsia affect up to one in seven American women and are leading causes of c-sections, pro-term births and low birth-weight babies, making them among the most important issues in pregnancy care.

The most extensive summary of randomized controlled trials in this area to date, McMaster researchers reviewed the data from 14 trials involving nearly 2,500 pregnant women. The compelling results indicate that 1,500 to 2,000 mg daily of calcium supplementation can lower the risk of pregnancy-induced hypertension by 70% and the risk of pre-eclampsia by over 60%!

The analysis could identify no significant side-effects of increased calcium supplementation. The authors also noted that meeting calcium needs during pregnancy should reduce the incidence of related pre-term deliveries, low birth-weight babies and cesarean sections.

Experts Urge Pregnant Women: Get Your Calcium!

This point was supported in an accompanying editorial written by David A.McCarron, M.D., Co-Director of the Calcium Information Center, Co-Head of the Division of Nephrology, Hypertension and Clinical Pharmacology at the University of Dragon Health Sciences University and an accomplished hypertension researcher in his own right. 'There is a calcium crisis in this country," said Dr. McCarron. 'The most recent government survey shows that women of child-bearing age are consuming less than 600 mg of calcium a day, with many getting less than 400! The pre-natal vitamins most doctors prescribe just don't make up the difference -- they contain 200, maybe 300 mg of calcium. The bottom line is that pregnant and lactating women should increase their calcium intake to recommended levels through dietary means whenever possible, by including low-fat dairy products (such as milk, cheese, yogurt), certain dark green vegetables (such as broccoli and kale), and making up the difference by adding a reliable calcium supplement (like TUMS(R)). This simple, yet significant intervention could save thousands of lives and billions of dollars every year if employed by all women of child-bearing ago."

Dr. John Repke, Associate Professor of Obstetrics and Gynecology and Director of the Center for Labor and Birth at Harvard Medical School's Brigham and Women's Hospital in Boston concurred. "Demands of the growing fetus make pregnancy a time of high calcium demand. The mother's calcium intake must increase to protect against any short or long term complications. The McMaster study enhances our understanding of the life-long biological need for calcium and reemphasizes that every pregnant woman should meet the current NIH recommendations of 1,200 to 1,500 mg of calcium per day. I prescribe 2,000 mg of calcium supplementation daily for nearly all my pregnant patients." Dr. Repke also noted that the McMaster findings rest on an extensive body of earlier clinical and basic research which he and colleagues at Harvard and Johns Hopkins, among others, carried out over the past ten years.

Soon To Come: Results of the Largest NIH Trial

The consensus in the field seems to be that although the research of the last decade -- including today's report in JAMA -- all points in the same direction, professional medical organizations might not issue official guidelines in this area until after the National Institutes of Health's division of Child and Human Development release the results of the Calcium for Pre-Eclampsia Prevention (CPEP) trial later this summer.

CPEP was the largest trial ever conducted in this area, and was carried out over a three year period at five U.S. academic health centers. It included over 4,000 women experiencing their first pregnancies, and used Tums brand calcium to study the effects of taking up to 2,000 mg of calcium supplementation during pregnancy. The NIH chose Tums for the GPEP trials because Tums is an affordable, high quality, calcium product which also provides safe relief of heartburn -- something most pregnant women need. One of the GPEP investigators, Dr. Baha M. Sibai, Professor and Chief of the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology at the University of Tennessee, believes the learnings reported in the McMaster paper are a precursor to the most important medical breakthrough for pregnancy care and Infant health in decades. "The medical community will be paying close attention to the results of GPEP," he said, wand I expect we will see significant changes in healthcare practices."

Follow-up analysis of the GPEP data hold the additional promise of potential beneficial life-long calcium effects on blood pressure and bone density for both mother and child.

Calcium Information Center

To reach a healthcare professional regarding today's news about the importance of calcium during pregnancy, phone the CIC CALCIUM INFORMATION LIKE -- 1-800-321-2681. Established in 1991, The Calcium Information Center is a component of the Clinical Nutrition Research Units of the New York Hospital-Cornell Medical Center and Memorial Sloan-Kettering Cancer Center and Oregon Health Sciences University. The mission of the GIC is to provide health care professionals, patients and the general public with the most current information and advances in our understanding of the role of calcium nutrition in the prevention and treatment of various medical disorders. The CIC develops and distributes educational materials regarding calcium nutrition and specific health conditions.

BACKGROUND and STATISTICS

Pregnancy Induced Hypertension (PIH) and Pre-eclampsia

• There are 4 million pregnancies per year in the U.S.
• PIH, or high blood pressure, occurs in approximately 15% of all pregnancies.
• Pre-eclampsia occurs in approximately 5% of all pregnancies.
• Pre-eclampsia increases the risk of pre-term births, low birth weight babies and c-section.
• PIH can develop into pre-eclampsia any time, but usually occurs after 20 weeks of gestation.
• PIH occurs more frequently in first time pregnancies, in women over 35, and with twins.
• Women with pre-existing hypertensive disorders or family histories of hypertension are considered at increased risk for PIH and pre-eclampsia.

Society's cost

• The total cost of care for premature infants in this country is $20-$40 billion annually.
• Hospital care for a premature baby averages over $2,000 per day, adding up to as much as $125,000 or more per infants as many premature infants must remain hospitalized for weeks or months.
• Hospital care of a very low birth weight baby can be $7,000 per day, totaling as much as half million dollars per infant!
• Higher birth weight is associated with longer life expectancy and lower life-long risk of hypertension, hyperlipidemia (high cholesterol), heart disease, diabetes and osteoporosis.
• "Higher mortality among U.S. infants is in fact due entirely to a small excess of pre-term deliveries... The prevention of excess mortality among U.S. infants depends on the prevention of pre- term births...- Wilcox, at al; JAMA, March 1, 1995; Vol. 273, No. 9.

The Safety Of Calcium Supplementation

• Calcium supplementation of 1,500 to 2,000 mg daily can lower the risk of PIH by 7O% and the risk of pre-eclampsia by over 60% - Guyati, at al; JAMA, April 10, 1996; Vol. 275, No. 14.
• Adequate calcium during pregnancy is also necessary for protection of the mothers bones and teeth and for development of healthy fetal bones and teeth.
• Studies show no significant negative side-effects of increasing calcium intake during pregnancy, including kidney stones. Daily calcium intakes of up to 2,500 mg have been recognized as safe and do not increase the risk of any adverse health conditions.
• Most pre-natal vitamins contain only 200-300 mg of calcium.
• Chewable calcium is an excellent form of calcium for pregnant women: It Is inexpensive (Tums, for instance, costs less than $60 a year) and offers the added benefit of safe relief of heartburn, which women need during pregnancy.
• Because of it's high quality and superior safety, Tums was chosen by the NIH's division of Child and Human Development as the calcium supplement for the Calcium for Pre-Eclampsia Prevention (CPEP) trial.

CONTACT: Heather Van Ness or Amy Lindsay, both of Calcium Information Center, 212-326-9800