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Counseling pregnant women on calcium: effects on calcium intake

  • Jessica P.M.M. Willemse EMAIL logo , Luc J.M. Smits , Mandy M.E. Braat , Linda J.E. Meertens , Pim van Montfort , Martien C. van Dongen , Jonas Ellerbrock , Ivo M.A. van Dooren , Ella. J. Duvekot , Iris M. Zwaan , Marc E.A. Spaanderman and Hubertina C.J. Scheepers
Published/Copyright: August 23, 2022
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 51 Issue 3

Abstract

Objectives

To evaluate the effect of incorporating calcium advice into early pregnancy counseling on calcium intake during pregnancy in the Netherlands.

Methods

A multicenter prospective before-after cohort study was conducted introducing risk-based care including calculating individual pre-eclampsia risk. Part of the intervention was to incorporate calcium advice into routine counseling. We calculated individual daily calcium intake and adequacy of calcium intake (≥1,000 mg/day) at 16, 24 and 34 weeks of pregnancy. We performed a multiple logistic regression adjusting for covariates to identify any differences in the risk of inadequate calcium intake between RC and CAC.

Results

In regular care (RC, 2013–2015, n=2,477) 60% had inadequate calcium intake, compared to 49% during calcium advice care (CAC, 2017–2018, n=774) (aOR 0.75, 95% CI 0.64–0.88). Specific calcium supplements were used by 2% and 29% in RC and CAC, respectively (OR 25.1, 95% CI 17.8–36.0). Determinants of an inadequate calcium intake were lower age (aOR per additional year 0.96, 95% CI: 0.94–0.98), nulliparity (aOR 1.22, 95% CI: 1.03–1.45) and non-Caucasian origin (aOR 1.83, 95% CI 1.09–3.09). In CAC, risk of inadequate intake decreased with increasing predicted pre-eclampsia risk, which was a trend reversal compared to RC.

Conclusions

Incorporating calcium advice into early pregnancy counseling was shown to lead to a decrease in the risk of inadequate calcium intake during pregnancy, but still inadequate intake in half of the women suggesting the need for further study on improving implementation. Awareness of individual increased PE risk had positive effect on calcium intake.

Keywords: calcium; calcium intake; counseling; diet; pre-eclampsia; supplements
Corresponding author: J.P.M.M. Willemse, Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands, E-mail:

Funding source: ZonMw

Award Identifier / Grant number: 209020007

Award Identifier / Grant number: 505200098150

Acknowledgments

We are grateful to all women who participated in the Expect study. We acknowledge participant recruitment by the participating midwifery practices and departments of obstetrics and gynaecology of hospitals in the Province of Limburg. We also acknowledge Nicole Wijckmans, department of Epidemiology, Maastricht University, for selecting the food items for the questionnaire.

  1. Research funding: ZonMw (The Netherlands Organization for Health Research and Development; federal funding) grant numbers 209020007 and 505200098150

  2. Author contributions: LJEM, HCJS, and LJMS contributed to the conception and design of the Expect study I. PM, LJEM, JPMMW, HCJS, and LJMS contributed to the conception and design of the Expect study II. JPMMW, LJEM, PM were responsible for the data collection. MCD was responsible for the selection of food items (FFQ) and assisted in the analysis of dietary intake data. JPMMW and LJMS conducted the statistical analyses, interpreted the data and drafted the manuscript. All authors were involved in interpretation of the outcomes, critically reviewed draft versions and approved the final manuscript.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The Medical Ethical Committee of the Maastricht University Medical Centre declared that no ethical approval was necessary for the Expect Study I and II (MEC-13-4-053 and MEC-17-4-057, respectively).

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Received: 2021-08-09
Accepted: 2022-07-29
Published Online: 2022-08-23
Published in Print: 2023-03-28

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. A Celebration of Professor Joachim Dudenhausen
  4. Reviews
  5. Gestational complications associated with SARS-CoV-2 infection in pregnant women during 2020–2021: systematic review of longitudinal studies
  6. Eclampsia a preventable tragedy: an African overview
  7. Original Articles – Obstetrics
  8. How do bicornuate uteri alter pregnancy, intra-partum and neonatal risks? A population based study of more than three million deliveries and more than 6000 bicornuate uteri
  9. Maternal urogenital infection and fetal heart functional assessment – what is the missing link?
  10. Knowledge and attitudes of pregnant women on maternal immunization against COVID-19 in Croatia
  11. Retrospective review of GCT cutoff value based on pre-pregnancy BMI class in patients with GDM
  12. Cervical strain elastography: pattern analysis and cervical sliding sign in preterm and control pregnancies
  13. Maternal race/ethnicity impacts the success rates of external cephalic version (ECV) in the United States
  14. Fetal adrenal gland size and umbilical artery Doppler in growth-restricted fetuses
  15. Counseling pregnant women on calcium: effects on calcium intake
  16. Relationship among anogenital distance, adrenal gland volume, and penile length and width at 22–36 weeks of pregnancy
  17. Intra-amniotic inflammation in the mid-trimester of pregnancy is a risk factor for neuropsychological disorders in childhood
  18. Genetic amniocentesis using atraumatic 29 gauge needle in patients having a chorioamniotic separation
  19. YouTube as a source of patient information on external cephalic version
  20. Midwives’ personal and professional attitudes towards women’s delivery choices, interventions and neonatal care
  21. Maternal serum midkine level in fetal growth restriction: a case-control study
  22. Original Articles – Neonates
  23. Interventions for reducing late-onset sepsis in neonates: an umbrella review
  24. Maternal knowledge of recommendations for safe infant sleep and intentions for implementation – a cross sectional analysis of data from the KUNO-Kids birth cohort study
  25. Short Communication
  26. Lysophosphatidylcholine acyltransferase 1 protein is present in maternal blood in the third trimester and is upregulated by antenatal corticosteroids
  27. Letters to the Editor
  28. Peripartum hysterectomy at a tertiary university perinatal center – retrospective analysis of the 25-year period
  29. Neonate, infected mother and monkeypox: the present concern
https://doi.org/10.1515/jpm-2021-0376
Keywords for this article
calcium; calcium intake; counseling; diet; pre-eclampsia; supplements

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. A Celebration of Professor Joachim Dudenhausen
  4. Reviews
  5. Gestational complications associated with SARS-CoV-2 infection in pregnant women during 2020–2021: systematic review of longitudinal studies
  6. Eclampsia a preventable tragedy: an African overview
  7. Original Articles – Obstetrics
  8. How do bicornuate uteri alter pregnancy, intra-partum and neonatal risks? A population based study of more than three million deliveries and more than 6000 bicornuate uteri
  9. Maternal urogenital infection and fetal heart functional assessment – what is the missing link?
  10. Knowledge and attitudes of pregnant women on maternal immunization against COVID-19 in Croatia
  11. Retrospective review of GCT cutoff value based on pre-pregnancy BMI class in patients with GDM
  12. Cervical strain elastography: pattern analysis and cervical sliding sign in preterm and control pregnancies
  13. Maternal race/ethnicity impacts the success rates of external cephalic version (ECV) in the United States
  14. Fetal adrenal gland size and umbilical artery Doppler in growth-restricted fetuses
  15. Counseling pregnant women on calcium: effects on calcium intake
  16. Relationship among anogenital distance, adrenal gland volume, and penile length and width at 22–36 weeks of pregnancy
  17. Intra-amniotic inflammation in the mid-trimester of pregnancy is a risk factor for neuropsychological disorders in childhood
  18. Genetic amniocentesis using atraumatic 29 gauge needle in patients having a chorioamniotic separation
  19. YouTube as a source of patient information on external cephalic version
  20. Midwives’ personal and professional attitudes towards women’s delivery choices, interventions and neonatal care
  21. Maternal serum midkine level in fetal growth restriction: a case-control study
  22. Original Articles – Neonates
  23. Interventions for reducing late-onset sepsis in neonates: an umbrella review
  24. Maternal knowledge of recommendations for safe infant sleep and intentions for implementation – a cross sectional analysis of data from the KUNO-Kids birth cohort study
  25. Short Communication
  26. Lysophosphatidylcholine acyltransferase 1 protein is present in maternal blood in the third trimester and is upregulated by antenatal corticosteroids
  27. Letters to the Editor
  28. Peripartum hysterectomy at a tertiary university perinatal center – retrospective analysis of the 25-year period
  29. Neonate, infected mother and monkeypox: the present concern
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