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October 8, 1997

Contempo 1997: Obstetrics and Gynecology

Author Affiliations

National Institute of Child Health and Human Development Bethesda, Md

JAMA. 1997;278(14):1147. doi:10.1001/jama.1997.03550140039022

To the Ediotr.  —I disagree with the recommendation of Drs DeCherney and Koos1 to administer 1.5 to 2 g/d of elemental calcium to pregnant women at high risk for developing preeclampsia. The studies included in the meta-analysis on which this recommendation was based were principally studies of healthy nulliparous women.2 There is no information with respect to the use of calcium supplementation for prevention of preeclampsia in women with multiple pregnancies, chronic hypertension, diabetes mellitus, or prior preeclampsia. As described elsewhere,3 many of the previous studies had serious methodological shortcomings. Moreover, the safety of calcium supplementation cannot be assured in women with hypercalcemia, renal disease, or a history of urolithiasis.The multicenter trial of Calcium for Preeclampsia Prevention (CPEP)3,4 supported by the National Institute of Child Health and Human Development and the National Heart, Lung, and Blood Institute found that calcium did not prevent preeclampsia or