WHO recommends routine calcium supplementation during pregnancy for prevention of pre-eclampsia in populations with low dietary calcium intake. What is the recommended daily dose?
- A 300 mg
- B 600 mg
- C 1.5 to 2 g ✓
- D 3 to 4 g
Correct answer: C. 1.5 to 2 g
Explanation
WHO guidance advises 1.5 to 2 g of elemental calcium daily for pregnant women whose dietary calcium intake is low, since pooled trials show a meaningful reduction in pre-eclampsia risk, greatest in high-risk and low-intake groups. The effect is thought to reflect reduced parathyroid hormone release and lowered intracellular calcium in vascular smooth muscle, decreasing vasoconstrictor sensitivity. Doses of 300 to 600 mg fall short of the studied effective range, while 3 to 4 g exceeds the recommended supplementation and adds gastrointestinal side effects without proven extra benefit.
Reference: Williams Obstetrics, 26th ed.
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