Publication:

Comparison of high dose calcium and vitamin D3 versus low dose aspirin combined with high dose calcium and vitamin D3 in prevention of preeclampsia: a prospective comparative study

Background It is hypothesized that, vitamin D supplementation with or without calcium in pregnancy has important role in reducing risk of preeclampsia. This study was designed to compare the efficacy of high dose calcium, vitamin D3 supplementation with high dose calcium, vitamin D3 combined with low dose aspirin, in prevention of pre-eclampsia.

Methods This hospital based prospective comparative study was conducted in the Department of Obstetrics and Gynaecology, Koppal Institute of Medical Sciences, Koppal, Karnataka State, India. A total of 210 females with gestational age of 12 weeks attending antenatal check-up divided into three groups of 70 each as group A (calcium and vitamin D3), group B (calcium and vitamin D and aspirin) and group C (routine antenatal medications) were enrolled.

Results Most of the women in all the three groups were aged between 21 to 25 years (p=0.913). Gestational age of 12 weeks at the start of supplementation was noted in 58.57%, 64.29% and 41.43% of the women in group A, B and C had respectively (p=0.031). Majority of the women (88.33%) of the women in group C had pedal oedema (p<0.001) with presence of urine albumin (52.86%) (p<0.001). Majority of the women in group C (67.14%) had pre-eclampsia and complications compared to 32.86% in group A and 18.57% of in group B (p<0.001). The median gestational age at delivery was statistically similar in all the three groups (p=0.981). Most of the women (37.14%) of the women in group C delivered before 38 weeks of gestational compared to 18.57% in group B and 21.43% of in group A (p=0.032).  In group C, 21.43% of the babies required NICU admission compared to 11.43% in group A and 8.57% of in group B (p=0.065). The common indication being preterm birth and low birth weight. Statistically significant difference was observed with respect to NICU stay (p=0.029).

Conclusions High dose calcium, vitamin D3 combined with low dose aspirin, has significant benefit in preventing the pedal oedema and presence of urine albumin, regulating blood pressure at the time of delivery thereby PE with its associated complications and neonatal morbidity in terms of shorter duration of NICU stay.