లా ప్రెన్సా మెడికా

Evaluation of serum calcium levels in pre-eclampsia

Heera Lal Roy, Susmita Nargis

Background: Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Reduced serum calcium level are found associated with elevated blood pressure in preeclampsia. Objectives: To evaluate serum calcium level in preeclamptic women. `Methods: This cross sectional study was carried out in among 50 pre-eclamptic patients, aged 20 to 40 years, and gestational age ranges from 20 to 40 weeks and 50 age and gestational age matched normotensive pregnant women having no proteinuria. Serum calcium was measured by Colorimetric method. Results: The mean age and mean gestational age of pre-eclampsia was not significantly different from those of normotensive pregnant women (p=0.203 and p=0.251 respectively). The mean body mass indexes of the test patients were significantly different from those of normotensive pregnant women (p<0.001). The mean serum calcium level was 7.27 ± 3.01 mg/ dl in pre–eclampsia and 7.25 ± 2.59 mg/dl in normal pregnant women; did not differ significantly between the subjects of pre–eclampsia and normal pregnant women (p=0.963). Conclusion: Serum calcium has no association in occurrence of pre–eclampsia. Pre-eclampsia is defined as gestational hypertension of at least 140/90mmHg on two separate occasions ≥ 4 hours apart accompanied by significant proteinuria of at least 300mg in a 24-hour collection of urine, arising de novo after the 20th week of gestation in a previously normotensive and non-proteinuric woman resolving completely by the 6th postpartum week . The pregnant woman’s body provides daily doses of 50 to 330mg of calcium to support the developing foetal skeleton. This high foetal demand for calcium is facilitated by profound physiological interaction between mother and fetus . This additional calcium is normally provided by an increase in maternal intestinal calcium absorption. There may not be a necessary increase in dietary calcium intake. Several studies have linked calcium to the aetiopathogenesis and prevention of preeclampsia, however, the precise mechanism involved is unclear. Normal Serum total calcium is 2.2- 2.6mmol/L(8.6-10.3mg/dl). Thus values less than 2.2mmol/L (< 600 mg/day, corresponding to less than two dairy serving per day) may harm by causing vasoconstriction, either through increasing magnesium levels or stimulating release of parathyroid hormone or renin, thereby increasing vascular smooth muscle intracellular calcium. Some studies have shown that changes in the level of serum trace elements in pre-eclamptic patients may be implicated in its pathogenesis. There is paucity of studies on the relationship between serum calcium and pre-eclampsia in Nigeria and none from Imo State. Thus, this study will give a baseline of the relationship between serum calcium and pre-eclampsia in pregnant women carrying singleton fetus in Imo State.