Single dose calcium may help reducing maternal mortality

Bangladesh has made a remarkable success in achieving the Millennium Development Goals (MDGs), specially when a reduction of 70% women were dying from labour. In the '70s, 650 in every 100,000 live births dramatically stands for only 194 now which is a history in the global health. The achievement was possible because of sustained Gross Domestic Product (GDP) growth rate of over 6 percent, reduction of poverty and accessing universal health coverage.

But the Bangladesh Maternal Mortality and Health Care (BMMHC) survey 2016 revealed no improvement since 2010, which the country put to achieve the Sustainable Development Goals (SDG) targets by 2030. The appropriate steps including necessary medicine to treat haemorrhage and eclampsia goes inadequate.

Globally, around 830 women die from preventable causes related to pregnancy and childbirth each day. 3/4th of these maternal deaths are accounted for high blood pressure during pregnancy (pre-eclampsia and eclampsia), severe bleeding, infections, and complications from delivery and unsafe abortion. Pre-eclampsia (blood pressure in pregnancy) has been found to be a leading cause of maternal and perinatal morbidity and mortality and yet the majority of cases could be avoided if women received timely and effective care, delivered according to evidence-based standards.

From 1990-2015, the maternal mortality declined from 385 to 216 deaths per 100,000 live births. As part of the SDGs, the target is to further reduce the global maternal mortality ratio to less than 70 per 100,000 live births.

A recent study published in the BMC Pregnancy and Childbirth, an international peer reviewed journal, indicated one single calcium tablet (500mg daily) could be sufficient to prevent pregnancy induced hypertension. "The one single dose of calcium supplement taken during pregnancy can reduce severe complications which lead to 70,000-150,000 pregnancy complications in the Bangladesh each year," says Dr Mahfuzar Rahman of Research and Evaluation Division of BRAC. Dr Rahman also said that significant improvement in weight gain was found among pregnant women who took more than 180 calcium tablets.

Pregnant women should increase their calcium intake to help avoid eclampsia and high blood pressure, the study concludes.

The study found that women who took supplements throughout their pregnancy were 47% less likely to get pre-eclampsia and other complications. Eclampsia can bring life-threatening convulsions which could lead to maternal deaths during labour. Currently the Maternal Mortality Rate (MMR) stands for 172 per 100,000 live births.

Globally, it has been proven that daily 1.5-2 gm is recommended during pregnancy. Each tablet contains 500 mg, therefore 3-4 tablets are required during pregnancy period.

Calcium decreases the risk of gestational hypertension, pre-eclamsia, low birth weight and chronic hypertension in children. The World Health Organisation (WHO) recommended 1.5-2.0 g daily where calcium intake is low and the Government of Bangladesh has adopted this recommendation.