Preventing pregnancy-induced hypertension

Calcium supplements taken during pregnancy can reduce severe complications which lead to 70,000-150,000 pregnancy complication in the Bangladesh each year, says Dr Mahfuzar Rahman of Research and Evaluation Division of BRAC. Pregnant women should increase their calcium intake to help avoid eclampsia and high blood pressure, Research and Evaluation of BRAC's study concludes.

The study found that women who took supplements throughout their pregnancy were 47% less likely to get preeclampsia and other complications. Dr Mahfuzar Rahman said the study was not conclusive with regard to preeclampsia but that the supplements did lead to a significant drop in incidence of the far more serious but rare eclampsia.

Eclampsia can bring life-threatening convulsions which could lead to maternal deaths during labour. Currently the Maternal Mortality Rate (MMR) is 172 per 100,000 live births in Bangladesh.

Globally it has been proven that 1.5-2g/daily Calcium is recommended. Each tablet contains 500mg. therefore 3-4 tablets are required during pregnancy period. Calcium decreases risk of gestational hypertension, pre-eclamsia, low birth weight, and chronic hypertension in children.

The World Health Organisation (WHO) recommended 1.5-2 daily where Calcium intake is low and Government of Bangladesh has adopted this recommendation. However, to date, these WHO recommendations have not been widely adopted, because of practical impediments to implementation, including the size and number.

BRAC Health, Nutrition and Population Programme is implementing a special maternal nutrition programme. One component is delivering Calcium Carbonate tablet 500 mg daily. 11,387 mothers from 10 upazilas (Lalmonirhat, Kurigram, Rangpur and Mymensingh) were monitored monthly on Calcium tablets delivered/consumed, blood pressure, and weight measurement.

Various tools were implemented during the project including awarding the husbands regarding their wives' food variety. High compliance (78%) during second trimester and 71% during the third trimester allowed observing a reduction of 47% less risk of being gestational hypertensive than who consumed less. It means, 70,000-150,000 pregnant mothers can be saved from pregnant-induced hypertension if Calcium Carbonate can be consumed for last 6 months of pregnancy with close monitoring.

This data allowed with an opportunity to assess the effectiveness in large MNCH programme as well as this evidence can help programme to promote practice of using Calcium which may be considered a policy in Bangladesh and similar countries.

Furthermore, about 50% pregnant women of the country suffer from anaemia while intake of 180 calcium tablets during pregnancy increases weight significantly, Dr Rahman concluded. The research also showed that right suggestion improves maternal nutrition and practical training to mothers brings variety in mothers' food.