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Hiki i ke koko kiʻekiʻe i ka wā hāpai ke alakaʻi i ka eclampsia a me ka hānau mua ʻana a he kumu nui ia o ka maʻi maʻi a me ka neonatal a me ka make. Ma ke ʻano he mea koʻikoʻi koʻikoʻi o ke olakino lehulehu, ʻōlelo ka World Health Organization (WHO) i nā wahine hāpai me ka lawa ʻole o ka meaʻai calcium hoʻohui i ka 1000 a 1500 mg o ka calcium i kēlā me kēia lā. Eia nō naʻe, ma muli o ka paʻakikī o ka hoʻohui calcium, ʻaʻole ʻoluʻolu ka hoʻokō ʻana i kēia ʻōlelo paipai.

Ua ʻike ʻia nā hoʻāʻo ʻana i hoʻopaʻa ʻia ma India a me Tanzania e Profesor Wafie Fawzi o ke Kula ʻo Harvard School of Public Health ma ʻAmelika Hui Pū ʻIa i ka haʻahaʻa haʻahaʻa o ka calcium supplementation i ka wā hāpai ʻaʻole i ʻoi aku ka maikaʻi ma mua o ka nui o ka calcium supplementation i ka hōʻemi ʻana i ka pilikia o ka pre-eclampsia. Ma keʻano o ka hōʻemiʻana i ka pilikia o ka hānau muaʻana, ua loaʻa i nā ho'āʻo Indian a me Tanzania nā hopena likeʻole.

Ua hoʻokomo ʻia nā hoʻokolohua ʻelua he 11,000 poʻe i komo i ka makahiki ≥18 makahiki, makahiki hānau

No ka preeclampsia,ʻo ka huiʻana o ka hui 500 mg versus 1500 mg i ka ho'āʻo Indian he 3.0% a me 3.6%, i kēlā me kēia (RR, 0.84; 95% CI, 0.68 ~ 1.03); I ka hoʻokolokolo Tanzanian, ʻo 3.0% a me 2.7% ka hopena (RR, 1.10; 95% CI, 0.88 ~ 1.36). Ua hōʻike ʻia nā hoʻokolohua ʻelua ʻaʻole i ʻoi aku ka ʻino o ka preeclampsia ma ka hui 500 mg ma mua o ka hui 1500 mg.

No ka hānau mua, ma ka ho'āʻo India,ʻo ka hopena o ka 500 mg versus 1500 mg pūʻulu he 11.4% a me 12.8%, i kēlā me kēia (RR, 0.89; 95% CI, 0.80 ~ 0.98), ua hoʻokumuʻia ka non-inferiority i loko o ka waiwai paepae o 1.54; Ma ka ho'āʻoʻana o Tanzania,ʻo 10.4% a me 9.7% ka nui o ka hānau hānau mua (RR, 1.07; 95% CI, 0.95 ~ 1.21),ʻoi aku ka nui o ka palena palenaʻole o 1.16, aʻaʻole i hoʻokūpaʻaʻia.

Ma nā wahi hope ʻelua a me ka palekana, ʻaʻohe mea hōʻike i ʻoi aku ka maikaʻi o ka hui 1500 mg ma mua o ka hui 500 mg. ʻAʻole ʻike ʻia kahi meta-analysis o nā hopena o nā hoʻāʻo ʻelua ma waena o nā hui 500 mg a me 1500 mg i ka preeclampsia, ka pilikia o ka hānau mua ʻana, a me nā hopena lua a me ka palekana.

Ua nānā kēia haʻawina i ka pilikia olakino koʻikoʻi o ka hoʻonui ʻana i ka calcium i nā wahine hāpai no ka pale ʻana i ka preeclampsia, a ua alakaʻi i kahi hoʻokolokolo hoʻokolokolo nui i hoʻopaʻa ʻia ma nā ʻāina ʻelua i ka manawa hoʻokahi e pane i ka nīnau ʻepekema koʻikoʻi akā ʻaʻole maopopo ka maikaʻi o ka hopena o ka hoʻohui calcium. He hoʻolālā koʻikoʻi ko ka haʻawina, he laʻana nui, kahi placebo makapō ʻelua, kuhiakau haʻahaʻa ʻole, a me ʻelua mau hopena lapaʻau koʻikoʻi o ka preeclampsia a me ka hānau mua ʻana ma ke ʻano he ʻelua hopena, a hiki i 42 mau lā postpartum. I ka manawa like, ua kiʻekiʻe ka maikaʻi o ka hoʻokō ʻana, ua haʻahaʻa loa ka nui o ka nalowale o ka hahai ʻana (99.5% ka hahai ʻana i ka hopena o ka hāpai ʻana, India, 97.7% Tanzania), a ua kiʻekiʻe loa ka hoʻokō: ʻo 97.7% ka median% o ka hoʻokō (India, 93.2-99.2 interquartile interquartile 92.7, 99.2% interquartile interquartile 92.7-99.2%). waena).

ʻO ka calcium kahi meaʻai kūpono no ka ulu ʻana a me ka ulu ʻana o ka fetal, a piʻi ka koi no ka calcium i nā wahine hāpai i hoʻohālikelike ʻia me ka lehulehu ākea, ʻoi aku hoʻi i ka hopena o ka hāpai ʻana i ka wā e ulu wikiwiki ai ka fetus a piʻi ka mineralization iwi, pono e hoʻohui ʻia ka calcium. Hiki ke hoʻemi i ka hoʻokuʻu ʻana o ka hormone parathyroid a me ka hoʻonui ʻana o ka calcium intracellular i nā wahine hāpai, a hoʻemi i ka hoʻopaʻa ʻana o nā kīʻaha koko a me nā ʻiʻo maʻemaʻe o ka ʻōpū. Ua hōʻike ʻia nā hoʻokolohua Placebo-controlled i ka hoʻonui ʻia ʻana o ka calcium i ka wā hāpai (> 1000 mg) i hōʻemi i ka pilikia o ka preeclampsia ma mua o 50% a me ka pilikia o ka hānau mua ʻana e 24%, a ʻoi aku ka nui o ka emi ʻana i ka poʻe me ka haʻahaʻa o ka calcium. No laila, ma ka "Recommendations Recommendations for Calcium Supplementation during Pregnancy to Prevent Preeclampsia and its Complications" i hoʻopuka ʻia e ka World Health Organization (WHO) i Nowemapa 2018, ua ʻōlelo ʻia i ka poʻe me ka haʻahaʻa calcium e hoʻohui i ka calcium me ka 1500 a i ka 2000 mg i kēlā me kēia lā, i māhele ʻia i ʻekolu mau dosis oral preeclamia i kekahi mau hola. Ua ʻōlelo ʻo China's Expert Consensus on Calcium Supplementation for Pregnant Women, i hoʻokuʻu ʻia ma Mei 2021, e paipai i nā wahine hāpai me ka haʻahaʻa calcium e hoʻohui i ka calcium 1000 ~ 1500 mg i kēlā me kēia lā a hiki i ka hānau ʻana.

I kēia manawa, he kakaikahi wale nō nā ʻāina a me nā ʻāina i hoʻokō i ka hoʻohui calcium nui-dose maʻamau i ka wā o ka hāpai ʻana, ʻo nā kumu he nui ka nui o ka calcium dosage form, paʻakikī ke ale, hoʻolālā hoʻokele paʻakikī (ʻekolu manawa i ka lā, a pono e hoʻokaʻawale ʻia mai ka hao), a ua hoʻemi ʻia ka mālama ʻana i ka lāʻau; I kekahi mau wahi, ma muli o ka liʻiliʻi o nā kumu waiwai a me nā kumukūʻai kiʻekiʻe, ʻaʻole maʻalahi ka loaʻa ʻana o ka calcium, no laila e hoʻopili ʻia ka hiki ʻana o ka nui o ka calcium supplementation. I nā hoʻokolohua lapaʻau e ʻimi ana i ka hoʻohui calcium haʻahaʻa haʻahaʻa i ka wā hāpai (ʻoi aku ka nui o 500 mg i kēlā me kēia lā), ʻoiai ke hoʻohālikelike ʻia me kahi placebo, ua hoʻemi ʻia ka pilikia o ka preeclampsia i ka hui supplementation calcium (RR, 0.38; 95% CI, 0.28 ~ 0.52), akā pono e makaʻala i ke ʻano o ka noiʻi kiʻekiʻe kiʻekiʻe. I loko o hoʻokahi hoʻokolohua hoʻokolohua liʻiliʻi liʻiliʻi e hoʻohālikelike ana i ka supplementation calcium haʻahaʻa haʻahaʻa a me ke kiʻekiʻe o ka preeclampsia, ua ʻike ʻia ka emi ʻana o ka preeclampsia i ka hui kiʻekiʻe i hoʻohālikelike ʻia me ka hui haʻahaʻa (RR, 0.42; 95% CI, 0.18 ~ 0.96); ʻAʻohe ʻokoʻa i ka pilikia o ka hānau mua ʻana (RR, 0.31; 95% CI, 0.09~1.08)