ROLE OF CALCIUM IN PREGNANCY FOCUS : Daily requirement of calcium according to age Calcium metabolism in pregnancy Calcium requirement in pregnancy Maternal benefits Fetal benefits Reduction in blood lead levels Nutrition to improve calcium Guidelines about dietary calcium intake / supplements in pregnancy

1. ROLE OF
CALCIUM IN
PREGNANCY
DR. SHARDA JAIN
Dr. Jyoti Agarwal
Dr. Rashmi Jain
Dr. Indu Tyagi
Dt. Naina Bhaskar
Dt. Shubhra Kestwal
…Caring hearts, healing hands

2. Over 300 ppts are available on
slideshare.net ***for use of public/Doctors
www.slideshare.net / Lifecarecentre

3. FOCUS :
• Daily requirement of calcium according to age
• Calcium metabolism in pregnancy
• Calcium requirement in pregnancy
• Maternal benefits
• Fetal benefits
• Reduction in blood lead levels
• Nutrition to improve calcium
• Guidelines about dietary calcium intake / supplements in
pregnancy

4. Daily requirement of calcium at
different stages in both sexes
Age Estimated requirement of calcium per
day 400mg
Birth-6 months 400 mg
6 months – 1 year 600 mg
1 year – 10 years 800-1200 mg
11 years – 24 years 1200 – 1500 mg
25 years – 50 years 1000 mg
51 years or older (women) 1500 mg
51 years – 64 years (men) 1500 mg
65 years or older (men & women) 1500 mg

5. CALCIUM METABOLISM IN PREGNANCY
Calcium needs are
physiologically – up
regulated during
pregnancy to meet the
demands of the
developing fetus for
skeletal mineralization
& growth

6. Calcium Mertabolism in Pregnancy
Extra Demand for calcium from the growing
Fetus (especially during the 3rd trimester)
Physiological compensation through changes
in hormone levels
Increased intestinal absorption & a
decrease in renal calcium loss
Increase in absorption from the maternal
skeleton
Intestinal Calcium absorption is the primary source

7. CALCIUM REQUIREMENT IN PREGNANCY
• Calcium absorption increases approximately two- fold
during pregnancy.
• By 2-3 months post partum, calcium absorption returns
to values close to those observed in early gestation or
prior to conception.
• There are a number of dietary constituents that affect
the percentage of calcium absorption, although the
total calcium content of the diet is usually the
overriding determinant.

8. Calcium Requirement in Pregnancy
• In developing countries, calcium needs in
pregnancy women are not always covered &
this is a threat to their health & of the fetus.
• Calcium intake is especially crucial during
pregnancy because of the potential adverse
effect on maternal bone health if maternal
calcium stores are depleted.

9. Calcium Requirement in Pregnancy
• Pregnancy : Fetal accrual is about 240mg per day.
• Maternal Urinary & insensible loss is about 180mg
• The target of absorbed calcium of 420 mg is
expected to be provided by intake of 940 mg
(calcium absorption is especially enhanced during
pregnancy, via higher calcitriol level), leading to
recommendation of 1200 mg per days

10. MATERNAL BENEFITS
• Calcium consumption
should be encouraged,
especially during
pregnancy to replace
maternal skeletal
calcium stores that are
depleted during these
periods.

11. MATERNAL BENEFITS
• Pre-eclampsia & eclampsia
are common causes of
serious morbidity &
maternal death.
• Sufficient calcium intake
reduces hypertension
onset & associated
disorders during pregnancy .

12. Fetal benefits
• The fetus in utero is
dependent on
maternal sources for
the total calcium load.
• Adequate maternal
calcium intake can also
affect fetal bone
health positively.

13. FETAL BENEFITS
• Increase total – body &
lumbar bone mineral content
in infant correlated with
increased total maternal
calcium intake.
• Positive correlation between
maternal dairy intake & fetal
femur length

14. Fetal Benefits
• In a study in India,
Maternal malnutrition,
Which included calcium
deficiency & its effect on
fetal BMD values, was
evaluated by comparing
pregnant women of high &
low socioeconomic
communities, which was
defined by their income

15. FETAL BENEFITS
• Women in the upper socioeconomic
group consumed 700 to 800mg/d
calcium, although members of the
Low asocioeconomic group
consumed only 300mg/d calcium.
• Fetal BMD values at the redius, ulna,
tibia & fibula were significantly
higher in the upper socieconomic
group than in the low socioeconomic
group.

16. Fetal benefits
• Given the importance of calcium to the
developing fetus & the need for adequate stores,
• A brief discussion of the importance of calcium
should be addressed early in pregnancy.

17. Dairy
Products
Ca-
containing
supplements
Fortified
foods
Leafy
greens
Nutrition to improve calcium
• Food is considered the best source
of calcium.
• Dairy products are the best dietary
source of calcium also some
vegetables & fruits that contain
considerable amounts of calcium
• Proper calcium consumption can
be attained through the diet,
fortified foods or by
supplementation

18. NUTRITION TO IMPROVE CALCIUM
• The economic status has been related to calcium intake in
pregnant women.
• Unselected pregnant women attending a medical collage
hospital in northern India were documented to have a
moderately good calcium intake of 842 ± 459mg/day, mainly due
to supplements advised during antenatal care.
*****************
• In contrast, rural, poor socio-economic group pregnant women,
studied in their home setting in barabanki district, uttar pradesh,
were documented to have a lower intake of 211 + 158 mg/ day

19. Nutrition to improve calcium t
• Explanation could be
prolonged deficiency
of dietary calcium
intake among poorer
part of India (rural
women in this study),
because of the
expensive nature of
milk & milk products.

20. Nutrition to improve Calcium
• The Consumption of milk has decreased drastically over
the last century with detrimental consequences on
overall calcium levels of the population.
• Other options for ensuring adequate intake are
necessary
Needs introspection

21. Guidelines about Dietary Calcium Intake
in Pregnancy
Good Dietary Sources of calcium in dairy products
Food example Amount Calcium in Milligrams
Milk 1 cup 580
Butter Milk 1cup 232
Yogurt 1 cup 452
Cheese 1 cubic inch 129
Ice- Cream 1 cup 272
Milk powder, skimmed 1 cup 1370
Milk powder, whole 1 cup 910

22. Dietary sources of calcium in
Non.. vegetarian Diet
Food item Calcium
(milligrams per 100 g)
Chicken (meat) 30 mg
Mutton (muscle) 150 mg
Prawn 320mg
Ruhu Fish 650 mg
Egg hen’s 60 mg

23. DIETARY SOURCES OF CALCIUM IN
VEGETABLES & FRUIT
VEGETABLES & FRUITS CALCIUM
(MILLIGRAMS PER 100 G)
cauliflower 140 mg
Fenugreek (methi) 570 mg
spinach 60 mg
Ladies fingers 90 mg
beetroot 200 mg
cabbage 80 mg
figs 60 mg
Grapes (blue) 30 mg
dates 70 mg
oranges 50 mg
raisins 100 mg
apple 10 mg
banana 10 mg
papaya 10 mg

24. Dietary sources of calcium in cereals
Food item Calcium
(milligrams per 100 g)
bajra 50 mg
Ragi 330 mg
Wheat flour, whole 50 mg
Wheat flour, refined 20 mg
Rice (boiled) 10 mg
Rice (flake/puffed) 20 mg
Soya bean 240 mg
Dal 160 mg
Black gram dal 200 mg

25. Dietary sources of calcium in nuts
Nuts Calcium
(milligrams per 100 g)
Almonds 230 mg
Groundnuts 50 mg
Pistachio 140 mg

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