Giving pregnant women a low-dose of calcium could prevent millions of cases of preterm birth and preeclampsia while saving money, according to a new global study published in PLOS Global Public Health.

The research, led by scientists from Tanzania, India, and the USA, include contributions from Honorati Masanja of the Ifakara Health Institute. It assessed whether giving pregnant women a low dose of calcium (500 mg/day) is an effective and cost-efficient way to prevent preeclampsia and preterm birth in low- and middle-income countries (LMICs) with low calcium diets.

Life-saving potential and economic benefits

Results showed that in 119 out of 129 countries studied, low-dose calcium supplementation is highly cost-effective. The intervention could potentially prevent 1.3 million preterm births and 1.8 million cases of preeclampsia, while saving $56 million in healthcare costs across these countries.

A first look at the economic impact

This study is the first to evaluate the economic impact of low-dose calcium, which has recently been shown to be as effective as the high-dose regimen recommended by the World Health Organization (WHO).

“This study represents the first cost-effectiveness evaluation of low-dose calcium supplementation during pregnancy,” explained the researchers. “Several studies have evaluated the cost-effectiveness of calcium supplementation for pregnant women, focusing on the 1000–1500mg daily dosage levels included in WHO guidelines.”

Uncertainty and need for further research

While the results are promising, the researchers acknowledge some uncertainty due to differences in previous studies, adherence rates, and country-specific data. They underscore that more research is needed to understand long-term benefits, how the intervention works across diverse populations, and strategies to ensure pregnant women can access and adhere to supplementation before it is widely adopted.

A promising investment for maternal and child health

Experts have long recommended high-dose calcium supplementation for pregnant women to prevent these complications, but adherence and cost have limited its implementation. These new findings suggest that most low- and middle-income countries could benefit from adopting low-dose calcium supplementation, potentially saving lives and reducing healthcare costs while improving maternal and newborn outcomes.

“Low-dose calcium supplementation provided during pregnancy could produce major health benefits in all settings considered, would be cost-saving compared to the currently recommended calcium dosage, and would be cost-effective in the large majority of countries,” the study concludes.

Ifakara contributes to the study

Seasoned scientist from the Ifakara Health Institute, Honorati Masanja, played a key role in the study, contributing to conceptualization, methodology, and writing – review & editing. The study was led by co-authors Happiness Saronga from Muhimbili University of Health and Allied Sciences (Tanzania) and Hening Cui from Harvard T.H. Chan School of Public Health (USA). Additional contributors came from St. John’s Research Institute (India), Africa Academy for Public Health (Tanzania), and St. John’s Medical College (India).

Read the publication here.