Suplementación con calcio durante el embarazo impacto en la salud ósea materna y de la descendencia
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Resumen
El embarazo y la lactancia suponen un desafío para el esqueleto materno con el fin de cubrir las necesidades del feto y la producción láctea. Esos estados fisiológicos desencadenan adaptaciones hormonales coordinadas que conducen a un aumento de la absorción intestinal de calcio (Ca) durante el embarazo y potencian la resorción ósea durante la lactancia.
En poblaciones con baja ingesta de Ca, como ocurre en la Argentina, estas demandas pueden comprometer la masa ósea materna, generando preocupación con respecto a la salud ósea a largo plazo. Si bien la Organización Mundial de la Salud recomienda la suplementación con Ca para reducir el riesgo de trastornos hipertensivos durante el embarazo, sus efectos sobre la densidad mineral ósea materna y el desarrollo esquelético infantil son motivo de controversia.
Esta revisión sintetiza la evidencia disponible sobre el metabolismo del Ca durante el embarazo y la lactancia, el papel de las hormonas reguladoras y el impacto de la suplementación en la salud ósea materna e infantil, destacando vacíos de conocimiento y sus implicanciones para las políticas de salud pública. La evidencia sugiere que la suplementación puede resultar más beneficiosa cuando se combina con vitamina D y se prolonga durante la lactancia. No obstante, en poblaciones con ingestas extremadamente bajas, la suplementación podría alterar el equilibrio fisiológico y generar efectos adversos sobre el esqueleto. La heterogeneidad en los diseños de estudio, las características poblacionales y los protocolos de suplementación subraya la necesidad de investigaciones rigurosas y de largo plazo que permitan establecer recomendaciones sólidas y contextualizadas.
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