Implication of Calcium Supplementation During Pregnancy on Maternal and Offspring Bone Health
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Abstract
Pregnancy and lactation impose substantial demands on maternal calcium (Ca) metabolism to support foetal skeletal development and milk production. These physiological states trigger coordinated hormonal adaptations that increase intestinal Ca absorption during pregnancy and enhance bone resorption during lactation. In countries with low dietary Ca intake, such as Argentina, these demands may compromise maternal bone mass, raising concerns about long-term skeletal health. Although Ca supplementation is recommended by World Health Organization (WHO) to reduce the risk of hypertensive disorders during pregnancy, its effects on maternal bone mineral density and offspring skeletal development remain controversial. This review synthesizes current evidence on Ca metabolism during pregnancy and lactation, the role of regulatory hormones, and the impact of Ca supplementation on maternal and infant bone health, highlighting gaps in knowledge and implications for public health strategies. Evidence suggests that supplementation may be more effective when combined with vitamin D and extended into lactation. However, in populations with very low intake, supplementation could disrupt physiological adaptation and may result in adverse skeletal outcomes. The heterogeneity in study designs, populations, and supplementation protocols underscores the need for rigorous, long-term research to inform context-specific recommendations.
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