Table 3.

The effect of calcium supplementation during pregnancy on maternal bone health, in comparison with placebo

Study	Raman et al. 12	Wang et al. 13	Diogenes et al. 14		Jarjou et al., 20 Jarjou et al. 21				Cullers et al. 15
Time point	Mid‐ to late‐term pregnancy	Mid‐ to late‐term pregnancy to delivery	5 weeks pp	20 weeks pp	2 weeks pp	52 weeks pp	NPNL	F52	36 gw	4 months pp	12 months pp
Bone site	Second and fourth metacarpal, first phalanx BMD ↑ a	Radius BMD ↑	Whole body BMD NS BMC NS BA NS	Whole body BMD NS BMC NS BA NS	Whole body BMD NS BMC NS BA NS	Whole body BMD ↓ BMC ↓ BA ↓	Whole body BMD ↓ BMC ↓ BA ↓	Whole boby BMD ↓ BMC ↓ BA ↓	Radial distal b tot vBMD NS trab vBMD NS	Radial distal b tot vBMD NS trab vBMD NS	Radial distal b tot vBMD NS trab vBMD NS
Bone site			Lumbar spine BMD NS BMC NS BA ↑	Lumbar spine BMD NS BMC NS BA NS	Lumbar spine BMD NS BMC NS BA NS	Lumbar spine BMD ↓ BMC ↓ BA NS	Lumbar spine BMD ↓ BMC ↓ BA NS	Lumbar spine BMD ↓ BMC ↓ BA NS	Radial proximal c tot vBMD NS cor vBMD NS	Radial proximal c tot vBMD NS cor vBMD NS	Radial proximal c tot vBMD NS d cor vBMD NS
Bone site			Total hip BMD NS BMC NS BA NS	Total hip BMD NS BMC NS BA NS	Total hip BMD ↓ BMC ↓ BA ↓	Total hip BMD ↓ BMC ↓ BA ↓	Total hip BMD ↓ BMC ↓ BA ↓	Total hip BMD ↓ BMC ↓ BA ↓	Tibial distal b tot vBMD NS trab vBMD NS	Tibial distal b tot vBMD NS trab vBMD NS	Tibial distal b tot vBMD NS trab vBMD NS
Bone site			Femoral neck BMD NS BMC NS BA NS	Femoral neck BMD NS BMC NS BA NS	Femoral neck BMD NS BMC NS BA NS	Femoral neck BMD ↓ BMC ↓ BA NS	Femoral neck BMD ↓ BMC ↓ BA ↓	Femoral neck BMD ↓ BMC ↓ BA NS	Tibial proximal c tot vBMD NS cor vBMD NS	Tibial proximal c tot vBMD NS cor vBMD NS	Tibial proximal c tot vBMD NS cor vBMD NS d
Bone site					Femoral shaft BMD ↓ BMC ↓ BA NS	Femoral shaft BMD ↓ BMC ↓ BA ↓	Femoral shaft BMD ↓ BMC ↓ BA ↓	Femoral shaft BMD ↓ BMC ↓ BA ↓
Bone site					Femoral trochanter BMD NS BMC NS BA NS	Femoral trochanter BMD ↓ BMC ↓ BA ↓	Femoral trochanter BMD ↓ BMC ↓ BA NS	Femoral trochanter BMD ↓ BMC ↓ BA ↓
Bone site					Distal radius BMD NS BMC NS BA NS
Bone site					Midshaft radius BMD NS BMC NS BA NS

NPNL indicates in the study by Jarjou et al. ²¹ that the same women as at 52 weeks pp were invited for follow‐up when neither pregnant nor lactating for >3 months. F52 indicates in the study by Jarjou et al. ²¹ that the same women as at 52 weeks pp were invited for follow‐up in a future lactation.

NS, no significant differences between the study groups; ↑, significantly higher in the intervention group compared with the placebo, P ≤ 0.05; ↓, significantly lower in the intervention group compared with the placebo, P ≤ 0.05.

^a In the highest supplementation group (600 mg): ↑ in the fourth metacarpal.

^b Bone density was assessed from a distal metaphyseal site of tibia or radius.

^c Bone density was assessed from a proximal diaphysis site of tibia or radius.

^d No difference at 12 months after delivery, but statistically significant group × time interaction effects were noticed from baseline to 12 months pp (visit 5) for two variables (radial diaphyseal total BMD: P = 0.029; tibial diaphyseal cortical BMD: P = 0.015).

BMC, bone mineral content (g); BA, bone area (cm²); cor, cortical; pp, postpartum; tot, total; trab, trabecular; (v)BMD, (volumetric) bone mineral density (g/cm² or g/cm³).