Evaluation of Serum Calcium and Inorganic Phosphate Levels in Pregnant and Lactating Women in Enugu Metropolis
Main Article Content
Abstract
The importance of calcium and inorganic phosphate in pregnancy cannot be overemphasized. Their adequacy or otherwise amongst pregnant and lactating women in Enugu metropolis receiving their routine antenatal supplements was the focus of this study. Two hundred subjects (forty in each trimester; forty lactating and forty controls) were used for this study with informed consent. All subjects
were within the age range of 19-40 years. Serum samples were analysed for calcium and inorganic phosphate using titrimetric and colorimetric methods respectively. Our result revealed a steady decrease in calcium from first trimester to lactating period with statistically significant values in second and third trimesters, and lactation (P<0.05) when compared with control (non-pregnant non-lactating women). Statistically significant level of inorganic phosphate (P<0.05) were observed only in the second and third trimesters. The significantly reduced level of calcium and inorganic phosphate during pregnancy and lactation (for calcium) observed in this study is indicative of inadequate calcium intake (dietary) during pregnancy or poor adherence to antenatal prescriptions. Higher provision of these elements and enlightenment on the need for supplementation within the studied metropolis is suggested to avoid the documented consequences of their deficiency to both the mother and the foetus.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Balasubramanian S, Shivbalan S and Kumar PS (2006) Hypocalcemia due to vitamin D deficiency in exclusively breastfed infants. Indian Pediatrics 43: 247-251.
Barker AM (1996) Nutrition and Dietetics for Health care. 9th ed Churchill Livingstone PP. 203-213.
Cunningham FG, Leveno JK, Bloom LS, Hanth CJ, GilstrapIII CL and Wenstrom DK (2005) Williams Obstetrics 22nd ed. Mc Graw Hill Companies USA. PP 700-701, 1198-11200.
Das G, Crocombe S, McGrath, Berry JL and Mughal MZ (2006) Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child,0000: 1-5 (www.archdischild.com)
DeSantiago S, Alonso L, Halhali A, Larrea F, Isoard F and Bourges H (2002) Negative calcium balance during lactation in rural Mexican women. Am J Clin Nutr 76:845-851.
Food and Nutrition Board, Institute of Medicine 1997, Dietary reference intakes for calcium phosphorus, Magnesium, vitamin D and Fluoride. Washington DC: National Academy Press.
Frolisch A, Rudricki M, Fischer- Rasmassen W and Ottosson K. 1991, serum concentration of intact parathyroid hormone during late human pregnancy: a longitudinal study. Eur.J Obstet Gynecol Reprod Biol. 42: 85-87.
Institute of Medicine (1999) Dietary reference intakes. Calcium, phosphorus, magnesium, vitamin, and fluoride. Washington, DC: National Academy Press.
Kassi GM, Gross CL, Bork MD and Moses D 1998. Vitamins and minerals . In: Gleicher N, Buttin L (eds.) Principles of Medical therapy in pregnancy 3rd edition Old tappan, NJ: Appleton and Lange, 311-319.
Kametas N, McAuliffe F and Krampl E (2003) , Maternal electrolyte and liver function changes during pregnancy at high altitude. Clin Chem Acta 328: 21.
Kerstetter J and Allen LH (1990), Journal of Nutrition 120:134-136.
Kiebzak GM and Sacktor B (1985), Age related phosphaturia and adaptation to phosphorus deprivation in rat. New York Raven Press P 123.
Laskey MA, Prentice A, Hanratty LA, Jarjou LM, Dibba B, Beavan SR and Cole TJ (1998) Bone changes after 3 mo of lactation; influence of calcium intake, breast-milk output, and vitamin D-receptor genotype. Am. J Clin. Nutr. 67: 685-692.
National Research Council (NRC) 1989. Recommended dietary allowances 10th ed Washington DC: National Academy Press. Nordin BEC 1976, Nutritional considerations; In calcium phosphate and magnesium metabolism. Nordin BEC (ed.) P 1- 35. Edinburgh: Churchill Livingstone.
Pitkin RM, (1985) Calcium metabolism in pregnancy and the perinatal period: a review. Am. J Obstet. Gynecol. 151: 99- 109.
Power ML, Heaney RP, Kalkwarf HJ, Pitkin RM, Repke JT, Tsang RC and Schulkin J (1999) Am J Obstet Gynecol 181: 1560-1569.
Robertson WG and Marshall RW (1981). Inonised calcium in body fluids. Crit. Revs. Clin Lab. Sci, 15: 85- 125.
Roy M, Reynold WA, Gerard AW and Gary KH, (1979). Calcium metabolism in normal pregnancy. Ame. J Obstet. and Gynecol. 133: 783-789
Sower M, Crutchfield M, Jannausch M, Updike S and Carton G (1996). A prospective evaluation of bone mineral change in pregnancy. Obstet Gynaecol 77: 741-745.
Stabile I, Chard T, Grudzinskas G eds. 1995 Clinical Obstetrics and Gynaecology. London Springer, 96-97.
Sukonpan K and Phupong V (2005) Serum calcium and serum magnesium in normal and preeclamptic pregnancy. Arch Gynecol Obstet 273: 12-16.
Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali M, Zavalta N Buscemi N et al. 2006. World Health Organisation randomised trial of calcium supplementation among low calcium intake pregnant women. American Journal of Obstetrics and Gynaecology; 194, 639-49.
Weisberg H and Rhodin J (1970) Relation of calcium to mucosal structure and B12 absorption in canine intestine. Am J Pathol. 61(2): 141-160.
Weiss M, Eisenstein Z, Ramot Y, Piptz S, Shulman A and Frenkel Y 1998. Renal reabsorption of inorganic phosphorus in pregnancy in relation to the calciotropic hormones. Br. J Obstet Gynecol. 105: 195- 199.
Wu DD, Boyd RD, Fix TJ and Burr DB (1990) Regional patterns of bone loss and altered bone remodelling in response to calcium deprivation in laboratory rabbits. Calcif Tissue Int. 47: 18-23