One of the most frequent causes of maternal and perinatal morbidity is represented by hypertensive disorders during pregnancy. Women at high risk must be subjected to a more intensive antenatal surveillance and prophylactic treatments. Many genetic risk factors, clinical features and
biomarkers have been proposed but none of these seems able to prevent
pre-eclampsia onset. English literature review of manuscripts focused on
calcium intake and hypertensive disorders during pregnancy was performed. We performed a critical analysis of evidences about maternal
calcium metabolism pattern in pregnancy analyzing all possible bias affecting studies.
Calcium supplementation seems to give beneficial effects on women with low
calcium intake. Some evidence reported that
calcium supplementation may drastically reduce the percentage of
pre-eclampsia onset consequently improving the neonatal outcome. Starting from this evidence, it is intuitive that investigations on maternal
calcium metabolism pattern in first trimester of pregnancy could represent a low cost, large scale tool to screen pregnant women and to identify those at increased risk of
pre-eclampsia onset. We propose a biochemical screening of maternal
calcium metabolism pattern in first trimester of pregnancy to discriminate patients who potentially may benefit from
calcium supplementation. In a second step we propose to randomly allocate the sub-cohort of patients with
calcium metabolism disorders in a treatment group (
calcium supplementation) or in a control group (placebo) to define if
calcium supplementation may represent a dietary mean to reduce
pre-eclampsia onset and to improve pregnancy outcome.