Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Carr, Kristen

Keywords

pre-eclampsia, aspirin, calcium supplementation, vitamin D supplementation, blood pressure, hypertensive disorders, pregnancy

Abstract

Pre-eclampsia is a hypertensive disorder that occurs during pregnancy. Onset is typically around the 20th week of gestation and serious complications may occur if it is not properly managed. Complications from pre-eclampsia include preterm delivery, disease progression to eclampsia, organ damage, placental abruption, and neonatal complications. Initial management involves the use of antihypertensive medications. Current guidelines recommend the initiation of 81 mg aspirin starting at 12 weeks gestation for women with increased risk factors. The goal of this literature review is to examine the effectiveness of calcium and vitamin D supplementation compared to daily prophylactic aspirin use for prevention of pre-eclampsia. The databases utilized for this literature review include Pub-Med, Cochrane Library, Clinical Key, and Google Scholar. Additional relevant studies were found in reference lists of the included studies. This comprehensive review will discuss initiation of therapy, dosing, and pregnancy outcomes. Review of the literature showed a decrease in blood pressure with the use of calcium and vitamin D supplementation. However, there was a greater impact shown with calcium supplementation in populations with a dietary deficiency than those without a dietary deficiency in calcium. The effect of 150 mg daily prophylactic aspirin was shown to reduce the occurrence of preterm preeclampsia but did not impact pre-eclampsia after 37 weeks of gestation. Calcium and vitamin D supplementation alone are not currently recommended for prevention of pre-eclampsia during pregnancy. Current guidelines in the United States are to follow the ACOG recommendation with a daily aspirin starting around the 12th week of gestation.

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