International Calcium in Pregnancy (i-CIP)
Calcium supplementation to prevent pre-eclampsia in Low- and Middle-Income Countries
Individual Participant Data (IPD) meta-analysis, network meta-analysis and economic evaluation
WHY IS THIS RESEARCH IMPORTANT?
Pre-eclampsia (characterised by new-onset hypertension and new-onset proteinuria during pregnancy) corresponds to a major cause of maternal and perinatal mortality contributing to about 76,000 maternal deaths and 500,000 foetal and new-born deaths every year. Low dietary calcium intake prior to and during pregnancy is a risk factor for pre-eclampsia, and calcium supplementation in women in areas of low dietary calcium intake is considered to reduce the risk of pre-eclampsia and its complications. However, clinical trials conducted to date have demonstrated conflicting results on calcium supplementation strategies for preventing pre-eclampsia.
There is an urgent need to determine how calcium supplementation can be used most effectively to prevent and reduce pre-eclampsia to reduce maternal and perinatal morbidity and mortality. Optimising the use of calcium to prevent pre-eclampsia is a priority area for the World Health Organisation (WHO), and the 2018 Guideline Development Group (GDG) identified that further research on the minimal dose and optimal commencement schedule for calcium supplementation was a high research priority.
Prevention of pre-eclampsia and its complications is crucial to achieving the health-related Sustainable Development Goals (SDGs), and the WHO Thirteenth General Programme of Work for universal health coverage.
THE i-CIP RESEARCH
The i-CIP Collaborative Network plans to fill the gap in evidence by investigating which calcium supplementation regimen is most clinically effective, acceptable, scalable, and cost-effective in preventing pre-eclampsia and improving maternal and perinatal outcomes in low- and middle-income countries.
The i-CIP Collaborative Network is divided in four work packages (WP):
Individual participant data (IPD) meta-analysis (WP 1)
Stakeholder views on uptake, implementation, and scalability of calcium supplementation strategies (WP 2)
Health economic and decision-analytic modelling (WP3)
Research capacity strengthening and sustainability (WP4)