ArticlePLOS global public health2025
Low-dose calcium supplementation during pregnancy in low and middle-income countries: A cost-effectiveness analysis.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Formative research in Ethiopia and Bangladesh: strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries.Journal of global health · 2026Article
- Correction: Low-dose calcium supplementation during pregnancy in low and middle-income countries: A cost-effectiveness analysis.PLOS global public health · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Calcium supplementation during pregnancy can reduce the risk of preeclampsia and preterm birth. Few countries have implemented WHO-recommended high-dose calcium supplementation (1500-2000mg/day), due to adherence and cost concerns. However, low-dose calcium supplementation (one 500mg tablet daily) has recently been shown to be similarly efficacious as high-dose supplementation. We assessed the cost-effectiveness of low-dose calcium supplementation during pregnancy, in low- and middle-income countries (LMICs) with low dietary calcium intake. To do so, we conducted a mathematical modelling analysis in which we estimated the lifetime health outcomes (cases, deaths, and DALYs averted) and costs of low-dose calcium supplementation provided through routine antenatal care to women giving birth in 2024, as compared to no supplementation. We assessed costs (2022 USD) from a health system perspective, including cost-savings from averted care for preeclampsia and preterm birth. This analysis showed that low-dose calcium supplementation could prevent 1.3 (95% uncertainty interval: 0.2, 2.6) million preterm births (a 10% (2, 18) reduction), 1.8 (1.0, 2.8) million preeclampsia cases (a 23% (14, 32) reduction), as well as 5.9 (1.3, 12.9) million disability-adjusted life years (DALYs). Intervention costs would be $267 (220, 318) million and produce cost-savings of $56 (26, 86) million, with incremental costs per DALY averted of $90 (38, 389) across all countries, and a return on investment of 19.1 (3.8, 39.5). The intervention was cost-effective in 119 of 129 countries modeled when compared to setting-specific cost-effectiveness thresholds. While there was substantial uncertainty in several inputs, cost-effectiveness conclusions were robust to parameter uncertainty and alternative analytic assumptions. Based on these results, low-dose calcium supplementation provided during pregnancy is cost-effective for prevention of preeclampsia and preterm birth in most LMICs.
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Registered trials
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