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Article(id=1324050831611404900, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202601112, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1767974400000, receivedDateStr=2026-01-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607917931, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607917931, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607917931, creator=13701087609, updateTime=1793607917931, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1613, endPage=1619, ext={EN=ArticleExt(id=1324050833482064485, articleId=1324050831611404900, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between calcium supplementation and blood pressure among pregnant women aged 30 years and older in Chengdu, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the association of calcium supplementation dosage and timing with blood pressure among pregnant women aged 30 years and older in Chengdu.

Methods

Pregnant women with singleton pregnancies aged ≥30 years who delivered at a hospital in Chengdu between January 2022 and December 2024 were enrolled. Baseline characteristics, calcium supplementation information, and blood pressure data during pregnancy were collected. Multiple linear regression models were employed to analyze the association between calcium supplementation and blood pressure. Dose-response analysis was conducted within the supplementation group, and sensitivity analysis was performed using the magnitude of blood pressure increase during pregnancy as the outcome.

Results

A total of 796 pregnant women with singleton pregnancies aged ≥30 years were included, with a median age of 32 years, and 46% received calcium supplementation during pregnancy. After adjusting for confounding factors, the calcium supplementation group showed a mean reduction of 4.29 mmHg (P<0.001) in systolic blood pressure (SBP) and 3.82 mmHg (P=0.048) in diastolic blood pressure (DBP) compared to the non-supplementation group. For every 100 mg/d increase in calcium intake, SBP decreased by 0.45 mmHg (P=0.016) and DBP decreased by 0.27 mmHg (P=0.009). Stratified analysis revealed that the most significant blood pressure-lowering effect occurred in those who initiated supplementation pre-pregnancy (SBP: β=-4.71, P<0.001; DBP: β=-4.32, P=0.031). Calcium supplementation was associated with a reduction in SBP among the 30-34 age group (β=-5.02, P<0.001), while no statistically significant difference was observed in the ≥35 age group. Furthermore, sensitivity analysis demonstrated that the magnitude of increase in SBP and DBP during pregnancy was reduced by an average of 1.09 mmHg (P=0.040) and 0.63 mmHg (P=0.037), respectively, in the supplementation group compared to the non-supplementation group.

Conclusion

Calcium supplementation during pregnancy is significantly associated with lower blood pressure levels among pregnant women aged ≥30 years, demonstrating a clear dose-response relationship. The blood pressure-lowering effect is more pronounced with earlier initiation of supplementation, particularly in the population aged 30-34 years.

, authors=Lu CHEN1, Xue-ting LIU2, Wen-huan LIAO2, Xiao-yu WANG2, 3, Zhi-bao CHENG2, Yu-jie XU2, Yi-xing GAO4, Jing-yuan XIONG5, 6, Yun-hui GONG7, Guo CHENG1, 2, 3, 8, authorsList=Lu CHEN, Xue-ting LIU, Wen-huan LIAO, Xiao-yu WANG, Zhi-bao CHENG, Yu-jie XU, Yi-xing GAO, Jing-yuan XIONG, Yun-hui GONG, Guo CHENG, authorCompany=null, correspAuthors=Guo CHENG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050833888911974, articleId=1324050831611404900, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=成都市30岁及以上孕妇孕期钙剂补充对血压的影响, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探讨成都市30岁及以上孕妇孕期钙剂补充剂量、补充时机与血压之间的关联。

方法

纳入2022年1月—2024年12月在成都市某医院分娩的≥30岁单胎妊娠孕妇。收集研究对象的基线特征、钙剂补充信息及孕期血压数据。采用多元线性回归模型分析钙剂补充与血压的关联，在补充组内进行剂量-效应分析，并以孕期血压升幅为结局进行敏感性分析。

结果

研究共纳入796名年龄≥30岁的单胎妊娠孕妇，中位年龄32岁，46%在孕期补充钙剂。在调整混杂因素后，与未补充组相比，钙剂补充组收缩压平均降低4.29 mm Hg（P<0.001），舒张压（舒张压）平均降低3.82 mm Hg（P=0.048）。钙摄入量每增加100 mg/d，收缩压降低0.45 mm Hg（P=0.016），舒张压降低0.27 mm Hg（P=0.009）。分层分析显示，孕前开始补充钙剂的降压效果最显著（收缩压：β=-4.71，P<0.001；舒张压：β=-4.32，P=0.031）。30～34岁组补充钙剂与收缩压降低相关（β=-5.02，P<0.001），在≥35岁组中未观察到显著差异。此外，敏感性分析显示补钙组孕期收缩压和舒张压的升幅分别比未补充组平均减少1.09 mm Hg（P=0.040）和0.63 mm Hg（P=0.037）。

结论

孕期补充钙剂与30岁及以上孕妇较低的血压水平显著相关，二者存在明确的剂量-效应关系；钙剂补充越早，降压作用越显著，这一效应在30～34岁人群尤为明显。

, authors=陈卢1, 刘雪婷2, 廖文欢2, 汪晓语2, 3, 程志宝2, 徐裕杰2, 高伊星4, 熊静远5, 6, 龚云辉7, 成果1, 2, 3, 8, authorsList=陈卢, 刘雪婷, 廖文欢, 汪晓语, 程志宝, 徐裕杰, 高伊星, 熊静远, 龚云辉, 成果, authorCompany=null, correspAuthors=成果, authorNote=

陈卢（1999—），女，硕士在读，研究方向：基础护理学

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成果，E-mail：
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陈卢（1999—），女，硕士在读，研究方向：基础护理学

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陈卢（1999—），女，硕士在读，研究方向：基础护理学

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J Clin Med, 2023, 12(14): 4701., articleTitle=A balancing act：navigating hypertensive disorders of pregnancy at very advanced maternal age, from preconception to postpartum, refAbstract=null)], funds=[Fund(id=1324050844928320199, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, awardId=U25A20154, language=CN, fundingSource=国家自然科学基金联合基金项目(U25A20154), fundOrder=null, country=null), Fund(id=1324050844991234760, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, awardId=2025-2-Z-04, language=CN, fundingSource=国家卫生健康委医院管理研究所(2025-2-Z-04), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324050834392228455, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=1., ext=[AuthorCompanyExt(id=1324050834400617064, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834392228455, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Nursing, Sichuan University/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1324050834413199977, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834392228455, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西护理学院/四川大学华西医院，四川 成都 610041)]), AuthorCompany(id=1324050834484503146, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=2., ext=[AuthorCompanyExt(id=1324050834492891755, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834484503146, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川大学华西第二医院华西妇儿营养中心，四川 成都 610041)]), AuthorCompany(id=1324050834564194924, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=3., ext=[AuthorCompanyExt(id=1324050834572583533, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834564194924, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室，四川 成都 610041)]), AuthorCompany(id=1324050834664858222, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=4., ext=[AuthorCompanyExt(id=1324050834673246831, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834664858222, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.陆军军医大学第二附属医院)]), AuthorCompany(id=1324050834736161392, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=5., ext=[AuthorCompanyExt(id=1324050834748744305, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834736161392, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=5.四川大学华西公共卫生学院/华西第四医院)]), AuthorCompany(id=1324050834828436082, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=6., ext=[AuthorCompanyExt(id=1324050834841018995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834828436082, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=6.主动健康与食品营养安全四川省重点实验室)]), AuthorCompany(id=1324050834916516468, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=7., ext=[AuthorCompanyExt(id=1324050834924905077, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050834916516468, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=7.四川大学华西第二医院产科)]), AuthorCompany(id=1324050835000402550, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, xref=8., ext=[AuthorCompanyExt(id=1324050835012985463, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, companyId=1324050835000402550, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=8.儿童药物四川省重点实验室，四川 成都 610041)])], figs=[ArticleFig(id=1324050843955241659, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=EN, label=Table 1, caption=

Characteristics of the study population ［M（P25，P75）, n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征总计(n=796)补充钙剂(n=371)未补充钙剂(n=425)χ2/Z值P值
年龄32.0 (31.0, 35.0)33.0 (31.0, 35.0)32.0 (31.0, 34.0)-0.710.478
孕前BMI(kg/m2)1.000.607
<18.593 (11.7)46 (12.4)47 (11.1)
18.5～23.9564 (70.9)265 (71.4)299 (70.4)
≥24139 (17.5)60 (16.2)79 (18.6)
民族2.410.121
汉族770 (96.7)355 (95.7)415 (97.6)
少数民族26 (3.3)16 (4.3)10 (2.4)
怀孕次数（次）4.550.103
1422 (53)182 (49.1)240 (56.5)
2196 (24.6)97 (26.1)99 (23.3)
≥3178 (22.4)92 (24.8)86 (20.2)
生产次数（次）4.160.245
0428 (53.8)188 (50.7)240 (56.5)
1210 (26.4)99 (26.7)111 (26.1)
2115 (14.4)60 (16.2)55 (12.9)
≥343 (5.4)24 (6.5)19 (4.5)
学历2.550.279
高中及以下68 (8.5)28 (7.5)40 (9.4)
大专/大学561 (70.5)257 (69.3)304 (71.5)
研究生及以上167 (21.0)86 (23.2)81 (19.1)
补充复合维生素384 (48.2)189 (50.9)195 (45.9)2.030.154
补充维生素D329 (41.3)194 (52.3)135 (31.8)34.42<0.001
有高血压家族史91 (11.4)42 (11.3)49 (11.5)0.010.926
患糖尿病206 (25.9)89 (24.0)117 (27.5)1.290.255
基线收缩压(mm Hg)104.8 (99.8, 111.2)104.8 (100.1, 110.4)104.6 (99.6, 112.6)1.080.279
基线舒张压(mm Hg)75.0 (71.0, 79.5)74.4 (71.1, 78.6)75.7 (70.8, 80.9)1.930.054
收缩压(mm Hg)119.37 (112.2, 126.6)116.48 (112.0, 122.0)123.27 (114.3, 130.2)6.47<0.001
舒张压(mm Hg)79.01 (75.8, 84.2)77.84 (75.6, 81.8)80.71 (76.2, 86.4)4.58<0.001
钙剂量(mg/d)250.0 (0.0, 600.0)600.0 (400.0, 875.0)———
钙剂开始补充时期
孕前期105 (28.3)105 (28.3)———
孕早期176 (47.4)176 (47.4)———
孕中晚期90 (24.3)90 (24.3)———
), ArticleFig(id=1324050844030739132, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=CN, label=表1, caption=

研究人群特征 ［M（P25，P75）,n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征总计(n=796)补充钙剂(n=371)未补充钙剂(n=425)χ2/Z值P值
年龄32.0 (31.0, 35.0)33.0 (31.0, 35.0)32.0 (31.0, 34.0)-0.710.478
孕前BMI(kg/m2)1.000.607
<18.593 (11.7)46 (12.4)47 (11.1)
18.5～23.9564 (70.9)265 (71.4)299 (70.4)
≥24139 (17.5)60 (16.2)79 (18.6)
民族2.410.121
汉族770 (96.7)355 (95.7)415 (97.6)
少数民族26 (3.3)16 (4.3)10 (2.4)
怀孕次数（次）4.550.103
1422 (53)182 (49.1)240 (56.5)
2196 (24.6)97 (26.1)99 (23.3)
≥3178 (22.4)92 (24.8)86 (20.2)
生产次数（次）4.160.245
0428 (53.8)188 (50.7)240 (56.5)
1210 (26.4)99 (26.7)111 (26.1)
2115 (14.4)60 (16.2)55 (12.9)
≥343 (5.4)24 (6.5)19 (4.5)
学历2.550.279
高中及以下68 (8.5)28 (7.5)40 (9.4)
大专/大学561 (70.5)257 (69.3)304 (71.5)
研究生及以上167 (21.0)86 (23.2)81 (19.1)
补充复合维生素384 (48.2)189 (50.9)195 (45.9)2.030.154
补充维生素D329 (41.3)194 (52.3)135 (31.8)34.42<0.001
有高血压家族史91 (11.4)42 (11.3)49 (11.5)0.010.926
患糖尿病206 (25.9)89 (24.0)117 (27.5)1.290.255
基线收缩压(mm Hg)104.8 (99.8, 111.2)104.8 (100.1, 110.4)104.6 (99.6, 112.6)1.080.279
基线舒张压(mm Hg)75.0 (71.0, 79.5)74.4 (71.1, 78.6)75.7 (70.8, 80.9)1.930.054
收缩压(mm Hg)119.37 (112.2, 126.6)116.48 (112.0, 122.0)123.27 (114.3, 130.2)6.47<0.001
舒张压(mm Hg)79.01 (75.8, 84.2)77.84 (75.6, 81.8)80.71 (76.2, 86.4)4.58<0.001
钙剂量(mg/d)250.0 (0.0, 600.0)600.0 (400.0, 875.0)———
钙剂开始补充时期
孕前期105 (28.3)105 (28.3)———
孕早期176 (47.4)176 (47.4)———
孕中晚期90 (24.3)90 (24.3)———
), ArticleFig(id=1324050844102042301, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=EN, label=Table 2, caption=

Linear regression analysis of calcium supplementation with systolic blood pressure and diastolic blood pressure

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压-5.91 (-7.79 ～ -4.03)<0.001-4.29 (-5.72 ～ -2.86)<0.001
舒张压-4.33 (-8.20 ～ -0.47)0.028-3.82 (-7.60 ～ -0.04)0.048
), ArticleFig(id=1324050844181734078, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=CN, label=表2, caption=

是否补充钙剂对收缩压和舒张压的线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压-5.91 (-7.79 ～ -4.03)<0.001-4.29 (-5.72 ～ -2.86)<0.001
舒张压-4.33 (-8.20 ～ -0.47)0.028-3.82 (-7.60 ～ -0.04)0.048
), ArticleFig(id=1324050844253037247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=EN, label=Table 3, caption=

Dose-response relationship of calcium supplementation with systolic blood pressure and diastolic blood pressure

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压-0.53 (-0.88 ～ -0.16)0.003-0.45 (-0.82 ～ -0.08)0.016
舒张压-0.35 (-0.55 ～ -0.16)<0.001-0.27 (-0.48 ～ -0.07)0.009
), ArticleFig(id=1324050844324340416, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=CN, label=表3, caption=

钙剂补充剂量与收缩压和舒张压的剂量-效应关系

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压-0.53 (-0.88 ～ -0.16)0.003-0.45 (-0.82 ～ -0.08)0.016
舒张压-0.35 (-0.55 ～ -0.16)<0.001-0.27 (-0.48 ～ -0.07)0.009
), ArticleFig(id=1324050844395643585, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=EN, label=Table 4, caption=

Linear regression analysis of calcium supplementation timing on systolic blood pressure and diastolic blood pressure

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压
孕前期-6.68 (-9.34 ～ -4.01)<0.001-4.71 (-6.89 ～ -2.53)<0.001
孕早期-6.01 (-8.29 ～ -3.73)<0.001-4.50 (-6.29 ～ -2.70)<0.001
孕中晚期-4.83 (-7.64 ～ -2.03)<0.001-3.41 (-5.73 ～ -1.09)0.004
舒张压
孕前期-5.12 (-9.09 ～ -1.15)0.012-4.32 (-8.24 ～ -0.40)0.031
孕早期-4.30 (-8.26 ～ -0.34)0.033-3.41 (-7.00 ～ 0.18)0.063
孕中晚期-3.47 (-7.46 ～ 0.52)0.088-3.12 (-7.39 ～ 1.15)0.153
), ArticleFig(id=1324050844471141058, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=CN, label=表4, caption=

钙剂补充时期对收缩压和舒张压的线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压
孕前期-6.68 (-9.34 ～ -4.01)<0.001-4.71 (-6.89 ～ -2.53)<0.001
孕早期-6.01 (-8.29 ～ -3.73)<0.001-4.50 (-6.29 ～ -2.70)<0.001
孕中晚期-4.83 (-7.64 ～ -2.03)<0.001-3.41 (-5.73 ～ -1.09)0.004
舒张压
孕前期-5.12 (-9.09 ～ -1.15)0.012-4.32 (-8.24 ～ -0.40)0.031
孕早期-4.30 (-8.26 ～ -0.34)0.033-3.41 (-7.00 ～ 0.18)0.063
孕中晚期-3.47 (-7.46 ～ 0.52)0.088-3.12 (-7.39 ～ 1.15)0.153
), ArticleFig(id=1324050844546638531, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=EN, label=Table 5, caption=

Stratified analysis of the association between calcium supplementation and blood pressure in pregnant women of different age groups

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
30～34岁组
收缩压-6.47 (-8.60 ～ -4.35)<0.001-5.02 (-6.70 ～ -3.34)<0.001
舒张压-5.32 (-10.34 ～ -0.30)0.038-2.61 (-5.46 ～ 0.25)0.076
≥35岁组
收缩压-4.49 (-8.49 ～ -0.50)0.028-3.62 (-8.09 ～ 0.85)0.112
舒张压-1.40 (-3.67 ～ 0.87)0.224-0.73 (-3.04 ～ 1.58)0.531
), ArticleFig(id=1324050844622136004, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=CN, label=表5, caption=

不同年龄组孕妇钙剂补充与血压关联的分层分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
30～34岁组
收缩压-6.47 (-8.60 ～ -4.35)<0.001-5.02 (-6.70 ～ -3.34)<0.001
舒张压-5.32 (-10.34 ～ -0.30)0.038-2.61 (-5.46 ～ 0.25)0.076
≥35岁组
收缩压-4.49 (-8.49 ～ -0.50)0.028-3.62 (-8.09 ～ 0.85)0.112
舒张压-1.40 (-3.67 ～ 0.87)0.224-0.73 (-3.04 ～ 1.58)0.531
), ArticleFig(id=1324050844706022085, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=EN, label=Table 6, caption=

Multiple linear regression analysis of calcium supplementation and blood pressure increase during pregnancy

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压-1.50 (-2.52 ～ -0.48)0.004-1.09 (-2.14 ～ -0.05)0.040
舒张压-0.74 (-1.31 ～ -0.16)0.012-0.63 (-1.22 ～ -0.04)0.037
), ArticleFig(id=1324050844789908166, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050831611404900, language=CN, label=表6, caption=

是否补充钙剂与孕期血压升幅的多元线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
β (95% CI)P值β (95% CI)P值
收缩压-1.50 (-2.52 ～ -0.48)0.004-1.09 (-2.14 ～ -0.05)0.040
舒张压-0.74 (-1.31 ～ -0.16)0.012-0.63 (-1.22 ～ -0.04)0.037
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成都市30岁及以上孕妇孕期钙剂补充对血压的影响
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陈卢 1 , 刘雪婷 2 , 廖文欢 2 , 汪晓语 2, 3 , 程志宝 2 , 徐裕杰 2 , 高伊星 4 , 熊静远 5, 6 , 龚云辉 7 , 成果 1, 2, 3, 8
现代预防医学 | 儿少卫生与妇幼保健 2026,53(9): 1613-1619
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (9) : 1613 -1619
成都市30岁及以上孕妇孕期钙剂补充对血压的影响
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2.四川大学华西第二医院华西妇儿营养中心，四川 成都 610041
3.四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室，四川 成都 610041
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陈卢1, 刘雪婷2, 廖文欢2, 汪晓语2, 3, 程志宝2, 徐裕杰2, 高伊星4, 熊静远5, 6, 龚云辉7, 成果1, 2, 3, 8
作者信息
  • 1.四川大学华西护理学院/四川大学华西医院，四川 成都 610041
  • 2.四川大学华西第二医院华西妇儿营养中心，四川 成都 610041
  • 3.四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室，四川 成都 610041
  • 4.陆军军医大学第二附属医院
  • 5.四川大学华西公共卫生学院/华西第四医院
  • 6.主动健康与食品营养安全四川省重点实验室
  • 7.四川大学华西第二医院产科
  • 8.儿童药物四川省重点实验室，四川 成都 610041
通讯作者:
成果，E-mail：
作者简介:

陈卢（1999—），女，硕士在读，研究方向：基础护理学

Association between calcium supplementation and blood pressure among pregnant women aged 30 years and older in Chengdu
Lu CHEN1, Xue-ting LIU2, Wen-huan LIAO2, Xiao-yu WANG2, 3, Zhi-bao CHENG2, Yu-jie XU2, Yi-xing GAO4, Jing-yuan XIONG5, 6, Yun-hui GONG7, Guo CHENG1, 2, 3, 8
Affiliations
  • West China School of Nursing, Sichuan University/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202601112
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摘要
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目的

探讨成都市30岁及以上孕妇孕期钙剂补充剂量、补充时机与血压之间的关联。

方法

纳入2022年1月—2024年12月在成都市某医院分娩的≥30岁单胎妊娠孕妇。收集研究对象的基线特征、钙剂补充信息及孕期血压数据。采用多元线性回归模型分析钙剂补充与血压的关联，在补充组内进行剂量-效应分析，并以孕期血压升幅为结局进行敏感性分析。

结果

研究共纳入796名年龄≥30岁的单胎妊娠孕妇，中位年龄32岁，46%在孕期补充钙剂。在调整混杂因素后，与未补充组相比，钙剂补充组收缩压平均降低4.29 mm Hg（P<0.001），舒张压（舒张压）平均降低3.82 mm Hg（P=0.048）。钙摄入量每增加100 mg/d，收缩压降低0.45 mm Hg（P=0.016），舒张压降低0.27 mm Hg（P=0.009）。分层分析显示，孕前开始补充钙剂的降压效果最显著（收缩压：β=-4.71，P<0.001；舒张压：β=-4.32，P=0.031）。30～34岁组补充钙剂与收缩压降低相关（β=-5.02，P<0.001），在≥35岁组中未观察到显著差异。此外，敏感性分析显示补钙组孕期收缩压和舒张压的升幅分别比未补充组平均减少1.09 mm Hg（P=0.040）和0.63 mm Hg（P=0.037）。

结论

孕期补充钙剂与30岁及以上孕妇较低的血压水平显著相关，二者存在明确的剂量-效应关系；钙剂补充越早，降压作用越显著，这一效应在30～34岁人群尤为明显。

钙剂补充  /  妊娠期高血压  /  补充时机  /  剂量-效应  /  高龄孕妇
Objective

To investigate the association of calcium supplementation dosage and timing with blood pressure among pregnant women aged 30 years and older in Chengdu.

Methods

Pregnant women with singleton pregnancies aged ≥30 years who delivered at a hospital in Chengdu between January 2022 and December 2024 were enrolled. Baseline characteristics, calcium supplementation information, and blood pressure data during pregnancy were collected. Multiple linear regression models were employed to analyze the association between calcium supplementation and blood pressure. Dose-response analysis was conducted within the supplementation group, and sensitivity analysis was performed using the magnitude of blood pressure increase during pregnancy as the outcome.

Results

A total of 796 pregnant women with singleton pregnancies aged ≥30 years were included, with a median age of 32 years, and 46% received calcium supplementation during pregnancy. After adjusting for confounding factors, the calcium supplementation group showed a mean reduction of 4.29 mmHg (P<0.001) in systolic blood pressure (SBP) and 3.82 mmHg (P=0.048) in diastolic blood pressure (DBP) compared to the non-supplementation group. For every 100 mg/d increase in calcium intake, SBP decreased by 0.45 mmHg (P=0.016) and DBP decreased by 0.27 mmHg (P=0.009). Stratified analysis revealed that the most significant blood pressure-lowering effect occurred in those who initiated supplementation pre-pregnancy (SBP: β=-4.71, P<0.001; DBP: β=-4.32, P=0.031). Calcium supplementation was associated with a reduction in SBP among the 30-34 age group (β=-5.02, P<0.001), while no statistically significant difference was observed in the ≥35 age group. Furthermore, sensitivity analysis demonstrated that the magnitude of increase in SBP and DBP during pregnancy was reduced by an average of 1.09 mmHg (P=0.040) and 0.63 mmHg (P=0.037), respectively, in the supplementation group compared to the non-supplementation group.

Conclusion

Calcium supplementation during pregnancy is significantly associated with lower blood pressure levels among pregnant women aged ≥30 years, demonstrating a clear dose-response relationship. The blood pressure-lowering effect is more pronounced with earlier initiation of supplementation, particularly in the population aged 30-34 years.

Calcium supplementation  /  Gestational hypertension  /  Timing of supplementation  /  Dose-response  /  Advanced maternal age
陈卢, 刘雪婷, 廖文欢, 汪晓语, 程志宝, 徐裕杰, 高伊星, 熊静远, 龚云辉, 成果. 成都市30岁及以上孕妇孕期钙剂补充对血压的影响. 现代预防医学, 2026 , 53 (9) : 1613 -1619 . DOI: 10.20043/j.cnki.MPM.202601112
Lu CHEN, Xue-ting LIU, Wen-huan LIAO, Xiao-yu WANG, Zhi-bao CHENG, Yu-jie XU, Yi-xing GAO, Jing-yuan XIONG, Yun-hui GONG, Guo CHENG. Association between calcium supplementation and blood pressure among pregnant women aged 30 years and older in Chengdu[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1613 -1619 . DOI: 10.20043/j.cnki.MPM.202601112
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妊娠期高血压疾病（hypertensive disorders of pregnancy, HDP）是导致全球孕产妇与围产儿发病率及死亡率升高的重要原因之一[1-2]。随着现代社会生育观念发生变化，女性生育年龄后移，高龄孕产妇的比例持续上升[3]。大量流行病学证据表明，年龄是妊娠期高血压及子痫前期的独立危险因素[4-5]。钙作为人体必需矿物质，在胎儿发育和孕期孕妇健康中起着至关重要的作用[6-7]。既往荟萃分析提示，孕期钙摄入不足与HDP风险升高相关，补充钙剂可降低子痫前期发生率[8-9]。基于现有证据，世界卫生组织（World Health Organination,WHO）与中国营养学会均建议孕期保证充足钙摄入[10-11]。然而，补钙策略在临床实践中仍存在若干关键争议。既往研究多聚焦子痫前期等严重结局的预防效果，对血压这一连续变量的量化影响与剂量-效应关系讨论不足[9,12]。补钙的最佳窗口期尚未形成统一共识。尽管有观点认为胎盘形成早期阶段具有关键意义[13]，但不同起始时机（孕前、孕早期与孕中晚期）的精细化对比研究仍相对有限[14-15]。此外，30岁以上孕妇面临年龄增长相关的血管顺应性下降[16]及代谢异常聚集[17]，该现象在≥35岁孕妇中更为明显。针对30岁及以上高危群体的研究较为匮乏，这些基础改变是否影响钙剂补充的效果仍缺乏直接证据[18]。
因此，本研究以成都市30岁及以上孕妇为研究对象，纳入钙摄入剂量、开始补充时机和孕期血压升幅，系统分析孕期钙剂补充与血压水平的关联，并探讨其在不同年龄中的差异。
1　对象与方法
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1.1　研究对象
研究对象来源于成都市某三级甲等妇产专科医院于2022年1月—2024年12月接受产前检查并分娩的孕产妇人群。该院为国家级妇产区域医疗中心，门诊及住院人群规模大，涵盖了不同年龄层次和社会经济背景的孕妇，能较好代表成都市及周边地区城镇女性的生育现状。纳入标准：（1）年龄≥30岁；（2）孕12+0周内建档；（3）单胎妊娠；（4）孕期有完整的产前检查记录和规范的血压测量数据。排除标准：（1）孕前患有高血压、肾脏疾病或其他已知的心血管系统疾病；（2）妊娠期被确诊为妊娠期高血压疾病或子痫前期；（3）钙剂补充情况等记录缺失。最终纳入796名孕产妇。本研究已获四川大学伦理委员会批准，研究对象均已签署知情同意书。
1.2　研究变量与测量
1.2.1　暴露变量
通过查阅病历资料和结构化问卷收集孕期钙剂补充信息，根据是否规律服用含钙补充剂，分为“补充钙剂组”和“未补充钙剂组”。记录补充钙剂组平均每日补充的元素钙剂量（mg/d）。钙剂补充组根据首次开始补充的时间分为孕前期（受孕前3个月内）、孕早期（妊娠<12周）和孕中晚期（妊娠≥12周）。
1.2.2　结局变量
主要结局变量为收缩压和舒张压。血压数据均由经过标准化培训的医护人员，使用校准后的血压计，在研究对象休息至少5 min后测量获得。血压指标取值为孕期不同阶段（孕早期、中期和晚期）多次测量值的算术平均值。
1.2.3　协变量
本研究纳入以下潜在混杂因素作为协变量进行调整，包括年龄、孕前身体质量指数（body mass index,BMI）、民族、怀孕次数、生产次数、学历、复合维生素补充情况、维生素D补充情况、高血压家族史、糖尿病史以及基线血压。基本信息、维生素补充情况、家族史及既往史采用面对面问卷调查方式于孕12+0周内建档时收集。孕前BMI分类标准根据《妊娠期妇女体重增长推荐值标准》[19]划分，按<18.5 kg/m2、18.5～23.9 kg/m2、≥24 kg/m2分为三组。民族分为汉族与少数民族；学历分为高中及以下、大专/大学、研究生及以上。怀孕次数分为1、2和≥3次，生产次数分为0、1、2和≥3次。
1.3　统计学方法
连续变量经正态性检验均不服从正态分布，采用中位数和四分位距［M（P25，P75）］表示；分类变量采用频数和构成比表示。连续变量组间比较采用Wilcoxon秩和检验，分类变量组间比较采用χ2检验。采用多元线性回归模型评估钙剂补充情况、钙剂补充时机与血压之间的关联。模型1为基础模型，未调整协变量，模型2调整了年龄、生产次数、怀孕次数、孕前BMI、民族、学历、是否补充复合维生素、是否补充维生素D、高血压家族史、糖尿病既往史和基线血压。进一步在补充钙剂的人群中，评估钙剂补充剂量与收缩压及舒张压的关系。剂量变量以100 mg/d为单位进行标准化处理。进一步按年龄（30～34岁与≥ 35 岁）进行的分层分析，探讨钙剂补充对不同年龄组孕妇血压影响的异质性；同时以钙剂补充时机和孕期血压升幅（孕晚期与孕早期的血压差值）作为结局指标进行敏感性分析。所有数据在R软件4.5.2版中分析，检验水准α=0.05。
2　结果
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2.1　研究对象基线特征
本研究共纳入796名受试者，钙剂补充组371例（46.6%），未补充组425例（53.4%）。钙剂补充组平均收缩压和舒张压均显著低于未补充组（P<0.001），服用维生素D的比例显著高于未补充组（P<0.001）。在钙剂补充组中，28.3%的孕妇孕前开始补充钙剂，47.4%孕早期开始，24.3%孕中晚期开始。见表1。
2.2　是否补充钙剂对血压的影响
在调整了年龄、生产次数、怀孕次数等协变量后，与未补充组相比，补充组的收缩压平均降低4.29 mm Hg（P<0.001），舒张压平均降低3.82 mm Hg（P=0.048）。结果显示，补充钙剂仍与血压降低显著相关，见表2。
2.3　钙剂补充剂量与血压的剂量-效应关系
结果显示，在钙剂补充组中，钙剂补充剂量与收缩压和舒张压均呈线性负相关，钙剂量每增加100 mg/d，收缩压平均降低 0.45 mm Hg（P=0.016），舒张压平均降低0.27 mm Hg（P=0.009）。见表3。
2.4　补钙时机对血压影响的分层分析
在调整了年龄、生产次数、怀孕次数等协变量后，以未补充组为参照组，孕前期（β=-4.71, P<0.001）、孕早期（β=-4.50,P<0.001）和孕中晚期（β=-3.41, P=0.004）开始补充钙剂均与收缩压降低显著相关，孕前期开始补充的降压幅度最大。此外，孕前期开始补充与舒张压降低也显著相关（β=-4.32, P=0.031）。孕早期和孕中晚期开始补充对舒张压的影响无统计学意义（P>0.05）。见表4。
2.5　不同年龄孕妇补钙效果的分层分析
本研究按年龄（30～34岁与≥35岁）进行了分层分析。见表5。结果显示，在30～34岁组中，与未补充组相比，钙剂补充显著降低收缩压（β=-5.02, P<0.001），但与舒张压（P>0.05）无统计学关联。在≥35岁组中未发现钙剂补充与血压的统计学关联（P均>0.05）。
2.6　钙剂补充对孕期血压升幅的影响
本研究以孕期血压升幅，即孕晚期与孕早期的血压差值作为因变量构建多元线性回归模型，见表6。
模型1显示，补充钙剂与收缩压升幅降低相关（β=-1.50, P=0.004），与舒张压升幅降低亦相关（β=-0.74, P=0.012）。模型2调整协变量后，补充钙剂与收缩压升幅降低相关（β=-1.09, P=0.040），也与舒张压升幅降低相关（β=-0.63, P=0.037）。
3　讨论
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在成都市30岁及以上孕妇中，孕期补充钙剂与血压升幅降低相关，且存在剂量-效应关系，孕前期及孕早期干预者血压控制效果优于孕中晚期干预者。本研究发现，孕期补充钙剂与收缩压及舒张压均呈显著负相关，补钙组收缩压平均降低约4.29 mm Hg，舒张压平均降低约3.82 mm Hg。研究显示钙剂摄入量每增加100 mg/d，收缩压降低0.45 mm Hg，舒张压降低0.27 mmHg。这一趋势与《中国居民膳食指南（2022）》关于孕中晚期推荐钙摄入量（800～1 000 mg/d）的建议方向一致[10]。在印度和坦桑尼亚的两项大样本低膳食钙摄入孕妇人群中发现，低剂量钙（如500 mg/d）在预防子痫前期方面可能不劣于WHO传统高剂量方案（如1 500 mg/d）[20]。系统综述也提示，不同剂量方案的效应比较仍受人群背景与研究质量的影响[21]。钙剂降压效果仅在基线摄入不足群体中显著，且地区间营养异质性可能导致分歧[9]，排除高偏倚风险的小样本研究后，保护效应会明显衰减[22]。与此同时，孕妇对钙剂补充的依从性会直接影响实际摄入量与观察到的效应大小[23-24]。剂量策略仍需结合基础膳食钙水平、依从性与安全性，在研究试验中进一步优化。
本研究发现孕前或孕早期开始补充钙剂的效果优于孕中晚期开始补充，且对舒张压的改善更为突出，与Hofmeyr[25]等随机对照试验结果一致。妊娠早期是子宫螺旋动脉重铸与胎盘灌注建立的核心阶段[26]。在此关键时期，母体充足的血钙水平可通过调节内源性一氧化氮的合成与释放，介导血管内皮舒张功能，为绒毛外滋养层细胞迁移与子宫螺旋动脉重塑营造良好环境[27]。早期补充钙剂有助于降低胎盘局部缺血缺氧的发生概率，阻断后续氧化应激及炎症因子的级联反应[28-29]。此外，钙剂对胎盘血流动力学的潜在改善作用在妊娠极早期便开始产生影响[30]，血钙可通过抑制肾素-血管紧张素系统过度激活，防止外周血管阻力异常升高[31]。
分层分析显示，钙剂的保护作用在30～34岁组具有统计学显著性，但在≥35岁组中未观察到显著差异。该结果与Cormick等[32]的研究结果一致，钙剂对年轻人的收缩压和舒张压的降压效果更显著。这一现象可能反映了高龄孕妇更复杂的病理生理状况[16]。随着年龄增长，血管内皮功能趋于衰退，血管僵硬度增加[33]，且高龄孕妇更可能合并隐匿的代谢异常如胰岛素抵抗、血脂异常等[17,34]。在这种基础风险更高且机制更复杂的情况下，单一的营养补充可能难以逆转既有的血管老化或系统性炎症状态[35]。《2023年澳大利亚和新西兰产科医学协会妊娠期高血压疾病指南》指出，高龄孕妇的血压管理往往需要更综合的生活方式干预与风险因素控制[36]。因此，对于≥35岁人群，除常规补钙外，还需定期监测血压、实施饮食调整与适度运动等多维度干预[37]，在必要时进行药物干预[38]。
本研究以孕期血压升幅为结局，在调整基线血压及其他协变量后，钙剂补充组收缩压升幅较未补充组低1.09 mm Hg，舒张压升幅低0.63 mm Hg。该指标排除了个体基础血压差异，更直接反映孕期血压的变化幅度，提示补钙与减缓孕期血压上升存在关联。孕期血压随孕周增加呈生理性上升，与血容量扩张及外周阻力改变相关[39]。30岁及以上孕妇血管内皮功能相对减退，血压调节能力可能下降[35,40]。本研究通过调整基线血压排除了初始血压水平对后续孕期血压升幅的影响，观察到钙剂补充对血压上升幅度具有一定削减作用。血压升幅减缓意味着更多孕妇可能维持在正常血压区间，减少因血压上升而达到临床诊断标准的风险。对于血管弹性可能下降的30岁及以上孕妇群体[35]，补钙可作为一种辅助营养干预手段，对预防妊娠中后期循环系统并发症具有潜在价值。
本研究较为完整地记录了补钙剂量与起始时机，并针对30岁以上人群进行了分层分析，从而更贴近临床风险分层需求。但是，本研究也存在局限，钙摄入量主要基于补充剂记录，未能完全量化膳食钙摄入，因而总钙摄入可能存在低估。未来有必要开展前瞻性队列研究或随机对照试验，以确证早期、足量补钙策略对血压及HDP结局的因果效应与长期影响。同时，后续研究也应探索将钙剂补充与个体化膳食、体重增长管理及生活方式干预相结合的综合模式，为更精准的临床干预策略与指南优化提供更高质量证据。
基金
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  • 国家自然科学基金联合基金项目(U25A20154)
  • 国家卫生健康委医院管理研究所(2025-2-Z-04)
文献
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doi: 10.20043/j.cnki.MPM.202601112
  • 接收时间：2026-01-10
  • 首发时间：2026-11-02
  • 出版时间：2026-05-10
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  • 收稿日期：2026-01-10
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国家自然科学基金联合基金项目(U25A20154)
国家卫生健康委医院管理研究所(2025-2-Z-04)
作者信息
    1.四川大学华西护理学院/四川大学华西医院，四川 成都 610041
    2.四川大学华西第二医院华西妇儿营养中心，四川 成都 610041
    3.四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室，四川 成都 610041
    4.陆军军医大学第二附属医院
    5.四川大学华西公共卫生学院/华西第四医院
    6.主动健康与食品营养安全四川省重点实验室
    7.四川大学华西第二医院产科
    8.儿童药物四川省重点实验室，四川 成都 610041

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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