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Effects of Calcium Supplementation on Pregnancy-Induced Hypertension-Reply

David A. McCarron, MD; Daniel C. Hatton, PhD
JAMA. 1996;276(17):1388. doi:10.1001/jama.1996.03540170032027.
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In Reply.  —The letters of Drs Roberts and D'Abarno and of Drs Levine and DerSimonian provide valuable insights to the challenges the obstetrical community faces in providing optimal prenatal care, particularly in a society in which first pregnancies are occurring in more women younger than 20 years. In responding to the article by Bucher et al,1 they point out appropriately that an increase in blood pressure during the last trimester of gestation does not necessarily equate with an increased risk of preeclampsia and the adverse maternal and fetal outcomes associated with this condition. Levine and DerSimonian further suggest that a significant increase in blood pressure may be a "normal" response during gestation with no adverse consequences to either mother or child. Both letters conclude that provision of sufficient calcium to pregnant women cannot be justified by the findings of Bucher et al.1However, that interpretation fails to consider the potential


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