Predictors of maternal hypocalcemia among pregnant women attending at a tertiary referral hospital in Tanzania: a cross-sectional study

BackgroundHypocalcemia is a problem among pregnant women mainly caused by pregnancy physiology, and poor dietary calcium intake, especially in African countries due to low socio-economic status. Worldwide, the prevalence of hypocalcemia varies from 25.5 to 70.6%. This study was designed to determine the prevalence of maternal hypocalcemia and its predictors among pregnant women attending Bugando Medical Centre, a tertiary referral hospital in Mwanza, Tanzania.MethodsThis was a cross-sectional study. Socio-demographic, clinical and laboratory data were collected using a standardized, pre-tested, and coded questionnaire, and laboratory form. Venous blood was taken for laboratory investigation to measure the serum calcium level. Data were entered into a computer using Microsoft Excel 2013, and analyzed using STATA version 15. We used univariate logistic regression followed by multivariate logistic regression models to determine the predictors of maternal hypocalcemia. Predictors with a p-value of less than 0.05 were considered statistically significant.ResultsA total of 651 pregnant women were enrolled. Their mean age was 29.5 +/- 5.6 years, and the majority, 79.7% (519/651) aged less than 35 years. The prevalence of maternal hypocalcemia was 23.2% (151/651) [95% CI 20.0% - 26.4%]. The independent predictors of maternal hypocalcemia were multiple pregnancy (OR 11.8; 95% CI 5.1-27.5; p-value <0.001), previous history of preeclampsia-eclampsia (PE-E) (OR 2.1; 95% CI 1.1-4.1; p-value 0.028), lack of calcium supplementation during antenatal visits (OR 11.8; 95% CI 2.4-57.8; p-value 0.002), number of antenatal visits less than 4 (OR 1.8; 95% CI 1.1 - 2.9; p-value 0.013), residing in rural (OR 2.8; 95% CI 1.5-5.4; p-value 0.002), and use of MgSO4 and/or Calcium channel blocker (CCB) (OR 18.6; 95% CI [6.1-57.0]; p-value <0.001).ConclusionWe found that one out of five pregnant women had maternal hypocalcemia. The independent predictors of maternal hypocalcemia were, having multiple pregnancies, previous history of PE-E, lack of calcium supplementation during antenatal visits, having less than 4 antenatal visits, residing in rural areas and use of MgSO4 and/or Calcium channel blocker. Routine screening for maternal hypocalcemia during antenatal clinic visits, routine calcium supplementation during antenatal visits should be strictly adhered, and education on nutrition regarding calcium-rich food should be emphasized.