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In 1999, the US Food and Nutrition Board revised the Adequate Intake (AI) for calcium in pregnancy and recommended 1000 mg/day for adult pregnant women and 1300 mg/day for adolescent women (<19 years). Our interest, from the perspective of an international health organization, was to assess if pregnant women globally meet those requirements. This is particularly important because, among the various biological functions of calcium, the potential protective effect of adequate calcium intake in pregnancy on the risk of pre-eclampsia may have major public health implications, pre-eclampsia being one of the most important causes of maternal and perinatal mortality world-wide. Therefore, we conducted a systematic review of studies, published from 1991 to 2004, that assessed calcium dietary intake in pregnant women. In addition, we conducted a multicentre survey of calcium dietary intake during pregnancy among nulliparous women attending antenatal care in developing countries. This survey was conducted before starting a large calcium supplementation multicentre trial: the WHO Calcium Supplementation Trial in Low Calcium Intake Women for the Prevention of Pre-eclampsia. This article presents the results of the systematic review and of the multicentre survey.