Vitamin-D dysregulation in early- and late-onset preeclampsia: A gestational-age matched study (original) (raw)
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Clinical Nutrition, 2019
Background &Aims. Vitamin D is thought to be involved in the pathogenesis of preeclampsia. To evaluate the relationship between vitamin D insufficiency in the first trimester of pregnancy and preeclampsia. Methods. Nested case-control study (FEPED study) in type 3 obstetrical units. Pregnant women from 10 to 15 WA. For each patient with preeclampsia, 4 controls were selected from the cohort and matched by parity, skin color, maternal age, season and BMI. The main outcome measure was serum 25(OH)D status in the first trimester Results: 83 cases of preeclampsia were matched with 319 controls. Mean 25(OH)D levels in the first trimester were 20.1 ± 9.3 ng/mL in cases and 22.3 ± 11.1 ng/mL in controls (p=0.09). The risk for preeclampsia with 25(OH)D level >30 ng/mL in the first trimester was decreased, but did not achieve statistical significance (OR, 0.57; 95% CI, 0.30-1.01; p=0.09). High 25(OH)D during the 3 rd trimester was associated with a significantly decreased risk of preeclampsia (OR, 0.43; 95%CI, 0.23-0.80; p=0.008). When women with 25(OH)D levels <30 ng/mL both in the first and 3 rd trimesters ("low-low") were taken as references, OR for preeclampsia was 0.59 (95% CI, 0.31-1.14; p=0.12) for "low-high" or "high-low" women and 0.34 (95% CI, 0.13-0.86; p = 0.02) for "high-high" women. Conclusions: No significant association between preeclampsia and vitamin D insufficiency in the first trimester was evidenced. However, women with vitamin D sufficiency during the 3 rd trimester and both in the first and 3 rd trimesters had a significantly lower risk of preeclampsia.
Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia
The Journal of Clinical Endocrinology & Metabolism, 2007
Context: Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of preeclampsia, yet the vitamin D-preeclampsia relation has not been studied. Objectives: We aimed to assess the effect of maternal 25-hydroxyvitamin D [25(OH)D] concentration on the risk of preeclampsia and to assess the vitamin D status of newborns of preeclamptic mothers. Design and Setting: We conducted a nested case-control study of pregnant women followed from less than 16 wk gestation to delivery (1997-2001) at prenatal clinics and private practices. Patients: Patients included nulliparous pregnant women with singleton pregnancies who developed preeclampsia (n ϭ 55) or did not develop preeclampsia (n ϭ 219). Women's banked sera were newly measured for 25(OH)D. Main Outcome Measure: The main outcome measure was preeclampsia (new-onset gestational hypertension and proteinuria for the first time after 20 wk gestation). Our hypotheses were formulated before data collection. Results: Adjusted serum 25(OH)D concentrations in early pregnancy were lower in women who subsequently developed preeclampsia compared with controls [geometric mean, 45.4 nmol/ liter, and 95% confidence interval (CI), 38.6-53.4 nmol/liter, vs. 53.1 and 47.1-59.9 nmol/liter; P Ͻ 0.01]. There was a monotonic dose-response relation between serum 25(OH)D concentrations at less than 22 wk and risk of preeclampsia. After confounder adjustment, a 50-nmol/liter decline in 25(OH)D concentration doubled the risk of preeclampsia (adjusted odds ratio, 2.4; 95% CI, 1.1-5.4). Newborns of preeclamptic mothers were twice as likely as control newborns to have 25(OH)D less than 37.5 nmol/liter (adjusted odds ratio, 2.2; 95% CI, 1.2-4.1). Conclusions: Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.
Vitamin D status in early pregnancy and risk of preeclampsia
American Journal of Obstetrics and Gynecology, 2014
We sought to examine the association between maternal serum 25-hydroxyvitamin D (25[OH]D) concentration in early pregnancy and the subsequent diagnosis of preeclampsia (PE). This was a nested case-control study from 2 prospective Canadian cohorts conducted in Quebec City, Quebec, and Halifax, Nova Scotia, from 2002 through 2010. Participants were pregnant women (n = 169 cases with PE and 1975 controls). Maternal serum was drawn &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;20 weeks of gestation, and 25(OH)D measurement was performed. Cases were ascertained from medical records. Logistic regression analysis was used to estimate adjusted odds ratios with 95% confidence intervals. Women who developed PE had a significantly lower 25(OH)D concentration at a mean gestational age of 14 weeks compared with women in the control group (mean ± SD 25[OH]D 47.2 ± 17.7 vs 52.3 ± 17.2 nmol/L, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). Women with 25(OH)D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;30 nmol/L compared to those with at least 50 nmol/L had a greater risk of developing PE (adjusted odds ratio, 2.23; 95% confidence interval, 1.29-3.83) after adjustment for prepregnancy body mass index, maternal age, smoking, parity, season and year of blood collection, gestational week at blood collection, and cohort site. Exploratory analysis with cubic splines demonstrated a dose-response relationship between maternal 25(OH)D and risk of PE, up to levels around 50 nmol/L, where the association appeared to plateau. Maternal vitamin D deficiency early in pregnancy defined as 25(OH)D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;30 nmol/L may be an independent risk factor for PE. The relevance of vitamin D supplementation for women of childbearing age should be explored as a strategy for reducing PE and for promoting a healthier pregnancy.
Association of Low Vitamin D with Pre Eclampsia
International Journal of Medical Science And Diagnosis Research
Objective: To determine the association of preeclampsia and vitamin D deficiency. Study design: Cohort study. Place and duration of study: Gynecology Department, Khwaja Muhammad Safdar Medical College, during 01-07-2018 to 31-12-2018. Material and Methods: In this study the pregnant females irrespective of their gravida and parity status and having gestational age more than 20 weeks were included. The cases that had vitamin D level lower were labelled as cases and those with normal levels as controls. They these cases were followed monthly until delivery and during this period they were followed for protein urea and BP to label pre eclampsia. Results: In this study 100 cases were selected. 50 in each group. Mean age in case and control group was 29.57±4.57 vs 28.43±3.79 years and mean duration of gestation at presentation was 26.43±5.11 vs 27.42±5.23 weeks. There were 39 vs 41 multigravida and 37 vs 38 uneducated females in cases and control group respectively. Preeclampsia was seen...
Nutrients
Preeclampsia is a pregnancy-specific illness that is hypothesized to occur due to vitamin D deficiency during pregnancy. Therefore, vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being. The present study follows a case-control analysis that aims to determine the effect of vitamin D supplements on reducing the probability of recurrent preeclampsia. We identified 59 patients for the control group without vitamin D supplementation during pregnancy, while 139 patients were included in the cases group of pregnant women with a history of preeclampsia who confirmed taking daily vitamin D supplements in either 2000 UI or 4000 UI until the 36th week of pregnancy. There were 61 (80.3%) patients with a normal serum vitamin D level measured at 32 weeks in the pregnant women who took a daily dose of 4000 UI vitamin D and 43 (68.3%) in those who took a 2000 UI dose of vitamin D, compared to just 32 (54.2%) in those who did n...
Early pregnancy vitamin D status and risk of preeclampsia
The Journal of clinical investigation, 2016
Low vitamin D status in pregnancy was proposed as a risk factor of preeclampsia. We assessed the effect of vitamin D supplementation (4,400 vs. 400 IU/day), initiated early in pregnancy (10-18 weeks), on the development of preeclampsia. The effects of serum vitamin D (25-hydroxyvitamin D [25OHD]) levels on preeclampsia incidence at trial entry and in the third trimester (32-38 weeks) were studied. We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia. Of 881 women randomized, outcome data were available for 816, with 67 (8.2%) developing preeclampsia. There was no significant difference between treatment (N = 408) or control (N = 408) groups in the incidence of preeclampsia (8.08% vs. 8.33%, respectively; relative risk: 0.97; 95% CI, 0.61-1.53). However, in a cohort analysis and after adjustment for confounders, a significant effect of su...
The Association between Maternal Vitamin D Status in Gestation and Pre- Eclampsia
Preeclampsia is a complex and life threatening pregnancy disorder is mojor cause of maternal and neonatal morbidity and mortality. A growing body of evidence has demonstrated that low vitamin D is associated with the pathophysiology of preeclampsia. As such, identification of the mechanisms behind this relationship and placental vascular endothelial dysfunction presents itself as a significant modifiable disease risk factor, which if identified and managed appropriately, may make a significant impact in reducing the burden of disease.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Pre eclampsia has remained a significant public health threat in both developed and developing countries contributing to maternal and perinatal morbidity and mortality globally. Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of pre eclampsia, yet the vitamin D-pre eclampsia relation has seldom been studied. In the present study we aimed to assess the association of vitamin D deficiency with the occurrence of pre eclampsia. If indeed vitamin D deficiency is related to pre eclampsia, this correlation can inform future studies, which hopefully will ultimately lead to a decrease in the incidence of pre eclampsia hence a decrease in adverse maternal and fetal outcomes. Methods: We conducted a comparative cross sectional study carried out for a period of one year from August 2014 to July 2015. A total of 384 patients were selected. 192 pre eclamptic and 192 non pre eclamptic pregnant patients aged 16-45 years attending in-patient department of Obstetrics and Gynaecology BRD Medical college Gorakhpur were included in the study. Results: About 82.8% of pre eclamptic and 31.25% of non pre eclamptic patients were found deficient in vitamin D. Also, severe pre eclamptic patients had more severe deficiency of vitamin D. Majority of these patients (51.78%) had very low vitamin D concentration. Conclusions: Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.
Vitamin D in Prevention of Preeclampsia
Journal of medical science and clinical research, 2019
The present study aimed to analyse the relation between vitamin D and preeclampsia. 120 pregnant females with a single ton pregnancy (healthy/preeclamptic) were selected and their body mass index was determined. They were further divided into four groups; normotensive patients with body mass index<25 kg/m2 (Group-I, N=30'CONTROL'), normotensive patients with body mass index>25 kg/m2 (Group-II, N=30), preeclamptic patients with body mass index<25 kg/m2 (Group-III, N=30), and preeclamptic patients with body mass index>25 kg/m2 (Group-IV, N=30). Their serum 25 OH D levels were analysed. Through the analysis, preeclamptic patients showed significantly reduced serum levels of vitamin D and a positive association between low vitamin D levels and preeclampsia was observed.