Relationship of maternal serum vitamin D level with preeclampsia
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20254278Keywords:
Preeclampsia, Pregnancy, Vitamin D, 25-hydroxyvitamin DAbstract
Background: Vitamin D deficiency has been increasingly implicated in adverse pregnancy outcomes, including preeclampsia; however, evidence from South Asian populations remains limited. This study aimed to evaluate the relationship between maternal serum vitamin D levels and preeclampsia in pregnant women in Bangladesh.
Methods: A hospital-based case-control study was conducted at Sir Salimullah Medical College Mitford Hospital in Dhaka from March 2019 to March 2020. A total of 106 pregnant women aged 18–35 years with gestational age 28-40 weeks were enrolled, 53 with preeclampsia and 53 normotensive controls. Data on sociodemographic and obstetric characteristics were collected through interviews. Serum 25(OH)D concentrations were measured using chemiluminescence immunoassay and categorized as deficient (≤20 ng/ml), insufficient (21-29 ng/ml), and sufficient (≥30 ng/ml). Statistical analyses were performed using SPSS version 23.0, and p<0.05 was considered significant.
Results: Mean serum vitamin D levels were significantly lower in preeclamptic women (13.41±6.83 ng/ml) than in controls (19.96±9.07 ng/ml, p<0.001). Women with vitamin D levels <30 ng/ml had 7.46 times greater odds of developing preeclampsia (95% CI 1.58-35.25). In the multivariate analysis, both deficient and insufficient vitamin D levels remained significant predictors (OR = 6.03 and 6.55, respectively).
Conclusions: Low maternal serum vitamin D levels were strongly associated with preeclampsia. Routine screening and adequate vitamin D supplementation during pregnancy may help reduce the risk of this potentially fatal disorder.
References
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130-137.
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 202: gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133(1):e1-25.
Benachi A, Cordier AG, Courbebaisse M, Souberbielle JC. Vitamin D and pregnancy. Presse Medicale (Paris, France: 1983). 2013;42(10):1377-82.
Fischer D, Schroer A, Ludders D, Cordes I, Bucker B, Reichrath J, et al. Metabolism of vitamin D~ 3 in the placental tissue of normal and preeclampsia complicated pregnancies and premature births. Clin Experim Obstetr Gynecol. 2007;34(2):80.
Ma R, Gu Y, Zhao S, Sun J, Groome LJ, Wang Y. Expressions of vitamin D metabolic components VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR in placentas from normal and preeclamptic pregnancies. Am J Physiol-Endocrinol Metabol. 2012;303(7):E928-35.
Tarcin O, Yavuz DG, Ozben B, Telli A, Ogunc AV, Yuksel M, et al. Effect of vitamin D deficiency and replacement on endothelial function in asymptomatic subjects. J Clin Endocrinol Metabol. 2009;94(10):4023-30.
Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. Am J Obstetr Gynecol. 2010;203(4):366-e1.
Tabesh M, Salehi-Abargouei A, Tabesh M, Esmaillzadeh A. Maternal vitamin D status and risk of pre-eclampsia: a systematic review and meta-analysis. J Clin Endocrinol Metabol. 2013;98(8):3165-73.
Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metabol. 2007;92(9):3517-22.
Li YC, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J. Vitamin D: a negative endocrine regulator of the renin–angiotensin system and blood pressure. J Steroid Biochem Mole Biol. 2004;89:387-92.
Purswani JM, Gala P, Dwarkanath P, Larkin HM, Kurpad A, Mehta S. The role of vitamin D in pre-eclampsia: a systematic review. BMC Pregnan Childb. 2017;17(1):231.
Roth DE, Al Mahmud A, Raqib R, Akhtar E, Perumal N, Pezzack B, et al. Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial. Nutrit J. 2013;12(1):47.
Ullah MI, Koch CA, Tamanna S, Rouf S, Shamsuddin L. Vitamin D deficiency and the risk of preeclampsia and eclampsia in Bangladesh. Hormone Metabol Res. 2013;45(09):682-7.
Mehmood S, Karim SA. Vitamin D Deficiency during pregnancy and its relationship with pre-eclampsia, eclampsia and gestational hypertension. Austin J Nutr Metab. 2016;3(2):1040.
Abedi P, Mohaghegh Z, Afshary P, Latifi M. The relationship of serum vitamin D with pre‐eclampsia in the I ranian women. Mater Child Nutrit. 2014;10(2):206-12.
Sadin B, Gargari BP, Tabrizi FP. Vitamin D status in preeclamptic and non-preeclamptic pregnant women: a case-control study in the north west of Iran. Health Promot Perspect. 2015;5(3):183.
Noyola-Martínez N, Díaz L, Avila E, Halhali A, Larrea F, Barrera D. Calcitriol downregulates TNF-α and IL-6 expression in cultured placental cells from preeclamptic women. Cytokine. 2013;61(1):245-50.
Faulkner JL, Amaral LM, Cornelius DC, Cunningham MW, Ibrahim T, Heep A, et al. Vitamin D supplementation reduces some AT1-AA-induced downstream targets implicated in preeclampsia including hypertension. Am J Physiol-Regulat Integrat Comparat Physiol. 2017;312(1): R125-31.
Sahu M, Tripathy S, Bhuyan P. Association of maternal serum vitamin D level with preeclampsia or eclampsia and its relationship with neonatal outcome and neonatal serum calcium level. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5580.
Motedayen M, Rafiei M, Tavirani MR, Sayehmiri K, Dousti M. The relationship between body mass index and preeclampsia: A systematic review and meta-analysis. Int J Reproduct Biomed. 2019;17(7):463.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutrit. 2000;72(3):690-3.
Mirzakhani H, Litonjua AA, McElrath TF, O’Connor G, Lee-Parritz A, Iverson R, et al. Early pregnancy vitamin D status and risk of preeclampsia. J Clin Investig. 2016;126(12):4702-15.
Downloads
Published
How to Cite
Issue
Section
