Vitamin D Deficiency During Pregnancy: Risk for Preeclampsia and Adverse Neonatal Outcome
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- Category: Vol. 82, December 2014
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Vitamin D Deficiency During Pregnancy: Risk for Preeclampsia and Adverse Neonatal Outcome, HANAN F. MOHAMED, SHERIF MAGDY and MOHAMED ELMOHANDES
Abstract
Preeclampsia is a pregnancy specific syndrome charac-terized by high blood pressure and proteinuria after 20 weeks gestation that may occur in up to 8% of pregnant women. Women who develop preeclampsia are at increased risk for development of pulmonary oedema, coagulation defects, hepatic or renal failure, seizeurs and even death. Infants born to preeclamptic mothers are at increased risk of prematurity and more likely to be small for gestational age.
An emerging area of study that has garnered significant attention, is the role of vitamin D in preeclampsia. Vitamin D has direct influence on the molecular pathways proposed to be important in the pathogenesis of preeclampsia.
Our objective was to assess the effect of maternal 25- hydroxy vitamin D deficiency on the risk of preeclampsia and to assess the vitamin D status of newborns of preeclamptic mothers.
Records were obtained for 160 pregnant women with singleton pregnancy followed from less than 16 weeks gestation till delivery. 30 subjects met the criteria for diagnosis of preeclampsia as described below and served as (cases group), 90 cases remained normotensive without any complications till delivery and served as (control group). The rest who developed gestational diabetes, autoimmune disorders or other medical diseases were excluded.
Serum 25 hydroxy vitamin D concentrations were mea-sured by vidas kit on Mini VIDAS immunoassay analyzer supplied by Bio Merieux using the ELFA technique (Enzyme Linked Fluorescent Assay).
Our results revealed that Serum 25 hydroxy vitamin D was significantly decreased among patients with preeclampsia compared to healthy control subjects 18.1±5.4ng/ml vs 32.1±9.8ng/ml (p-value 0.0003).
Cord serum 25(OH)D concentration were significantly lower among neonates of preeclamptic mothers than among neonates of non preeclamptic control mothers (17.7±2.9ng/ml vs 21.6±2.3ng/ml, p=0.02).
Logistic regression analysis when performed, demonstrated that 25(OH)D at levels <20ng/ml was statistically significantly
associated with a tendency towards increased risk of preec-lampsia [Odds Ratio 3.8,95% CI (1.6-9.1), p 0.002]. A strong inverse relation between serum 25(OH)D and the probability risk of preeclampsia was derived from linear regression correlation curve (slope = –0.102, r2=0.877, p=0.0009).
In conclusion, our study reinforces the potential link between vitamin D deficiency and preeclampsia risk. Thus preeclampsia may be added to the growing list of adverse health consequences of maternal vitamin D deficiency. Sup-plementing vitamin D among deficient women either in the preconception period or in early pregnancy should be explored as a safe and effective means of preventing preeclampsia and promoting neonatal well-being.
Thus, we recommend early screening of all pregnant women for vitamin D deficiency for earlier supplementation to mitigate its adverse outcomes.