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Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013

Maternal Vitamin D Status and Risk of Pre-Eclampsia: A Systematic Review and Meta-Analysis

The Journal of Clinical Endocrinology & Metabolism August 1, 2013 vol. 98 no. 8 3165-3173
Marjan Tabesh, Amin Salehi-Abargouei, Maryam Tabesh and Ahmad Esmaillzadeh
Food Security Research Center (Marj.T., A.S.-A., Mary.T., A.E.), and Department of Community Nutrition, School of Nutrition and Food Science (Marj.T., A.S.-A., A.E.), Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Address all correspondence and requests for reprints to: Ahmad Esmaillzadeh, PhD, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran. E-mail: esmaillzadeh at hlth.mui.ac.ir.

Background: Although several studies have investigated the association between maternal serum vitamin D levels and risk of pre-eclampsia, findings are inconsistent. This systematic review and meta-analysis of published observational studies was conducted to summarize the evidence on the association between maternal serum vitamin D levels and risk of pre-eclampsia.

Methods: PubMed, ISI (Web of science), SCOPUS, SCIRUS, Google Scholar, and EMBASE databases were searched to identify related articles published through December 2012. For systematic review, we found 15 articles that assessed the association between maternal serum vitamin D levels and risk of pre-eclampsia. The meta-analysis was done on 8 studies that reported odds ratios or relative risks for pre-eclampsia. Between-study heterogeneity was examined using Cochran's Q test and I2. Subgroup analysis and meta-regression were used to find possible sources of heterogeneity.

Results: The meta-analysis on 8 relevant papers revealed an overall significant association between vitamin D deficiency and risk of pre-eclampsia; however, there was significant between-study heterogeneity (I2 = 52.7%; P = .039).
In the subgroup analysis, we found that the overall effect was significant for studies that defined vitamin D deficiency as 25(OH)D ≤ 50 nmol/L (20 ng/mL), but not for those that considered it as <38 nmol/L (15.2 ng/mL).
The association was seen for “cohort or nested case-control studies” as well as for “cross-sectional or case-control studies” (2.78; 1.45–5.33; P = .002).
When the analysis was done by study location, the associations remained significant only for studies that came from the United States.

Conclusion: There was a significant relationship between vitamin D deficiency and increased risk of pre-eclampsia.
Further studies are required, particularly in developing countries.
PDF is attached at the bottom of this page

One of the many charts in the PDF


Preeclampsia 2.86 X more likely with vitamin D < 20 ng - Sept 2013

Vitamin D, secondary hyperparathyroidism, and preeclampsia.
Am J Clin Nutr. 2013 Sep;98(3):787-93. doi: 10.3945/ajcn.112.055871. Epub 2013 Jul 24.
Scholl TO, Chen X, Stein TP.
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Stratford, NJ, USA. schollto at rowan.edu

BACKGROUND: Secondary hyperparathyroidism, which is defined by a high concentration of intact parathyroid hormone when circulating 25-hydroxyvitamin D [25(OH)D] is low, is a functional indicator of vitamin D insufficiency and a sign of impaired calcium metabolism. Two large randomized controlled trials examined effects of calcium supplementation on preeclampsia but did not consider the vitamin D status of mothers.

OBJECTIVE: We examined the association of secondary hyperparathyroidism with risk of preeclampsia.

DESIGN: Circulating maternal 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone were measured at entry to care (mean ± SD: 13.7 ± 5.7 wk) using prospective data from a cohort of 1141 low-income and minority gravidae.

RESULTS: Secondary hyperparathyroidism occurred in 6.3% of the cohort and 18.4% of women whose 25(OH)D concentrations were <20 ng/mL.
Risk of preeclampsia was increased 2.86-fold (95% CI: 1.28-, 6.41-fold) early in gestation in these women.
Gravidae with 25(OH)D concentrations <20 ng/mL who did not also have high parathyroid hormone and women with high parathyroid hormone whose 25(OH)D concentrations were >20 ng/mL were not at increased risk. Intact parathyroid hormone was related to higher systolic and diastolic blood pressures and arterial pressure at week 20 before clinical recognition of preeclampsia. Energy-adjusted intakes of total calcium and lactose and circulating 25(OH)D were correlated inversely with systolic blood pressure or arterial pressure and with parathyroid hormone.

CONCLUSION: Some women who are vitamin D insufficient develop secondary hyperparathyroidism, which is associated with increased risk of preeclampsia.

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Created by admin. Last Modification: Wednesday February 20, 2019 15:32:56 GMT-0000 by admin. (Version 12)

Attached files

ID Name Comment Uploaded Size Downloads
3204 Pre-Eclampsia F2.jpg admin 05 Nov, 2013 49.51 Kb 2387
3203 Pre-Eclampsia.pdf admin 05 Nov, 2013 743.68 Kb 1480