Association Between 25(OH) Vitamin D Levels and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus
Arthritis Care Res (Hoboken) 2024 Sep 23. doi: 10.1002/acr.25440 – PDF behind a $15 paywall
Nima Madanchi 1, Andrea Fava 1, Daniel W Goldman 1, Laurence S Magder 2, Michelle Petri 1
Objective: We evaluated the association of 25(OH) vitamin D levels with adverse pregnancy outcomes in systemic lupus erythematosus (SLE).
Methods: The Hopkins Lupus Cohort includes visits of pregnant patients, including assessment of 25(OH) vitamin D at each visit. We examined the relationship between 25(OH) vitamin D levels and adverse pregnancy outcomes (miscarriage, preterm delivery, and small for gestational age). We also used a time-to-event analysis to assess whether time-varying of 25(OH) vitamin D levels were associated with time to miscarriage or preterm delivery.
Results: In subgroups of patients defined by the average of 25(OH) vitamin D levels,
we observed significantly different risks of
- miscarriage (p=0.0045),
- preterm delivery (p=0.0007)
and the composite measure of all three adverse pregnancy outcomes (p=0.011).
The highest risks were observed among those with lowest or highest levels of vitamin D.
- Nine out of 10 pregnancies with low vitamin D during the 2nd trimester resulted in a premature delivery.
The time-to-event model confirmed the same U-shaped association after adjustment for SLE disease activity, however, the increased risk among those with highest levels of vitamin D was not statistically significant. Body mass index did not appear to be a confounding factor.
Conclusion: Our study is not able to prove causation, but the results strongly suggest an association of 25(OH) vitamin D at both lower and higher levels with adverse pregnancy outcomes. We recommend monitoring of maternal serum 25(OH) vitamin D levels during SLE pregnancies, aiming for the ideal range of 40-59 ng/mL.
VitaminDWiki – Lupus category contains
Some of the studies in VitaminDWiki
- Every aspect of Lupus is associated with low viramin D – Oct 2021
- It is time to routinely give vitamin D to Lupus patients – Dec 2016
- 93 pcnt of these Lupus patients supplemented with Vitamin D - Nov 2020
- Lupus patients are 5 X more likely to have low vitamin D – many meta-analyses
- Lupus fought by Vitamin D in all trials longer than 12 weeks - review Sept 2017
Autoimmune disease, mainly in 50 per 100,000 women, no cure, many parts of body Wikipedia
VitaminDWiki – Preterm birth and low Vitamin D - many studies
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