The Journal of Obstetrics and Gynecology of India, January 2015
Taru Gupta, Sonika Wahi, Nupur Gupta, Sarika Arora, Sangeeta Gupta, Pushpa Bhatia
ESI Post Graduate Institute Medical Science & Research, Basaidarapur, New Delhi, India
|Severe vitamin D deficiency||90 %||62 %|
|Vitamin D level||4 ng/ml||9 ng/ml|
|Cesarean section||36 %||9 %|
Overview Pregnancy and vitamin D has the following summary
|IU||Cumulative Benefit||Blood level||Cofactors||Calcium||$*/month|
|200|| Better bones for mom|
with 600 mg of Calcium
|6 ng/ml increase||Not needed||No effect||$0.10|
|400|| Less Rickets (but not zero with 400 IU)|
3X less adolescent Schizophrenia
Fewer child seizures
|20-30 ng/ml||Not needed||No effect||$0.20|
|2000|| 2X More likely to get pregnant naturally/IVF |
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
|42 ng/ml||Desirable||< 750 mg||$1|
|4000|| 2X fewer pregnancy complications |
2X fewer pre-term births
|49 ng/ml|| Should have |
|< 750 mg||$3|
|6000||Probable: larger benefits for above items|
Just enough D for breastfed infant
More maternal and infant weight
|< 750 mg||$4|
Preeclampsia 280 items as of Jan 2015
Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
Dark skin births are much riskier due to lack of vitamin D study on this page was done in India
Why India's vitamin D deficiency is grim - 40 pages Feb 2014 study on this page was done in India
Hypertension and vitamin D
See also web
Clinical trials for Preeclampsia with Vitamin D intervention 12 as of Sept 2017
One trial which used 4,000 IU of vitamin D has completed, but not published as of Jan 2015
To evaluate maternal vitamin D levels in term normotensive and preeclamptic patients in labor and to assess additional factors such as maternal and cord blood levels of calcium, phosphorus, parathormone, and alkaline phosphatase and associated factors such as BMI, birth weight, and mode of delivery.
This was a case control study carried out in Department of Obstetrics and Gynaecology, ESIC-PGIMSR, New Delhi, India from August 2012–April 2014. A total of 100 patients were divided into two equal groups (control and study groups of 50 each). Control group had women with singleton uncomplicated, term normotensive pregnant women in labor while the study group composed of term preeclamptic women in labor. Blood samples were drawn for vitamin D, serum calcium, serum phosphorus, serum alkaline phosphatase, and serum parathormone levels during first stage of labor, and subsequently, their levels were evaluated in cord blood also.
All the enrolled patients had vitamin D deficiency pointing toward a universal prevalence of this micronutrient deficiency in antenatal patients.
We found more incidence of severe vitamin D deficiency (90 %) in preeclamptic patients as compared to normotensive patients (62 %).
Also preeclamptic group had lower median vitamin D levels (3.9 ng/ml) when compared to normotensive group (9 ng/ml). Similarly, all the neonates were found to be vitamin D deficient as assessed by their cord blood levels. Neonates born to preeclamptic mothers had lower median cord blood vitamin D levels (4.4 ng/ml) when compared to those born to normotensive mothers (7.25 ng/ml). The mean maternal calcium levels followed trends observed in vitamin D levels with preeclamptic patients having consistently lower calcium levels (mean value of 8.50 ± 0.80 mg/dl) when compared to normotensive patients (mean value of 8.89 ± 0.56 mg/dl). Preeclamptic group was found to have more number of patients (58 %) with higher BMI when compared to normotensive group (32 % of patients).
A slightly more incidence (36 %) of low birth weight babies is being born to preeclamptic mothers as compared to normotensive mothers (34 %).
Significantly a more number of patients (36 %) with vitamin D levels below 15 ng/ml underwent cesarean section when compared to only 9 % of patients having vitamin D level above this level.
Preeclampsia is indeed associated with lower vitamin D levels, and its pathophysiology involves vitamin D and calcium metabolism.
- Forman JP, Giovannucci E, Holmes MD, et al. Plasma 25-hydroxyvitamin d levels and risk of incident hypertension. Hypertension. 2007;49:1063–9. CrossRef
- Martins D, Wolf M, Pan D, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin d in the united states: Data from the third national health and nutrition examination survey. Arch Intern Med. 2007;167:1159–65. CrossRef
- Melamed ML, Michos ED, Post W, et al. 25-hydroxyvitamin d levels and the risk of mortality in the general population. Arch Intern Med. 2008;168:1629–37. CrossRef
- Bodnar LM, Catov JM, Simhan HN, et al. Maternal vitamin D deficiency increases the risk of pre eclampsia. Clin J Endocrinol Metab. 2007;92:3517–22. CrossRef
- Merewood A, Mehta SD, Chen TC, et al. Association between vitamin D deficiency and primary cesarean section. J ClinEndocrinolMetab. 2009;94(3):940–5. CrossRef
- Sahu M, Das V, Agarwal A, et al. Vitamin D replacement in pregnant women in rural north india: a pilot study. Eur J Clin Nutr. 2009;63:1157–9. CrossRef
- Evans KN, Bulmer JN, Kilby MD, et al. Vitamin D and placental-decidual function. J SocGynecolInvestig. 2004;11:263–71.
- Daftary GS, Taylor HS. Endocrine regulation of HOX genes. Endocr Rev. 2006;27:331–55. CrossRef
- Braam LA, Hoeks AP, Brouns F, et al. Beneficial effects of vitamins D and K on the elastic properties of the vessel wall in postmenopausal women: a follow-up study. ThrombHaemost. 2004;91:373–80.
- Powe CE, Seely EW, Rana S, et al. First trimester vitamin D, vitamin D binding protein, and subsequent preeclampsia. Hypertension. 2010;56(4):758–63. CrossRef
- Kumru S, Aydin S, Simsek M, et al. Comparison of serum copper, zinc, calcium, and magnesium levels in pre-eclamptic and healthy pregnant women. Biol Trace Elem Res. 2003;94:105–12. CrossRef
- Adam B, Malatyalioglu E, Alvur M, et al. Magnesium, zinc and iron levels in pre-eclampsia. J Matern Fetal Med. 2001;10:246–50. CrossRef
- Joshi VK, Sapre S, Govilla V. Role of micronutrients and calcium in pregnancy induced hypertension. Obs Gynae Today. 2003;8:617–9.
- Sukonpan K, Phupong V. Serum calcium and serum magnesium in normal and pre-eclamptic pregnancy. Arch Gynecol Obstet. 2005;273:12–6. CrossRef
- Belizan JM, Villar J. The relationship between calcium intake and edema, proteinuria and hypertension-gestosis: a hypothesis. Am J Clin Nutr. 1980;33:2202–10.
- Hamlin RH. The prevention of eclampsia and pre-eclampsia. Lancet. 1952;1:64–8. CrossRef
- Villar J, Belizan JM, Fischer PJ. Epidemiologic observations on the relationship between calcium intake and eclampsia. Int J Gynaecol Obstet. 1983;21:271–8. CrossRef
- Belizan JM, Villar J, Repke J. The relationship between calcium intake and pregnancy-induced hypertension: up-to-date evidence. Am J Obstet Gynecol. 1988;158:898–902. CrossRef
- Jain S, Sharma P, Kulshreshtha S, et al. The role of calcium, magnesium, and zinc in pre-eclampsia. Biol Trace Elem Res. 2010;133:162–70. CrossRef
- Xiong X, Demianczuk NN, Saunders LD, et al. Impact of preeclampsia and gestational hypertension on birth weight by gestational age. Am J Epidemiol. 2002;155(3):203–9. CrossRef
- Bodnar LM, Simhan HN, Catov JM. Maternal vitamin D status and the risk of mild and severe preeclampsia. Epidemiology. 2014;25(2):207–14. CrossRef
- Wei SQ, Audibert F, Hidiroglou N, et al. Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia. BJOG. 2012;119(7):832–9. CrossRef
- Baker AM, Haeri S, Camargo CA Jr, et al. A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia. J Clin Endocrinol Metab. 2010;95(11):5105–9. CrossRef
- Ullah MI, Koch CA, Tamanna S, et al. Vitamin D deficiency and the risk of preeclampsia and eclampsia in Bangladesh. Horm Metab Res. 2013;45(9):682–7. CrossRef