Vitamin D level in pregnant women with preeclampsia
https://doi.org/10.18705/1607-419X-2015-21-6-623-629
Abstract
Objective. The objective of this research was to estimate frequency of vitamin D deficiency and insufficiency in pregnant women with preeclampsia.
Design and methods. This is a cohort retrospective and prospective study. From September 2013 to June 2014 we enrolled 99 pregnant women (mean age 29 ± 2,1 years) with preeclampsia (main group, n = 48) and with physiological pregnancy (control group, n = 51). Blood samples were taken from all women for 25 (ОН)D detection. All patients were citizens of St Petersburg and Leningrad region. All of them took multivitamin complex containing vitamin D 400 IU.
Results. Vitamin D deficiency was found in 73 % of women in the main group, while there was not a single case of vitamin D deficiency among controls. The occurrence of vitamin D insufficiency was 25 % and 14 % in the main and control groups, respectively. Only 2 % of women in the main group had normal level of vitamin D, while the rate of normal vitamin D level achieved 86 % in the control group (p < 0,0001).
Conclusions. The frequency of serum vitamin D insufficiency (less than 30 ng/ml) is 2,5‑fold higher in pregnant women with preeclampsia than in control women. The role of vitamin D level (insufficiency and deficiency) as a risk factor for preeclampsia development should be considered in pregnancy.
About the Authors
E. S. ShelepovaRussian Federation
MD, Researcher, Department of Reproduction and Women Health, Institute of Perinatology and Pediatrics, V. A. Almazov
Federal North-West Medical Research Centre
2 Akkuratov street, St Petersburg, 197341 Russia
N. Yu. Yakovleva
Russian Federation
MD, Assistant, Department of Obstetrics and Gynecology, V. A. Almazov Federal North-West Medical Research Centre
N. R. Ryabokon’
Russian Federation
MD, Researcher, Department of Physiology and Pathology of Pregnancy and Delivery, V. A. Almazov Federal North-West
Medical Research Centre
L. V. Kuznetsova
Russian Federation
PhD, Chief, Department of Reproduction and Women Health, V. A. Almazov Federal North-West Medical Research Centre
E. D. Khadzhieva
Russian Federation
MD, PhD, DSc, Professor, Department of Obstetrics and Gynecology, V. A. Almazov Federal North-West Medical Research Centre
I. E. Zazerskaya
Russian Federation
MD, PhD, DSc, Head, Department of Obstetrics and Gynecology, V. A. Almazov Federal North-West Medical Research Centre
References
1. Акушерство: национальное руководство. Под ред. В. И. Кулакова, Э. К. Айламазян, В. Е. Радзинского. М.: ГЭОТАР-Медиа, 2008. 1200 с. [Obstetrics: national guidelines. Eds. VI Kulakov, EK Ailamazyan, VE Radzinskiy. Moscow: GEOTARMedia, 2008. 1200 p. In Russian].
2. Marya RK, Rathee S, Lata V, Mudgil S. Effects of vitamin D supplementation in pregnancy. J Gynecol Obstet Invest. 1981;12 (3):155–161.
3. Diaz L, Noyola-Martinez N, Barrera D, Hernández G, Avila E, Halhali A et al. Calcitriol inhibits TNF-alpha-induced inflammatory cytokines in human trophoblasts. J Reprod Immunol. 2009;81 (1):17–24.
4. Parlak M, Kalay S, Kalay Z, Kirecci A, Guney O, Koklu E. Severe vitamin D deficiency among pregnant women and their newborns in Turkey. J Matern Fetal Neonatal Med. 2015;28 (5):548–551.
5. August P, Marcaccio B, Gertner JM, Druzin ML, Resnick LM, Laragh JH. Abnormal 1,25‑dihydroxyvitamin D metabolism in preeclampsia. Am J Obstet Gynecol. 1992;166 (4):1295–1299.
6. Frolich A, Rudnicki M, Storm T, Rasmussen N, Hegedus L. Impaired 1,25‑dihydroxyvitamin D production in pregnancyinduced hypertension. Eur J Obstet Gynecol Reprod Biol. 1992; 47(1):25–29.
7. Haugen M, Brantsaeter AL, Trogstad L, Alexander J, Roth C, Magnus P et al. Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology. 2009;20 (5):720–726.
8. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR et al. Toll-like receptor triggering of a vitamin D‑mediated human antimicrobial response. Science. 2006;311(5768):1770–1773.
9. Hollis BW. Circulating 25‑hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 2005;135(2):317–322.
10. Hollis BW, Wagner CL, Drezner MK, Binkley NC. Circulating vitamin D3 and 25‑hydroxyvitamin D in humans: An important tool to define adequate nutritional vitamin D status. J Steroid Biochem Mol Biol. 2007;103 (3–5):631–634.
11. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357 (3):266–281.
12. Baker AM, Haeri S, Camargo CA Jr, Espinola JA, Stuebe AM. First trimester maternal vitamin D status and risk of gestational diabetes: nested case-control study. Diabetes Metab Res Rev. 2012;28(2):164–168.
13. Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Maternal vitamin D and fetal growth in early-onset severe preeclampsia. Am J Obstet Gynecol. 2011;204(6):551–554.
14. Liu NQ, Kaplan AT, Lagishetty V, Ouyang YB, Ouyang Y, Simmons CF et al. Vitamin D and regulation of placental inflammation. J Immunol. 2011;186(10):5968–5974.
15. Mayhew TM. Fetoplacental angiogenesis during gestation is biphasic, longitudinal and occurs by proliferation and remodeling of vascular endothelial cells. Placenta. 2002;23(10):742–750.
16. Jaffe R, Jauniaux E, Hustin J. Maternal circulation in the first trimester human placenta — myth or reality? Am J Obstet Gynecol 1997;176:695–705.
17. Gale CR, Robinson SM, Harvey NC, Javaid MK, Jiang B, Martyn CN et al. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr. 2008;62(1):68–77.
18. Lewis S, Lucas RM, Halliday J, Ponsonby AL. Vitamin D deficiency and pregnancy: from conception to birth. Mol Nutr Food Res. 2010;54(8):1092–1102.
19. Wehr E, Pieber TR, Obermayer-Pietsch B. Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in PCOS women pilot study. J Endocrinol Invest. 2011;34 (10):757–763.
20. Weinert LS, Silveiro SP. Maternal-fetal impact of vitamin D deficiency: a critical review. J Matern Child Health. 2015;19 (1):94–101.
21. Novakovic B, Sibson M, Ng HK, Manuelpillai U, Rakyan V, Down T et al. Placenta-specific methylation of the vitamin D 24‑hydroxylase gene: implications for feedback autoregulation of active vitamin D levels at the fetomaternal interface. J Biol Chem. 2009;284(22):14838–14848.
22. Powe CE, Seely EW, Rana S, Bhan I, Ecker J, Karumanchi SA et al. First trimester vitamin D, vitamin D‑binding protein, and subsequent preeclampsia. Hypertension. 2010;56(4):758–763.
Review
For citations:
Shelepova E.S., Yakovleva N.Yu., Ryabokon’ N.R., Kuznetsova L.V., Khadzhieva E.D., Zazerskaya I.E. Vitamin D level in pregnant women with preeclampsia. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2015;21(6):623-629. (In Russ.) https://doi.org/10.18705/1607-419X-2015-21-6-623-629