Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia

Thread view:

Enable EMail Alerts

Start New Thread

Thread rating:

MarilynMann - 08 Sep 2007 16:02 GMT

The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 9
3517-3522

Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia

Lisa M. Bodnar, Janet M. Catov, Hyagriv N. Simhan, Michael F. Holick,
Robert W. Powers and James M. Roberts
Department of Epidemiology (L.M.B., J.M.C., J.M.R.), University of
Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
15261; Department of Obstetrics, Gynecology, and Reproductive Sciences
(L.M.B., J.M.C., H.N.S., R.W.P., J.M.R.), University of Pittsburgh
School of Medicine, Pittsburgh, Pennsylvania 15261; Magee-Womens
Research Institute (L.M.B., J.M.C., H.N.S., R.W.P., J.M.R.),
Pittsburgh, Pennsylvania 15213; and Vitamin D Laboratory (M.F.H.),
Section of Endocrinology, Nutrition and Diabetes, Department of
Medicine, Boston University School of Medicine, Boston, Massachusetts
02115

Address all correspondence and requests for reprints to: Lisa M.
Bodnar, Ph.D., M.P.H., R.D., Department of Epidemiology, University of
Pittsburgh Graduate School of Public Health, A742 Crabtree Hall, 130
DeSoto Street, Pittsburgh, Pennsylvania, 15261. E-mail:
bodnar@edc.pitt.edu.

Context: Vitamin D has direct influence on molecular pathways proposed
to be important in the pathogenesis of preeclampsia, yet the vitamin D-
preeclampsia relation has not been studied.

Objectives: We aimed to assess the effect of maternal 25-
hydroxyvitamin D [25(OH)D] concentration on the risk of preeclampsia
and to assess the vitamin D status of newborns of preeclamptic
mothers.

Design and Setting: We conducted a nested case-control study of
pregnant women followed from less than 16 wk gestation to delivery
(1997-2001) at prenatal clinics and private practices.

Patients: Patients included nulliparous pregnant women with singleton
pregnancies who developed preeclampsia (n = 55) or did not develop
preeclampsia (n = 219). Women's banked sera were newly measured for
25(OH)D.

Main Outcome Measure: The main outcome measure was preeclampsia (new-
onset gestational hypertension and proteinuria for the first time
after 20 wk gestation). Our hypotheses were formulated before data
collection.

Results: Adjusted serum 25(OH)D concentrations in early pregnancy were
lower in women who subsequently developed preeclampsia compared with
controls [geometric mean, 45.4 nmol/liter, and 95% confidence interval
(CI), 38.6-53.4 nmol/liter, vs. 53.1 and 47.1-59.9 nmol/liter; P <
0.01]. There was a monotonic dose-response relation between serum
25(OH)D concentrations at less than 22 wk and risk of preeclampsia.
After confounder adjustment, a 50-nmol/liter decline in 25(OH)D
concentration doubled the risk of preeclampsia (adjusted odds ratio,
2.4; 95% CI, 1.1-5.4). Newborns of preeclamptic mothers were twice as
likely as control newborns to have 25(OH)D less than 37.5 nmol/liter
(adjusted odds ratio, 2.2; 95% CI, 1.2-4.1).

Conclusions: Maternal vitamin D deficiency may be an independent risk
factor for preeclampsia. Vitamin D supplementation in early pregnancy
should be explored for preventing preeclampsia and promoting neonatal
well-being.

Reply to this Message

MarilynMann - 08 Sep 2007 19:59 GMT

European Journal of Clinical Nutrition (2007) 61, 1136-1139;

Does vitamin D supplementation in infancy reduce the risk of pre-
eclampsia?

Guarantor: E Hypp?nen.

Contributors: EH had the study idea, carried out the analyses and
wrote the paper. AP reviewed the hospital records and certified the
diagnoses. Thirty-one year survey was designed by AP, ALH and MRJ. US
managed the data and commented statistical methods. All authors
participated in the evaluation of the results and contributed to the
final version of the paper.

E Hypp?nen1, A-L Hartikainen2, U Sovio3, M-R J?rvelin3,4 and A
Pouta2,4

1Centre for Paediatric Epidemiology and Biostatistics, Institute of
Child Health, London, UK
2Department of Obstetrics and Gynecology, Oulu University Hospital,
University of Oulu, Oulu, Finland
3Department of Epidemiology and Public Health, Imperial College
London, London, UK
4National Public Health Institute, Oulu, Finland
Correspondence: Dr E Hypp?nen, Centre for Paediatric Epidemiology and
Biostatistics, Institute of Child Health, 30 Guilford Street, London
WCIN 1EH, UK. E-mail: e.hypponen@ich.ucl.ac.uk

Abstract
Vitamin D has been suggested to affect the balance between T helper
(Th1) and (Th2) type cytokines by favouring Th2 domination. We
investigated the association between infant vitamin D supplementation
and later pre-eclampsia, a disorder suggested to be dominated by Th1
response. We used data on 2969 women born in the Northern Finland
Birth Cohort 1966 of whom 68 (2.3%) had pre-eclampsia in their first
pregnancy. Risk of pre-eclampsia was halved (OR 0.49, 95% confidence
interval (CI) 0.26-0.92) in participants who had received vitamin D
supplementation regularly during the first year of life and this
association was not affected by adjustment for own birth order, birth
weight, gestational age, social class in 1966 and hospitalizations or
pregnancy-induced hypertension of their mothers. Together with earlier
observations on a reduced risk of type 1 diabetes after vitamin D
supplementation, these data suggest that vitamin D intake in infancy
may affect long-term programming of the immune response pattern.

Reply to this Message