Association of vitamin D level and vitamin D deficiency with risk of preeclampsia: A systematic review and updated meta-analysis

Akbari, Soheila; Khodadadi, Babak; Ahmadi, Seyyed Amir Yasin; Abbaszadeh, Sepideh; Shahsavar, Farhad

doi:10.1016/j.tjog.2018.02.013

Cited by 58 publications

(40 citation statements)

References 34 publications

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“…Several investigations have shown that low serum 25(OH)D concentrations are associated with some adverse neonatal and pregnancy outcomes [ 65 , 66 , 67 , 68 ]. In this context, several reviews and meta-analyses support the notion that low serum 25(OH)D concentrations are a risk factor for hypertensive disorders in pregnancy such as pre-eclampsia, and for gestational diabetes mellitus [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. Moreover, in the majority of the published meta-analyses low serum 25(OH)D concentration in pregnant women are associated with an increased risk of their children for childhood asthma, wheeze, respiratory tract infections, allergic rhinitis, and eczema [ 79 , 80 , 81 , 82 , 83 , 84 , 85 ].…”

Section: Pregnancy Outcomesmentioning

confidence: 99%

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

Pilz

Zittermann

Obeid

et al. 2018

IJERPH

116

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Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation.

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Section: Pregnancy Outcomesmentioning

confidence: 99%

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

Pilz

Zittermann

Obeid

et al. 2018

IJERPH

116

View full text Add to dashboard Cite

show abstract

“…They suggested that vitamin D supplementation may reduce gestational diabetes, low birthweight, and preeclampsia, but a higher than currently recommended dose appeared to have no additional benefit except for possible further reduction of gestational diabetes [74,75]. However, several studies in recent years have highlighted that women are at high risk for vitamin D deficiency, and this is associated with adverse pregnancy outcomes, including preeclampsia and gestational diabetes [76][77][78][79][80]. It has been demonstrated that vitamin D supplementation is able to reduce adverse pregnancy outcomes when a higher level is achieved, with an increasing efficacy when the target level is raised from 20 to 40 ng/mL or 50 ng/mL.…”

Section: Pregnancymentioning

confidence: 99%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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Vitamin D testing and the use of vitamin D supplements have increased substantially in recent years. Currently, the role of vitamin D supplementation, and the optimal vitamin D dose and status, is a subject of debate, because large interventional studies have been unable to show a clear benefit (in mostly vitamin D replete populations). This may be attributed to limitations in trial design, as most studies did not meet the basic requirements of a nutrient intervention study, including vitamin D-replete populations, too small sample sizes, and inconsistent intervention methods regarding dose and metabolites. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L or 20 ng/ml) is associated with unfavorable skeletal outcomes, including fractures and bone loss. A 25(OH)D level of >50 nmol/L or 20 ng/ml is, therefore, the primary treatment goal, although some data suggest a benefit for a higher threshold. Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible. The data on a benefit for mortality and prevention of infections, at least in severely deficient individuals, appear convincing. Vitamin D is clearly not a panacea, and is most likely efficient only in deficiency. Given its rare side effects and its relatively wide safety margin, it may be an important, inexpensive, and safe adjuvant therapy for many diseases, but future large and well-designed studies should evaluate this further. A worldwide public health intervention that includes vitamin D supplementation in certain risk groups, and systematic vitamin D food fortification to avoid severe vitamin D deficiency, would appear to be important. In this narrative review, the current international literature on vitamin D deficiency, its relevance, and therapeutic options is discussed.

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“…36,37 Vitamin D can effectively prevent or delay eclampsia, and the serum level decreased earlier than clinical symptoms of PE. 38 So, clinical attention should be paid to vitamin D supplementation during pregnancy, and the metabolic pathway of vitamin D in pregnant women should be monitored to reduce the risk of GDM and PE. In addition, studies have shown that the expression level of vitamin D receptor (VDR) in placenta of PE pregnant women is lower than that of normal pregnant women.…”

Section: Sphingomyelinsmentioning

confidence: 99%

The application of metabolomics analysis in the research of gestational diabetes mellitus and preeclampsia

Teng

Zhang

et al. 2020

J of Obstet and Gynaecol

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Aim The aim of the study was to investigate the difference of the serum metabolic profile between gestational diabetes mellitus (GDM) patients and preeclampsia (PE) patients, to establish the disease differentiation model and to find characteristic metabolites, in order to provide a new idea for the occurrence, development and treatment of the disease. Methods Twenty‐nine patients with GDM group and 29 PE group who were examined in Tianjin No. 3 Central Hospital from March 2018 to August 2018 were enrolled as case group, and 29 normal pregnant women were selected as control group. All the serum samples were analyzed by using the ultra‐performance liquid chromatography and mass spectrometry. Based on the multivariate statistical analysis method of pattern recognition, we screened out and identified the differential characteristic metabolites. Results The serum metabolic profile model of GDM group and PE group was successfully constructed. A total of nine characteristic metabolites were screened and identified in this study, including LPC 18:0, LPC 22:6, LPC 16:0, (S)‐14‐methylhexadecanoic acid, behenic acid, palmitic acid, sphingosine, phytosphingosine and 1,25‐dihydroxyvitamin D3‐26,23‐lactone. Among them, six characteristic metabolites which were LPC 18:0, LPC 22:6, behenic acid, palmitic acid, sphingosine and 1,25‐dihydroxyvitamin D3‐26,23‐lactone all had a significant statistical difference among GDM, PE and normal pregnancy groups (P < 0.05). Conclusion The construction of metabolic profile discriminant model has a strong ability to differentiate GDM patients from PE pregnant women. The screened characteristic metabolites can early reflect the disorder of lipid, calcium and phosphorus metabolism of patients, and provide reference and help for the discussion of the occurrence, development and treatment of diseases.

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Association of vitamin D level and vitamin D deficiency with risk of preeclampsia: A systematic review and updated meta-analysis

Abstract: Women with vitamin D deficiency at cutoff 20 ng/ml are more at risk of preeclampsia. This association can be specific up to 90% at 10.60 ng/ml cutoff. Treatment of vitamin D deficiency is necessary before pregnancy.

Cited by 58 publications

References 34 publications

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

Vitamin D deficiency 2.0: an update on the current status worldwide

The application of metabolomics analysis in the research of gestational diabetes mellitus and preeclampsia

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