Decreased 1,25‐dihydroxy vitamin D levels in women with intrahepatic cholestasis of pregnancy

Shemer, Elisabeth Wikström; Marschall, Hanns‐Ulrich

doi:10.3109/00016349.2010.515665

Cited by 39 publications

(15 citation statements)

References 21 publications

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“… 23 Furthermore, there seems to be an inverse relation between low active vitamin D (1,25-dihydroxy vitamin D) and meconium-stained amniotic fluid, a sign of fetal distress, in pregnancies complicated by intrahepatic cholestasis. 24 …”

Section: Discussionmentioning

confidence: 99%

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case–control study

et al. 2016

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ObjectiveVitamin D deficiency causes not only skeletal problems but also muscle weakness, including heart muscle. If the fetal heart is also affected, it might be more susceptible to fetal distress and birth asphyxia. In this pilot study, we hypothesised that low maternal vitamin D levels are over-represented in pregnancies with fetal distress/birth asphyxia.Design and settingA population-based nested case–control study.PatientsBanked sera of 2496 women from the 12th week of pregnancy.Outcome measuresVitamin D levels were analysed using a direct competitive chemiluminescence immunoassay. Vitamin D levels in early gestation in women delivered by emergency caesarean section due to suspected fetal distress were compared to those in controls. Birth asphyxia was defined as Apgar <7 at 5 min and/or umbilical cord pH≤7.15.ResultsVitamin D levels were significantly lower in mothers delivered by emergency caesarean section due to suspected fetal distress (n=53, 43.6±18 nmol/L) compared to controls (n=120, 48.6±19 nmol/L, p=0.04). Birth asphyxia was more common in women with vitamin D deficiency (n=95) in early pregnancy (OR 2.4, 95% CI 1.1 to 5.7).ConclusionsLow vitamin D levels in early pregnancy may be associated with emergency caesarean section due to suspected fetal distress and birth asphyxia. If our findings are supported by further studies, preferably on severe birth asphyxia, vitamin D supplementation/sun exposure in pregnancy may lower the risk of subsequent birth asphyxia.

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Section: Discussionmentioning

confidence: 99%

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case–control study

et al. 2016

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“…As the liver contributes to vitamin D metabolism, it is conceivable that there might be disturbances in bone transformation among women in the ICP group. At delivery, women with ICP have been reported to have significantly lower levels of 1,25‐dihydroxyvitamin D 3 in their serum than healthy women (25). We therefore expected to find differences in osteoporosis and, more clearly, in the incidence of bone fractures between the ICP and control groups.…”

Section: Discussionmentioning

confidence: 99%

Health history after intrahepatic cholestasis of pregnancy

Turunen

Mölsä

Helander

et al. 2012

Acta Obstet Gynecol Scand

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“…The aetiology of ICP is complex and incompletely understood, with evidence for genetic, immunological and endocrine components 11–20 . It runs in families, particularly in monozygotic twin pregnancies, suggesting a genetic component to its pathogenesis 12 .…”

Section: Classificationmentioning

confidence: 99%

“…A single‐nucleotide polymorphism of the PXR gene correlates both with ICP and low neonatal birth weight 19 . In terms of other hormone systems, ICP correlates with low maternal circulating levels of 1,25‐dihydroxy vitamin D levels 18 and increased maternal circulating levels of endothelin‐1 20 . The epidemiology of ICP suggests that multiple factors are involved in its aetiology.…”

Section: Classificationmentioning

confidence: 99%

Recent developments in the specific dermatoses of pregnancy

Beard

Millington

2011

Clinical and Experimental Dermatology

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During pregnancy, the mother undergoes changes to sustain and enable normal growth and development of the fetus. Common physiological changes include linea nigra, fibroepithelial polyps, striae, spider angioma, palmar erythema and pruritis gravidarum. However, there are some changes that are purely pathological, and these are termed the pregnancy-specific dermatoses (PSDs). The PSDs occur during pregnancy or in the immediate postpartum period. They do not include the various benign conditions or pre-existing dermatoses and tumours that may present or worsen with pregnancy. They do include a number of distinct and identifiable conditions: atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy (PEP), intrahepatic cholestasis of pregnancy (ICP) and pemphigoid gestationis (PG). These are a heterogeneous group of skin conditions characterized by pruritis and inflammatory changes. In addition, pruritis gravidarum is sometimes considered pathophysiological and thus part of this group, rather than a physiological process. Each of these conditions has a distinct, but not fully understood, pathogenesis. The mechanisms leading to PSD may be a reflection on the hormonal and immunological changes associated with pregnancy. AEP and PEP are benign conditions, and although they can cause distress to the mother, they are otherwise minor. However, ICP and PG are more serious conditions, and both carry the potential for serious risks to both the mother and the fetus. Thus, the pathophysiology of these latter two conditions is considered in more detail in the following article.

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Decreased 1,25‐dihydroxy vitamin D levels in women with intrahepatic cholestasis of pregnancy

Abstract: Lower 1,25-D3 levels in ICP are inversely correlated by meconium staining, a major indicator of fetal distress. Our finding may have pathogenetic and clinical implications since vitamin D regulates steroid metabolism and 1,25-D3 deficiency may impair fetal outcome.

Cited by 39 publications

References 21 publications

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case–control study

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case–control study

Health history after intrahepatic cholestasis of pregnancy

Recent developments in the specific dermatoses of pregnancy

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