Dietary calcium intake was related to the onset of pre‐eclampsia: The TMM BirThree Cohort Study

Abstract

This study aimed to explore the relationship between dietary electrolyte intake and the prevalence of hypertensive disorders of pregnancy (HDP) subtypes. Our analysis included 19 914 pregnant women from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. A food frequency questionnaire was used to estimate dietary calcium, potassium, sodium, and magnesium intakes. HDP was determined based on the medical records during regular antenatal care. Logistic regression analysis assessed the relationship between dietary electrolytes intake quintiles, and HDP subtypes with adjustment for basic characteristics. Dietary electrolyte intakes were applied for the prediction model. Of the cohort, 547 participants delivered with pre-eclampsia (PE), 278 with superimposed PE (SP), and 896 with gestational hypertension (GH). PE was associated with low crude calcium intake (odds ratio of the first quintile [<251 mg/day] to the fifth quintile [>623 mg/day] and 95% confidence interval, 1.31 [1.00-1.70]) and P for trend was .02. SP was not associated with any nutritional intake; however, the combined outcome of PE and SP was related to low crude calcium and potassium and energy-adjusted calcium, potassium, and magnesium intakes (P for trend, .01, .048, .02, .04, and .02, respectively). The same tendency was observed for GH. A prediction model that included crude calcium and potassium intakes performed better than a model without them. In conclusion, low dietary calcium, potassium, and magnesium were associated with higher HDP subtypes prevalence. The prediction model implied that crude calcium and potassium intakes might play a critical role in PE and SP pathogenesis.

Preeclampsia prediction with maternal and paternal polygenic risk scores: the TMM BirThree Cohort Study

“…We applied the competing risk model, 30 which has been validated internally and externally in Europe 31 and yielded comparable results in the TMM BirThree Cohort Study. 22, 23 The competing risks model assumes that all pregnant women will develop PE during pregnancy, but only some will actually develop PE because of competing of delivery without PE. We employed a parametric survival model with a Gaussian distribution.…”

“…Based on previous research on PE prediction models, [22][23][24][25][26] we selected following predictive variables: maternal age at conception, pre-pregnancy body mass index (BMI), chronic hypertension (CH), systemic lupus erythematosus (SLE), type 1 and 2 diabetes mellitus (DM), maternal family (mother or sisters) history of HDP, conception via in vitro fertilization (IVF), parity (nulliparous, parous with or without previous HDP), gestational age at the previous delivery, the inter-birth interval, and BP at the first antenatal care during 10-13 weeks of gestation. We collected BP data at 10-13 weeks of gestation, when the majority of population underwent the first or second antenatal care.…”

Vitamin D may alleviate pre‐eclampsia by modulating the ferroptosis signalling pathway: A hypothesis based on recent literature

“…28 Intake of calcium and potassium may play an important role in PE. 29 It is reasonable to speculate that vitamin D supplementation may inhibit iron absorption by promoting calcium absorption, and ultimately inhibit the occurrence of ferroptosis.…”

“…One study suggested that oxidative stress may be associated with disruption of vitamin D homeostasis and placental calcium transport in PE patients 28 . Intake of calcium and potassium may play an important role in PE 29 . It is reasonable to speculate that vitamin D supplementation may inhibit iron absorption by promoting calcium absorption, and ultimately inhibit the occurrence of ferroptosis.…”

Pathophysiological Insight into Fatty Acid-Binding Protein-4: Multifaced Roles in Reproduction, Pregnancy, and Offspring Health

“…Vitamin D (VD) deficiency is associated with GDM, miscarriage, and stillbirth [ 126 ]. Calcium deficiency is associated with PE [ 127 ] and pregnancy lactation-associated osteoporosis [ 128 ]. Moreover, dietary lipid intakes, such as n-3 polyunsaturated fatty acids (PUFAs) and long-chain polyunsaturated fatty acids (LCPUFAs), are indispensable in utero for the growing fetal brain and neurodevelopment [ 129 , 130 ].…”