Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia

Bodnar, Lisa M.; Catov, Janet M.; Simhan, Hyagriv N.; Holick, Michael F.; Powers, Robert W.; Roberts, James M.

doi:10.1210/jc.2007-0718

Cited by 777 publications

(688 citation statements)

References 44 publications

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“…This study reported a decrease in the inflammatory response with vitamin D treatment by measurement of IL-8 [24]. Also of note, vitamin D has been associated with increased risk of preeclampsia [25], infants that are small for gestational age (SGA) [26][27][28][29], cesarean section [30], and gestational diabetes (GDM) [31].…”

Section: Pregnancy Lossmentioning

confidence: 73%

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Pacis

Fortin

Zarek

et al. 2014

J Assist Reprod Genet

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Purpose To review the current literature regarding the role of vitamin D status in pregnancy outcomes in women undergoing assisted reproductive technology (ART) and to assess cost-effectiveness of routine vitamin D deficiency screening and repletion prior to initiation of ART.Methods A systematic literature review was conducted using PubMed. Relevant study outcomes were compared among the selected studies. A cost-benefit analysis was performed using a decision tree mathematical model with sensitivity analyses from the perspective of direct societal cost. Published data were used to estimate probabilities and costs in 2014 US dollars. Results Thirty-four articles were retrieved, of which eight met inclusion criteria. One study demonstrated a negative relationship between vitamin D status and ART outcomes, while two studies showed no association. The remaining five studies concluded that ART outcomes improved after vitamin D repletion. Conclusion The majority of reviewed studies reported a decrement in ART outcomes in patients with vitamin D deficiency. Cost-benefit analyses suggested that screening and supplementing vitamin D prior to ART might be cost effective, but further evidence is needed. Given the absence of Level I evidence regarding vitamin D status and ART outcomes, full endorsement of routine vitamin D screening and supplementation prior to ART is premature.

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Section: Pregnancy Lossmentioning

confidence: 73%

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Pacis

Fortin

Zarek

et al. 2014

J Assist Reprod Genet

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“…4,5). Placental expression of inflammatory cytokines is part of normal immune function during pregnancy (32), but overexuberant cytokine responses are also known to play a key role in adverse outcomes of pregnancy (33)(34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

“…With respect to the latter, impaired vitamin D status during gestation is associated with poor skeletal growth in childhood (3), consistent with the classical functions of vitamin D. However, low maternal levels of the major circulating form of vitamin D, 25-hydroxyvitamin D 3 (25OHD 3 ), have also been linked to adverse outcomes in pregnancy such as pre-eclampsia, a disorder involving dysregulated placental vascularization that affects up to 10% of pregnancies (5,6). In this way, the physiological impact of maternal vitamin D status may not be restricted to the endocrine regulation of skeletal homeostasis, but may also extend to more localized events in the placenta.…”

mentioning

confidence: 99%

Vitamin D and the Regulation of Placental Inflammation

Liu

Kaplan

Lagishetty

et al. 2011

The Journal of Immunology

182

118

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The vitamin D-activating enzyme 1α-hydroxylase (CYP27B1) and vitamin D receptor (VDR) support anti-inflammatory responses to vitamin D in many tissues. Given the high basal expression of CYP27B1 and VDR in trophoblastic cells from the placenta, we hypothesized that anti-inflammatory effects of vitamin D may be particularly important in this organ. Pregnant wild type (WT) mice i.p. injected with LPS showed elevated expression of mouse Cyp27b1 (4-fold) and VDR (6-fold). Similar results were also obtained after ex vivo treatment of WT placentas with LPS. To assess the functional impact of this, we carried out ex vivo studies using placentas −/− for fetal (trophoblastic) Cyp27b1 or VDR. Vehicle-treated −/− placentas showed increased expression of IFN-γ and decreased expression of IL-10 relative to +/+ placentas. LPS-treated −/− placentas showed increased expression of TLR2, IFN-γ, and IL-6. Array analyses identified other inflammatory factors that are dysregulated in Cyp27b1−/− versus Cyp27b1+/+ placentas after LPS challenge. Data highlighted enhanced expression of IL-4, IL-15, and IL-18, as well as several chemokines and their receptors, in Cyp27b1−/− placentas. Similar results for IL-6 expression were observed with placentas −/− for trophoblastic VDR. Finally, ex vivo treatment of WT placentas with the substrate for Cyp27b1, 25-hydroxyvitamin D3, suppressed LPS-induced expression of IL-6 and the chemokine Ccl11. These data indicate that fetal (trophoblastic) vitamin D plays a pivotal role in controlling placental inflammation. In humans, this may be a key factor in placental responses to infection and associated adverse outcomes of pregnancy.

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“…An NCCS found that a 50-nmol/l decline in 25(OH)D concentration doubled the risk of pre-eclampsia (adjusted odds ratio 2.4; 95% confidence interval 1.1-5.4) (Bodnar et al, 2007). In a study in South Carolina, subjects with early-onset severe pre-eclampsia (n ¼ 50) had lower total 25(OH)D levels than those of healthy control subjects (n ¼ 100; Po0.001).…”

Section: Maternal Sepsismentioning

confidence: 99%

An estimate of the global reduction in mortality rates through doubling vitamin D levels

Grant

2011

Eur J Clin Nutr

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Background/Objectives: The goal of this work is to estimate the reduction in mortality rates for six geopolitical regions of the world under the assumption that serum 25-hydroxyvitamin D (25(OH)D) levels increase from 54 to 110 nmol/l. Subjects/Methods: This study is based on interpretation of the journal literature relating to the effects of solar ultraviolet-B (UVB) and vitamin D in reducing the risk of disease and estimates of the serum 25(OH)D level-disease risk relations for cancer, cardiovascular disease (CVD) and respiratory infections. The vitamin D-sensitive diseases that account for more than half of global mortality rates are CVD, cancer, respiratory infections, respiratory diseases, tuberculosis and diabetes mellitus. Additional vitamin D-sensitive diseases and conditions that account for 2 to 3% of global mortality rates are Alzheimer's disease, falls, meningitis, Parkinson's disease, maternal sepsis, maternal hypertension (pre-eclampsia) and multiple sclerosis. Increasing serum 25(OH)D levels from 54 to 110 nmol/l would reduce the vitamin D-sensitive disease mortality rate by an estimated 20%. Results: The reduction in all-cause mortality rates range from 7.6% for African females to 17.3% for European females. Reductions for males average 0.6% lower than for females. The estimated increase in life expectancy is 2 years for all six regions. Conclusions: Increasing serum 25(OH)D levels is the most cost-effective way to reduce global mortality rates, as the cost of vitamin D is very low and there are few adverse effects from oral intake and/or frequent moderate UVB irradiance with sufficient body surface area exposed.

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Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia

Abstract: 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.

Cited by 777 publications

References 44 publications

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Vitamin D and the Regulation of Placental Inflammation

An estimate of the global reduction in mortality rates through doubling vitamin D levels

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