The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia

Sasan, Sanam Behjat; Zandvakili, Farnaz; Soufizadeh, Nasrin; Baybordi, Elaheh

doi:10.1155/2017/8249264

Cited by 77 publications

(86 citation statements)

References 27 publications

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“…Along with our study, several other RCTs have been published ( 11 , 86 – 95 ), with the main finding that a daily dose of vitamin D of 4,000 IU/safely elevated circulating 25(OH)D concentrations that, regardless of race, fully and safely normalized vitamin D metabolism and calcium homeostasis in the pregnant women. Using repeated measures, the concentration of 25(OH)D that fully normalized 1,25(OH) 2 D in our study cohort was determined on each subject and plotted to determine the point at which first order kinetics went to zero order ( 11 ), which was 100 nmol/L (40 ng/mL), the beginning point of the plateau at which the production of 1,25(OH) 2 D became substrate independent ( 11 ).…”

Section: Vitamin D Deficiency During Pregnancy: Human Studiessupporting

confidence: 72%

The Implications of Vitamin D Status During Pregnancy on Mother and her Developing Child

2018

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Pregnancy is a time of tremendous growth and physiological changes for mother and her developing fetus with lifelong implications for the child. The concert of actions that must occur so mother does not reject the foreign tissue of the fetus is substantial. There must be exquisite balance between maternal tolerance to these foreign proteins of paternal origin but also immune surveillance and function such that the mother is not immunocompromised. When this process goes awry, the mother may experience such pregnancy complications as preeclampsia and infections. Vitamin D deficiency affects these processes. Controversy continues with regard to the optimal daily intake of vitamin D, when sunlight exposure should be taken into account, and how to define sufficiency during such vulnerable and critical periods of development. The importance of vitamin D supplementation during pregnancy in preventing some of the health risks to the mother and fetus appears linked to achieving 25(OH)D concentrations >40 ng/mL, the beginning point of the plateau where conversion of the vitamin D metabolite 25(OH)D, the pre-hormone, to 1,25(OH)2D, the active hormone, is optimized. Throughout pregnancy, the delivery of adequate vitamin D substrate—through sunlight or supplement—is required to protect both mother and fetus, and when in sufficient supply, favorably impacts the epigenome of the fetus, and in turn, long term health. There is a growing need for future research endeavors to focus not only on critical period(s) from pre-conception through pregnancy, but throughout life to prevent certain epigenetic changes that adversely affect health. There is urgency based on emerging research to correct deficiency and maintain optimal vitamin D status. The impact of vitamin D and its metabolites on genetic signaling during pregnancy in both mother and fetus is an area of great activity and still in its early stages. While vitamin D repletion during pregnancy minimizes the risk of certain adverse outcomes (e.g., preterm birth, asthma, preeclampsia, and gestational diabetes), the mechanisms of how these processes occur are not fully understood. As we intensify our research efforts in these areas. it is only a matter of time that such mechanisms will be defined.

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Section: Vitamin D Deficiency During Pregnancy: Human Studiessupporting

confidence: 72%

The Implications of Vitamin D Status During Pregnancy on Mother and her Developing Child

2018

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“…26,33 Studies in HIV-uninfected women have demonstrated a variable association of lower vitamin D levels with hypertensive diseases of pregnancy, [34][35][36][37] though clinical questions around whether supplementation, and the timing and amount of supplementation, that may reduce this risk remain unanswered. 35,36,[38][39][40] The current study was novel in that it looked at the association of vitamin D levels with PIH in HIV-infected pregnant women, a group historically felt to be at increased risk for vitamin D deficiency and with variably increased risks for adverse obstetric outcomes. Our study demonstrated that lower vitamin D levels are associated with HIV disease severity in pregnant HIV-infected women with poorer disease control or on less effective treat-ment regimens.…”

Section: Discussionmentioning

confidence: 99%

Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period

et al. 2019

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Objective To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women. Study Design This is a retrospective cohort study evaluating the impact of low maternal vitamin D levels on PIH and perinatal outcomes among HIV-infected pregnant women receiving care at an urban HIV center from 1991 to 2014. Results A total of 366 pregnant women were included, of which 11% developed PIH. Lower levels of 25-hydroxyvitamin D (25(OH)D) and bioactive 1,25-dihydroxyvitamin D (1,25(OH)2D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)2D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79–0.95], p = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80–0.97], p = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)2D levels were associated with group B Streptococcus colonization (OR: 0.92 [95% CI: 0.86–0.99]) and low birth weight (LBW) (OR: 0.90 [95% CI: 0.83–0.98]) on multivariate analysis. Mean 1,25(OH)2D levels were significantly lower in women with preterm delivery and LBW infants. Conclusion Lower bioactive vitamin D levels are related to PIH in HIV-infected women. This association may be related to the coexistence of abnormal placental vitamin D metabolism and abnormal placental implantation.

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“…Our ndings support previous studies mentioned above, which have proven that 4000IU/day of vitamin D supplementation is safe and effective in reducing vitamin D de ciency in pregnant women and newborns and has the most impact compared to supplementing 2000 IU/day or the recommended 400 IU/day The relationship between Vitamin D de ciency and GDM has been described frequently in literature (Zhang et al, 2008) Similar to a study conducted in neighbouring countries, our study also found an insigni cant effect of vitamin D supplementation on GDM (Asemi, Samimi, Tabassi, Shakeri, & Esmaillzadeh, 2013;Sablok et al, 2015;Tehrani, Mostajeran, & Banihashemi, 2017). The same effect of vitamin D was seen on incidence of pre-eclampsia, where although groups receiving a higher dose of vitamin D presented fewer cases of pre-eclampsia, the overall occurrence of pre-eclampsia and the difference between groups was not signi cant (Asemi et al, 2013;Naghshineh & Sheikhaliyan, 2016;Sablok et al, 2015;Sasan, Zandvakili, Sou zadeh, & Baybordi, 2017).…”

Section: Discussionmentioning

confidence: 88%

Vitamin D Supplementation during Pregnancy- A Double Blinded Randomized, Controlled, Dose-Comparison, Trial in Pakistan

Nausheen¹,

Shaikh²,

Habib³

et al. 2020

Preprint

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Vitamin D deficiency during pregnancy is a public health problem in Pakistan, and prevalent among most women of reproductive age in the country. Vitamin D supplementation during pregnancy is suggested to prevent adverse pregnancy outcomes and prevent vitamin D deficiency in both the mother and her newborn. However, there remains uncertainty surrounding the appropriate and safe dose for vitamin D supplementation in pregnant women who experience deficiency. We conducted a double-blinded, randomized, controlled, dose-comparison trial aimed to evaluate the relationship between different doses of vitamin D supplementation during pregnancy and pregnancy outcomes among women in a maternity hospital of the Aga Khan University (AKU) in Karachi, Pakistan. Pregnant women (n=350) in their first trimester were recruited and randomized to three treatment groups of vitamin D supplementation: 4,000 IU/day (Group A; n=120), 2,000 IU/day (Group B; n=115), or 400 IU/day (Group C – control; n=115). Deficiency in serum vitamin D (serum 25OHD <20ng/mL) at baseline was prevalent in more than 95% of women in each group. Participants in group A had the lowest vitamin D deficiency at endline and in newborns (endline: 75.9%; neonatal: 64.9%), followed by group B (endline: 84.9%; neonatal: 73.7%) and then the control group (endline: 90.2%; neonatal: 91.8%). Vitamin D deficiency was significantly lower in group A than group C (p=0.006) for women at endline, and lower in both group A and group B than the control group (p=0.001) in neonates. There were no adverse events attributable to vitamin D supplementation in all groups. Our study concluded that vitamin D supplementation with 4000 IU/day is safe and effective in reducing the risk of maternal and neonatal vitamin D deficiency.

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The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia

Cited by 77 publications

References 27 publications

The Implications of Vitamin D Status During Pregnancy on Mother and her Developing Child

The Implications of Vitamin D Status During Pregnancy on Mother and her Developing Child

Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period

Vitamin D Supplementation during Pregnancy- A Double Blinded Randomized, Controlled, Dose-Comparison, Trial in Pakistan

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