Vitamin D status in early pregnancy and risk of preeclampsia

Achkar, Madonna; Dodds, Linda; Giguère, Yves; Forest, Jean‐Claude; Armson, B. Anthony; Woolcott, Christy; Agellon, Sherry; Spencer, Andrew; Weiler, Hope A.

doi:10.1016/j.ajog.2014.11.009

Cited by 107 publications

(61 citation statements)

References 36 publications

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“…A relationship between RLS and growing pains has been observed among not only adults but also children, and both have been found to respond to the administration of vitamin D (37). Vitamin D deficiency is not uncommon during pregnancy (38, 39), and this deficiency has been found to be related to impaired dopaminergic neurotransmission through various means (32, 33, 40). Thus, in addition to iron and folate deficiency, vitamin D deficiency might be another contributor to the pathogenesis of RLS during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

et al. 2015

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Restless legs syndrome (RLS) is a common sleep disorder that may be associated with pregnancy. Studies have found that the prevalence of RLS among pregnant women ranged from 10 to 34%. Typically, there is complete remission of symptoms soon after parturition; however, in some patients, they may continue postpartum. RLS has been shown to be associated with a number of complications in pregnancy including preeclampsia and increased incidence of Cesarean sections. Although multiple hypotheses have been proposed to explain this association, each individual hypothesis cannot completely explain the whole pathogenesis. Present understanding suggests that a strong family history, low serum iron and ferritin level, and high estrogen level during pregnancy might play important roles. Vitamin D deficiency and calcium metabolism may also play a role. Medical treatment of RLS during pregnancy is difficult and challenging considering the risks to mother and fetus. However, in some cases, the disease may be severe enough to require treatment.

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Section: Introductionmentioning

confidence: 99%

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

et al. 2015

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“…When this principal component was included as a model predictor, ROC analysis ( model3 AUC: 0.752 (95%CI 0.658, 0.846)) showed that it significantly (p=0.006) outperformed a baseline model including mother’s age, race, site, and gestational age ( model 1 AUC: 0.573 (95%CI 0.463, 0.682)) (Fig 2). Pre-pregnancy BMI, which was significantly associated with risk in this population, and serum vitamin D levels have both previously been shown to predict preeclampsia risk (Achkar et al, 2015, Hyppönen et al, 2013, Bodnar et al, 2014, O’Brien et al, 2003). Therefore models that additionally included pre-pregnancy BMI and baseline serum vitamin D (deficient at <30ng/ml versus sufficient at ≥30ng/ml) ( model 2 AUC: 0.731 (95%CI 0.624, 0.838) were compared.…”

Section: Resultsmentioning

confidence: 65%

“…The summary score based on these features outperformed serum vitamin D. Vitamin D deficiency is thought to play an important role in the pathophysiology of preeclampsia due to its involvement in immunomodulation and placental development (Novakovic et al, 2009), and has previously been shown to be a predictor of risk (Bodnar et al, 2014, Hyppönen et al, 2013, Achkar et al, 2015). The metabolite score also outperformed pre-pregnancy BMI.…”

Section: Discussionmentioning

confidence: 99%

Integration of metabolomic and transcriptomic networks in pregnant women reveals biological pathways and predictive signatures associated with preeclampsia

et al. 2016

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Introduction Preeclampsia is a leading cause of maternal and fetal mortality worldwide, yet its exact pathogenesis remains elusive. Objectives This study, nested within the Vitamin D Antenatal Asthma Reduction Trial (VDAART), aimed to develop integrated omics models of preeclampsia that have utility in both prediction and in the elucidation of underlying biological mechanisms. Methods Metabolomic profiling was performed on first trimester plasma samples of 47 pregnant women from VDAART who subsequently developed preeclampsia and 62 controls with healthy pregnancies, using liquid-chromatography tandem mass-spectrometry. Metabolomic profiles were generated based on logistic regression models and assessed using Received Operator Characteristic Curve analysis. These profiles were compared to profiles from generated using third trimester samples. The first trimester metabolite profile was then integrated with a pre-existing transcriptomic profile using network methods. Results In total, 72 (0.9%) metabolite features were associated (p<0.01) with preeclampsia after adjustment for maternal age, race, and gestational age. These features had moderate to good discriminatory ability; in ROC curve analyses a summary score based on these features displayed an area under the curve (AUC) of 0.794 (95%CI 0.700, 0.888). This profile retained the ability to distinguish preeclamptic from healthy pregnancies in the third trimester (AUC:0.762 (95% CI 0.663, 0.860)). Additionally, metabolite set enrichment analysis identified common pathways, including glycerophospholipid metabolism, at the two time-points. Integration with the transcriptomic signature refined these results suggesting a particular role for lipid imbalance, immune function and the circulatory system. Conclusions These findings suggest it is possible to develop a predictive metabolomic profile of preeclampsia. This profile is characterized by changes in lipid and amino acid metabolism and dysregulation of immune response and can be refined through interaction with transcriptomic data. However validation in larger and more diverse populations is required.

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“…There has been an approximate 25% increase in the incidence of preeclampsia in the past 2 decades . Preeclampsia is the leading cause of maternal and perinatal morbidity and mortality . The United States has one of the highest rates of maternal mortality and morbidity among the industrialized countries .…”

Section: Vitamin D Preterm Birth and Preeclampsiamentioning

confidence: 99%

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review

Woo

Giurgescu

Wagner

2019

J Midwife Womens Health

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Vitamin D deficiency has been associated with adverse pregnancy and birth outcomes such as increased risk for preterm birth and preeclampsia. This state of the science review analyzed recently published meta-analyses and relevant studies that have evaluated the association between vitamin D deficiency and preeclampsia or preterm birth. The results suggest that a positive association between vitamin D deficiency and preterm birth exists. However, the findings of the relationship between vitamin D deficiency and preeclampsia were inconclusive, possibly because of the need for supplementation to occur prior to placentation. This may be because of a lack of studies with ethnic minority populations, who are more likely to experience vitamin D deficiency, and inadequate supplementation doses used for treatment of vitamin D deficiency. Health care providers should screen pregnant women at risk for vitamin D deficiency and supplement women accordingly based on their vitamin D status. Lastly, well-designed and standardized clinical trials need to include large cohorts of minority pregnant women to establish the impact of vitamin D supplementation on improving preterm birth and preeclampsia risk in pregnancy.

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Vitamin D status in early pregnancy and risk of preeclampsia

Cited by 107 publications

References 36 publications

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

Integration of metabolomic and transcriptomic networks in pregnant women reveals biological pathways and predictive signatures associated with preeclampsia

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review

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