Maternal Vitamin D Status and Risk of Pre-Eclampsia: A Systematic Review and Meta-Analysis
The Journal of Clinical Endocrinology & Metabolism August 1, 2013 vol. 98 no. 8 3165-3173
Marjan Tabesh, Amin Salehi-Abargouei, Maryam Tabesh and Ahmad Esmaillzadeh
Food Security Research Center (Marj.T., A.S.-A., Mary.T., A.E.), and Department of Community Nutrition, School of Nutrition and Food Science (Marj.T., A.S.-A., A.E.), Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Address all correspondence and requests for reprints to: Ahmad Esmaillzadeh, PhD, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran. E-mail: esmaillzadeh at hlth.mui.ac.ir.
Background: Although several studies have investigated the association between maternal serum vitamin D levels and risk of pre-eclampsia, findings are inconsistent. This systematic review and meta-analysis of published observational studies was conducted to summarize the evidence on the association between maternal serum vitamin D levels and risk of pre-eclampsia.
Methods: PubMed, ISI (Web of science), SCOPUS, SCIRUS, Google Scholar, and EMBASE databases were searched to identify related articles published through December 2012. For systematic review, we found 15 articles that assessed the association between maternal serum vitamin D levels and risk of pre-eclampsia. The meta-analysis was done on 8 studies that reported odds ratios or relative risks for pre-eclampsia. Between-study heterogeneity was examined using Cochran's Q test and I2. Subgroup analysis and meta-regression were used to find possible sources of heterogeneity.
Results: The meta-analysis on 8 relevant papers revealed an overall significant association between vitamin D deficiency and risk of pre-eclampsia; however, there was significant between-study heterogeneity (I2 = 52.7%; P = .039).
In the subgroup analysis, we found that the overall effect was significant for studies that defined vitamin D deficiency as 25(OH)D ≤ 50 nmol/L (20 ng/mL), but not for those that considered it as <38 nmol/L (15.2 ng/mL).
The association was seen for “cohort or nested case-control studies” as well as for “cross-sectional or case-control studies” (2.78; 1.45–5.33; P = .002).
When the analysis was done by study location, the associations remained significant only for studies that came from the United States.
Conclusion: There was a significant relationship between vitamin D deficiency and increased risk of pre-eclampsia.
Further studies are required, particularly in developing countries.
PDF is attached at the bottom of this page
One of the many charts in the PDF
Preeclampsia 2.86 X more likely with vitamin D < 20 ng - Sept 2013
Vitamin D, secondary hyperparathyroidism, and preeclampsia.
Am J Clin Nutr. 2013 Sep;98(3):787-93. doi: 10.3945/ajcn.112.055871. Epub 2013 Jul 24.
Scholl TO, Chen X, Stein TP.
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Stratford, NJ, USA. schollto at rowan.edu
BACKGROUND: Secondary hyperparathyroidism, which is defined by a high concentration of intact parathyroid hormone when circulating 25-hydroxyvitamin D [25(OH)D] is low, is a functional indicator of vitamin D insufficiency and a sign of impaired calcium metabolism. Two large randomized controlled trials examined effects of calcium supplementation on preeclampsia but did not consider the vitamin D status of mothers.
OBJECTIVE: We examined the association of secondary hyperparathyroidism with risk of preeclampsia.
DESIGN: Circulating maternal 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone were measured at entry to care (mean ± SD: 13.7 ± 5.7 wk) using prospective data from a cohort of 1141 low-income and minority gravidae.
RESULTS: Secondary hyperparathyroidism occurred in 6.3% of the cohort and 18.4% of women whose 25(OH)D concentrations were <20 ng/mL.
Risk of preeclampsia was increased 2.86-fold (95% CI: 1.28-, 6.41-fold) early in gestation in these women.
Gravidae with 25(OH)D concentrations <20 ng/mL who did not also have high parathyroid hormone and women with high parathyroid hormone whose 25(OH)D concentrations were >20 ng/mL were not at increased risk. Intact parathyroid hormone was related to higher systolic and diastolic blood pressures and arterial pressure at week 20 before clinical recognition of preeclampsia. Energy-adjusted intakes of total calcium and lactose and circulating 25(OH)D were correlated inversely with systolic blood pressure or arterial pressure and with parathyroid hormone.
CONCLUSION: Some women who are vitamin D insufficient develop secondary hyperparathyroidism, which is associated with increased risk of preeclampsia.
See also VitaminDWiki
Pages listed in BOTH the categories Pregnancy and Hypertension (preeclampsia)
- Low Vitamin D is a top predictor of adverse events during pregnancy – Feb 2024
- Preeclampsia reduced by 33 percent if high vitamin D – meta-analysis Feb 2023
- Risk of preeclampsia should drop to nearly zero at 60 ng of Vitamin D – July 2022
- Hypertension during pregnancy: low Vitamin D, poor Vit. D genes – June 2022
- Low Vitamin D associated with preeclampsia - meta-analysis Feb 2022
- Low Vitamin D associated with pre-eclampsia -40th meta-analysis – Feb 2022
- Preeclampsia reduced by Vitamin D - many studies
- Preeclampsia (hypertension while pregnant) varies with season (O.R. 0.57) – June 2021
- Preeclampsia (low vitamin D) doubles the risk of later cardiovascular problems – Sept 2019
- Preeclampsia 11X more likely if poor Vitamin D Binding Protein (South Africa) - Sept 2019
- Preeclampsia 2X more likely if poor Vitamin D Receptor – April 2019
- Preeclampsia reduced 1.7 X by aspirin (but reduced 7 X by Vitamin D) – Feb 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Preeclampsia of offspring cut in half if mother who smoked had vitamin D fortified margarine – Dec 2017
- Preeclampsia reduced 2X by Vitamin D, by 5X if also add Calcium – meta-analysis Oct 2017
- Child 49 percent higher risk of being overweight if preeclampsia during pregnancy – Sept 2017
- Preeclampsia risk reduced 60 percent if supplement with Vitamin D (they ignored dose size) – meta-analysis Sept 2017
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Preeclampsia is not reduced by vitamin D (if you ignore vitamin D level, dose size, frequency and duration) – July 2017
- Preeclampsia doubles the risk of mild cognitive impairment – July 2017
- No Preeclampsia during pregnancy if more than 60 ng of vitamin D – RCT July 2013
- Preeclampsia changes to Vitamin D Binding Protein reduces Vitamin D in placenta – Dec 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Preeclampsia 4X less likely if vitamin D levels increased by 8 ng during pregnancy – March 2016
- Preeclampsia 2X more likely if low vitamin D, unless adjust for vitamin D factors (BMI, skin color) – Dec 2015
- Preeclampsia and eclampsia associated with lower vitamin D, etc. – Sept 2015
- Preeclampsia increased risk of Congenital Heart Defects by 60 percent (vitamin D not mentioned) Oct 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Burka clothing reduces vitamin D levels, which causes pregnancy problems – Oct 2015
- Preeclampsia – hypothesis as to why vitamin D helps – June 2015
- Preeclampsia inversely proportional to serum Magnesium – Oct 2014
- Hypertension in pregnancy (preeclampsia) more frequent in winter (low vitamin D) – Jan 2015
- Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
- Preeclampsia 40 percent less likely if mother had more than 20 ng of vitamin D – Jan 2014
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- During pregnancy even 400 IU helps metabolic status – RCT July 2013
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- 7X increase in early severe preeclampsia associated with low vitamin D – Aug 2012
- 200 IU of Vitamin D does not prevent preeclampsia – RCT Aug 2012
- Preeclampsia 3X more likely if low vitamin D at 25th week – April 2012
- Low vitamin D results in severe preeclampsia and low birth weight – Mar 2011
- Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
- Seasonal variation on preeclampsia is correlated with sunlight intensity - June 2010
See also web
- Vitamin D status in early pregnancy and risk of preeclampsia (E14-0363) Nov 2014
<12 ng vs > 20 ng 2.2X more likely. Canada