Vitamin D status and hypertensive disorders in pregnancy

Ann Epidemiol. 2014 May;24(5):399-403.e1. doi: 10.1016/j.annepidem.2014.02.001. Epub 2014 Feb 15.

Abstract

Purpose: Several studies have reported increased risk of preeclampsia when 25-hyrdoxyvitamin D (25[OH]D) levels are low. The extent to which 25(OH)D may lower risk for hypertensive disorder during pregnancy remains unclear.

Methods: Among women enrolled in the Project Viva prenatal cohort in Massachusetts, we examined associations of 25(OH)D levels obtained at 16.4-36.9 weeks of gestation (mean 27.9 weeks) with hypertensive disorders of pregnancy, including preeclampsia (56/1591, 3.5%) and gestational hypertension (109/1591, 6.9%).

Results: We did not detect an association between plasma 25(OH)D concentration (mean 58, standard deviation 22 nmol/L) and preeclampsia. For each 25 nmol/L increase in 25(OH)D, the adjusted odds ratio for preeclampsia was 1.14 (95% confidence interval, 0.77-1.67). By contrast and contrary to hypothesis, higher 25(OH)D concentrations were associated with higher odds of gestational hypertension: adjusted odds ratio for gestational hypertension was 1.32 (95% confidence interval, 1.01-1.72) per each 25 nmol/L increment in 25(OH)D. Vitamin D intake patterns suggest that this association was not because of reverse causation. Although the elevated hypertension risk may be due to chance, randomized trials of vitamin D supplementation during pregnancy should monitor for gestational hypertension.

Conclusions: These data do not support the hypothesis that higher 25(OH)D levels lower the overall risk of hypertensive disorders of pregnancy.

Keywords: 25-Hydroxyvitamin D; Hypertension; Preeclampsia; Pregnancy; Pregnancy-induced; Vitamin D.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / blood
  • Hypertension, Pregnancy-Induced / etiology*
  • Hypertension, Pregnancy-Induced / prevention & control
  • Logistic Models
  • Pregnancy
  • Pregnancy Trimester, Second / blood
  • Pregnancy Trimester, Third / blood
  • Prospective Studies
  • Risk Factors
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / diagnosis

Substances

  • Biomarkers
  • Vitamin D
  • 25-hydroxyvitamin D