Is first trimester vitamin D status in nulliparous women associated with pregnancy related hypertensive disorders?. (March 2016)

• Record Type: Journal Article
• Authors: van Weert, Britte; van den Berg, Denice; Hrudey, E. Jessica; Oostvogels, Adriëtte J.J.M.; de Miranda, Esteriek; Vrijkotte, Tanja G.M.
• Is Part Of: Midwifery. Volume 34(2016)
• Page Start: 117
• Page End: 122
• Publication Date: 2016-03
• Subjects: Pregnancy-induced hypertension -- Pre-eclampsia -- 25-Hydroxyvitamin D -- Blood pressure -- Mid-pregnancy drop; Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2015.12.007
• Languages: English
• ISSNs: 0266-6138

Abstract

Abstract: Objectives: this study aimed to explore if maternal vitamin D status in early pregnancy was associated with pre-eclampsia and pregnancy-induced hypertension. Relationships between vitamin D status and blood pressure at the start of pregnancy as well as the occurrence of a mid-pregnancy drop in blood pressure were also explored. This secondary analysis was completed to investigate a possible mechanism for the association between vitamin D status and pregnancy related hypertensive disorders. Design and setting: data were obtained from the Amsterdam Born Children and their Development study, a prospective community-based cohort study based in Amsterdam, The Netherlands. Participants: a total of 2074 nulliparous women without pre-existing hypertension and with a known vitamin D status before 17 weeks gestation were included in the study. Vitamin D status was categorized into four groups: "normal" (≥50 nmol/L), "insufficient" (30–49.9 nmol/L) "deficient" (20–29.9 nmol/L) or "severely deficient" (<20 nmol/L). Measurements: logistic regression analysis was used to investigate if vitamin D status was related to the odds of experiencing pre-eclampsia or pregnancy-induced hypertension. Models were corrected for maternal age, ethnicity, pre-pregnancy BMI, smoking and socioeconomic status. χ 2 and ANOVA tests were used to investigate relationships between vitamin D status and the blood pressure parameters. Findings: when compared to women with a normal vitamin D status, women who were severely deficient had an increased risk for pre-eclampsia (OR 2.08; 95% CI, 1.05–4.13), but the association was rendered non-significant after correction (OR 1.88; 95% CI 0.79–4.48). There were no associations between vitamin D status and pregnancy-induced hypertension, starting blood pressure or the occurrence of a mid-pregnancy drop in blood pressure. Key conclusions: no strong evidence was found for an association between first trimester vitamin D status and pregnancy related hypertensive disorders in nulliparous women. Implications for practice: at this time, vitamin D supplementation is not warranted for the specific purpose of preventing pregnancy related hypertensive disorders. Highlights: large cohort study on vitamin D status and blood pressure related parameters during pregnancy. low vitamin D not related to risk of pregnancy related hypertensive disorders after correction. blood pressure risk factors for pregnancy related hypertensive disorders not related to vitamin D.