Lisa M Bodnar1, Hyagriv N Simhan, Janet M Catov, James M Roberts, Robert W Platt, Jill C Diesel, Mark A Klebanoff. 1. From the aDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; bDepartment of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA; cMagee-Womens Research Institute, Pittsburgh, PA; dDepartment of Pediatrics and Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; eCenter for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH; and fDepartment of Pediatrics, The Ohio State University College of Medicine, Columbus, OH.
Abstract
BACKGROUND: We sought to determine the association between maternal vitamin D status at ≤26 weeks' gestation and the risk of preeclampsia by clinical subtype. METHODS: We conducted a case-cohort study among women enrolled at 12 US sites from 1959 to 1966 in the Collaborative Perinatal Project. In serum collected at ≤26 weeks' gestation (median 20.9 weeks) from 717 women who later developed preeclampsia (560 mild and 157 severe cases) and from 2986 mothers without preeclampsia, we measured serum 25-hydroxyvitamin D, over 40 years later, using liquid chromatography-tandem mass spectrometry. RESULTS: Half of women in the subcohort had 25-hydroxyvitamin D (25(OH)D) >50 nmol/L. Maternal 25(OH)D 50 to 74.9 nmol/L was associated with a reduction in the absolute and relative risk of preeclampsia and mild preeclampsia compared with 25(OH)D <30 nmol/L in the crude analysis but not after adjustment for confounders, including race, prepregnancy body mass index, and parity. For severe preeclampsia, 25(OH)D ≥50 nmol/L was associated with a reduction in three cases per 1000 pregnancies (adjusted risk difference = -0.003 [95% confidence interval = -0.005 to 0.0002]) and a 40% reduction in risk (0.65 [0.43 to 0.98]) compared with 25(OH)D <50 nmol/L. Conclusions were unchanged (1) after restricting to women with 25(OH)D measured before 22 weeks' gestation or (2) with formal sensitivity analyses for unmeasured confounding. CONCLUSIONS: Maternal vitamin D deficiency may be a risk factor for severe preeclampsia but not for its mild subtypes. Contemporary cohorts with large numbers of severe preeclampsia cases would be needed to confirm or refute these findings.
BACKGROUND: We sought to determine the association between maternal vitamin D status at ≤26 weeks' gestation and the risk of preeclampsia by clinical subtype. METHODS: We conducted a case-cohort study among women enrolled at 12 US sites from 1959 to 1966 in the Collaborative Perinatal Project. In serum collected at ≤26 weeks' gestation (median 20.9 weeks) from 717 women who later developed preeclampsia (560 mild and 157 severe cases) and from 2986 mothers without preeclampsia, we measured serum 25-hydroxyvitamin D, over 40 years later, using liquid chromatography-tandem mass spectrometry. RESULTS: Half of women in the subcohort had 25-hydroxyvitamin D (25(OH)D) >50 nmol/L. Maternal 25(OH)D 50 to 74.9 nmol/L was associated with a reduction in the absolute and relative risk of preeclampsia and mild preeclampsia compared with 25(OH)D <30 nmol/L in the crude analysis but not after adjustment for confounders, including race, prepregnancy body mass index, and parity. For severe preeclampsia, 25(OH)D ≥50 nmol/L was associated with a reduction in three cases per 1000 pregnancies (adjusted risk difference = -0.003 [95% confidence interval = -0.005 to 0.0002]) and a 40% reduction in risk (0.65 [0.43 to 0.98]) compared with 25(OH)D <50 nmol/L. Conclusions were unchanged (1) after restricting to women with 25(OH)D measured before 22 weeks' gestation or (2) with formal sensitivity analyses for unmeasured confounding. CONCLUSIONS: Maternal vitamin D deficiency may be a risk factor for severe preeclampsia but not for its mild subtypes. Contemporary cohorts with large numbers of severe preeclampsia cases would be needed to confirm or refute these findings.
Authors: Alan Buchbinder; Baha M Sibai; Steve Caritis; Cora Macpherson; John Hauth; Marshall D Lindheimer; Mark Klebanoff; Peter Vandorsten; Mark Landon; Richard Paul; Menachem Miodovnik; Paul Meis; Gary Thurnau Journal: Am J Obstet Gynecol Date: 2002-01 Impact factor: 8.661
Authors: Carol L Wagner; Bruce W Hollis; Kalliopi Kotsa; Hana Fakhoury; Spyridon N Karras Journal: Rev Endocr Metab Disord Date: 2017-09 Impact factor: 6.514
Authors: Katharyn M Baca; Manika Govil; Joseph M Zmuda; Hyagriv N Simhan; Mary L Marazita; Lisa M Bodnar Journal: Eur J Obstet Gynecol Reprod Biol Date: 2017-11-16 Impact factor: 2.435
Authors: Rachel S Kelly; Damien C Croteau-Chonka; Amber Dahlin; Hooman Mirzakhani; Ann C Wu; Emily S Wan; Michael J McGeachie; Weiliang Qiu; Joanne E Sordillo; Amal Al-Garawi; Kathryn J Gray; Thomas F McElrath; Vincent J Carey; Clary B Clish; Augusto A Litonjua; Scott T Weiss; Jessica A Lasky-Su Journal: Metabolomics Date: 2016-12-12 Impact factor: 4.290
Authors: Madonna Achkar; Linda Dodds; Yves Giguère; Jean-Claude Forest; B Anthony Armson; Christy Woolcott; Sherry Agellon; Anne Spencer; Hope A Weiler Journal: Am J Obstet Gynecol Date: 2014-11-13 Impact factor: 8.661
Authors: C L Wagner; C Baggerly; S L McDonnell; L Baggerly; S A Hamilton; J Winkler; G Warner; C Rodriguez; J R Shary; P G Smith; B W Hollis Journal: J Steroid Biochem Mol Biol Date: 2014-11-13 Impact factor: 4.292