Heather H Burris1, Sheryl L Rifas-Shiman2, Susanna Y Huh3, Ken Kleinman4, Augusto A Litonjua5, Emily Oken6, Janet W Rich-Edwards7, Carlos A Camargo8, Matthew W Gillman9. 1. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA; Division of Newborn Medicine, Boston Children's Hospital, MA; Harvard Medical School, Boston, MA. Electronic address: heburris@bidmc.harvard.edu. 2. Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA. 3. Harvard Medical School, Boston, MA; Division of Gastroenterology and Nutrition, Boston Children's Hospital, MA. 4. Harvard Medical School, Boston, MA; Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA. 5. Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA. 6. Harvard Medical School, Boston, MA; Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA. 7. Harvard Medical School, Boston, MA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA. 8. Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Emergency Medicine, Massachusetts General Hospital, Boston. 9. Harvard Medical School, Boston, MA; Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA; Department of Nutrition, Harvard School of Public Health, Boston, MA.
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.
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.
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