Alexandra Benachi1, Amandine Baptiste2, Joëlle Taieb3, Vassilis Tsatsaris4, Jean Guibourdenche5, Marie-Victoire Senat6, Hazar Haidar7, Jacques Jani8, Meriem Guizani8, Jean-Marie Jouannic9, Marie-Clotilde Haguet10, Norbert Winer11, Damien Masson12, Marie Courbebaisse13, Caroline Elie2, Jean-Claude Souberbielle14. 1. Department of Obstetrics and Gynecology, Antoine-Béclère Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud, Clamart, France; Fondation PremUp, Paris, France. Electronic address: alexandra.benachi@aphp.fr. 2. URC/CIC Paris Descartes Necker Cochin, Necker-Enfants Malades Hospital, AP-HP, Paris, France. 3. Department of Biochemistry, Antoine-Béclère Hospital, AP-HP, Université Paris-Sud, Clamart, France. 4. Fondation PremUp, Paris, France; Department of Obstetrics, Cochin Hospital, AP-HP, Université René Descartes, Paris, France. 5. Department of Hormonal Biochemistry, Cochin Hospital, AP-HP, Université René Descartes, Paris, France. 6. Department of Obstetrics and Gynecology, Bicêtre Hospital, AP-HP, Université Paris-Sud, Kremlin Bicêtre, France. 7. Department of Molecular Genetics, Pharmacogenetics and Hormonology, Bicêtre Hospital, AP-HP, Université Paris-Sud, Kremlin Bicêtre, France. 8. Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium. 9. Fetal Medicine Department, Armand Trousseau Hospital, UPMC-Sorbonne Université, Paris, France. 10. Department of Biochemistry, Armand Trousseau Hospital, UPMC-Sorbonne Université, Paris, France. 11. Department of Obstetrics and Gynecology, Nantes University Hospital, 44000, France. 12. Department of Biochemistry, Nantes University Hospital, Nantes, 44000, France. 13. Service de Physiologie-Explorations Fonctionnelles Rénales, Georges Pompidou European Hospital, AP-HP, Université Paris Descartes, INSERM U1151, Paris, France. 14. Laboratoire d'Explorations Fonctionnelles, Necker-Enfants Malades Hospital, AP-HP, Paris, France.
Abstract
BACKGROUND & AIMS: Vitamin D is thought to be involved in the pathogenesis of preeclampsia. To evaluate the relationship between vitamin D insufficiency in the first trimester of pregnancy and preeclampsia. METHODS: Nested case-control study (FEPED study) in type 3 obstetrical units. Pregnant women from 10 to 15 WA. For each patient with preeclampsia, 4 controls were selected from the cohort and matched by parity, skin color, maternal age, season and BMI. The main outcome measure was serum 25(OH)D status in the first trimester. RESULTS: 83 cases of preeclampsia were matched with 319 controls. Mean 25(OH)D levels in the first trimester were 20.1 ± 9.3 ng/mL in cases and 22.3 ± 11.1 ng/mL in controls (p = 0.09). The risk for preeclampsia with 25(OH)D level ≥30 ng/mL in the first trimester was decreased, but did not achieve statistical significance (OR, 0.57; 95% CI, 0.30-1.01; p = 0.09). High 25(OH)D during the 3rd trimester was associated with a significantly decreased risk of preeclampsia (OR, 0.43; 95%CI, 0.23-0.80; p = 0.008). When women with 25(OH)D levels <30 ng/mL both in the first and 3rd trimesters ("low-low") were taken as references, OR for preeclampsia was 0.59 (95% CI, 0.31-1.14; p = 0.12) for "low-high" or "high-low" women and 0.34 (95% CI, 0.13-0.86; p = 0.02) for "high-high" women. CONCLUSIONS: No significant association between preeclampsia and vitamin D insufficiency in the first trimester was evidenced. However, women with vitamin D sufficiency during the 3rd trimester and both in the first and 3rd trimesters had a significantly lower risk of preeclampsia.
BACKGROUND & AIMS:Vitamin D is thought to be involved in the pathogenesis of preeclampsia. To evaluate the relationship between vitamin Dinsufficiency in the first trimester of pregnancy and preeclampsia. METHODS: Nested case-control study (FEPED study) in type 3 obstetrical units. Pregnant women from 10 to 15 WA. For each patient with preeclampsia, 4 controls were selected from the cohort and matched by parity, skin color, maternal age, season and BMI. The main outcome measure was serum 25(OH)D status in the first trimester. RESULTS: 83 cases of preeclampsia were matched with 319 controls. Mean 25(OH)D levels in the first trimester were 20.1 ± 9.3 ng/mL in cases and 22.3 ± 11.1 ng/mL in controls (p = 0.09). The risk for preeclampsia with 25(OH)D level ≥30 ng/mL in the first trimester was decreased, but did not achieve statistical significance (OR, 0.57; 95% CI, 0.30-1.01; p = 0.09). High 25(OH)D during the 3rd trimester was associated with a significantly decreased risk of preeclampsia (OR, 0.43; 95%CI, 0.23-0.80; p = 0.008). When women with 25(OH)D levels <30 ng/mL both in the first and 3rd trimesters ("low-low") were taken as references, OR for preeclampsia was 0.59 (95% CI, 0.31-1.14; p = 0.12) for "low-high" or "high-low" women and 0.34 (95% CI, 0.13-0.86; p = 0.02) for "high-high" women. CONCLUSIONS: No significant association between preeclampsia and vitamin Dinsufficiency in the first trimester was evidenced. However, women with vitamin D sufficiency during the 3rd trimester and both in the first and 3rd trimesters had a significantly lower risk of preeclampsia.
Authors: Mai-Lei Woo Kinshella; Shazmeen Omar; Kerri Scherbinsky; Marianne Vidler; Laura A Magee; Peter von Dadelszen; Sophie E Moore; Rajavel Elango Journal: Reprod Health Date: 2022-09-05 Impact factor: 3.355