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Preeclampsia Rates are Elevated during Winter Month when Sunlight Dependent Vitamin D Production is reduced

Madhu Jain, Kapry S, Jain S, Singh SK and Singh TB

Aim: To assess maternal vitamin D deficiency in early pregnancy and risk of preeclampsia. Settings and Design: Nested case control study. Two maternal blood samples, one at <20 wks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=57) and control group (n=178) after abstracting past medical records at delivery.
Methods and material: Vitamin D was estimated by 25-Hydroxyvitamin D 125 I RIA Kit and categorized according to ACOG criteria. Statistical analysis used: Pearson χ2, ANOVA and logistic regression were used. Linear correlation and regression coefficient was used between maternal 25(OH) D at <20 wks and term and cord serum 25(OH) D levels.
Results: Serum 25(OH)D concentrations in early pregnancy were 56% significantly lower in women who subsequently developed preeclampsia compared with controls [mean, 9.79 ± 4.09 ng/ml , 95% CI, 8.71–10.88 ng/ml, vs 22.26 ± 15.28 ng/ml, 95%CI, 20.0 -24.52 ng/ml, P <0.001] independent of age, BMI, calcium intake, socioeconomic status, periconceptional multivitamin use, residence. There was 17 times increased risk of preeclampsia in vitamin D deficient mothers compared to controls at early pregnancy and at term. (P<0.001; rr = 17.93). Newborns of preeclampsia mothers were more than three times as likely as newborns of controls to have hypovitaminosis D (relative risk 3.55) Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is an independent risk factor for preeclampsia