Therapeutic significance of vitamin D and calcium in reducing the risk of preeclampsia
https://doi.org/10.17749/2313-7347.2019.13.2.103-110
Abstract
Aim: to study the possibility of reducing the incidence of preeclampsia (PE) by giving vitamin D and calcium (Ca) to pregnant women with a high PE risk starting from the second trimester of pregnancy.
Materials and methods. A total of 101 patients from the PE high risk group were examined on weeks 14–16 of pregnancy followed by treatment with vitamin D and Ca; then, the course of pregnancy and labor was analyzed. Serum 25-hydroxycholecalciferol, vitamin D binding protein, endothelin 1-38, and ionized Ca were determined using enzyme immunoassays.
Results. In the examined women at high risk of PE, severe serum deficiency of vitamin D and Ca was detected. In patients treated with vitamin D and Ca, a two-fold decrease in the incidence of PE, a three-fold decrease in the incidence of intrauterine growth retardation syndrome, and a decrease in the number of urgent surgery-assisted deliveries were found.
Conclusion. Therapy with vitamin D and Ca from the second trimester of pregnancy increases the availability of vitamin D, leads to a more favorable course of pregnancy, and prevents the development of severe forms and early onset of PE in patients at high risk.
About the Authors
E. N. VasilyevaRussian Federation
Elvira N. Vasilyeva – PhD, Associate Professor, Department of Obstetrics and Gynecology
L. I. Maltseva
Russian Federation
Larisa I. Maltseva – MD, PhD, Professor, Department of Obstetrics and Gynecology
T. G. Denisova
Russian Federation
Tamara G. Denisova – MD, PhD, Professor, Department of Obstetrics and Gynecology
Vice-Rector for Research and Informatics
L. I. Gerasimova
Russian Federation
Ludmila I. Gerasimova – MD, PhD, Professor, Head of Department of Public Health and Healthcare
References
1. Alpert P.T., Shaikh U. The effects of vitamin D deficiency and insufficiency on the endocrine and paracrine systems. Biol Res Nur. 2007;9(2):117–29. DOI: 10.1177/1099800407308057.
2. Holick M.F. Medical progress: vitamin D deficiency. New Engl J Med. 2007;357(3):266–81. DOI: 10.1056/NEJMra070553.
3. Heaney R.P. Vitamin D in health and disease. Clin J Am Soc Nephrol. 2008;3(5):1535–41. DOI: 10.2215/CJN.01160308.
4. Lanham-New S.A., Buttriss J.L., Miles L.M. et al. Proceedings of the rank forum on vitamin D. Br J Nutr. 2011;105(1):144–56. DOI: 10.1017/S0007114510002576.
5. Holmes V.A., Barnes M.S., Alexander H.D. et al. Vitamin D deficiency and insufficiency in pregnant women: A longitudinal study. Br J Nutr. 2009;102(6):876–81. DOI: 10.1017/S0007114509297236.
6. Lapillonne A. Vitamin D deficiency during pregnancy may impair maternal and fetal outcomes. Med Hypotheses. 2010;7(1):71–5. DOI: 10.1016/j.mehy.2009.07.054.
7. Liu N.Q., Kaplan A.T., Lagishetty V. et al. Vitamin D and the regulation of placental inflammation. J Immunol. 2011;186(10):5968–74. DOI: 10.4049/jimmunol.1003332.
8. Lewis S., Lucas R.M., Halliday J., Ponsonby A.L. Vitamin D deficiency and pregnancy: From preconception to birth. Mol Nutr Food Res. 2010;54(8):1092–102. DOI: 10.1002/mnfr.201000044.
9. Lucas R.M., Ponsonby A.L., Pasco J.A., Morley R. Future health implications of prenatal and early-life vitamin D status. Nutr Rev. 2008;66(12):710–20. DOI: 10.1111/j.1753-4887.2008.00126.x.
10. Yusupova Z.S., Novikova V.A., Olenev A.S. Current conceptions of preeclampsia – pathogenesis, diagnosis, prediction. [Sovremennye predstavleniya o preeklampsii – patogenez, diagnostika, prognozirovanie]. Prakticheskaya medicina. 2018;(6):45–51. (In Russ.).
11. Bodnar L.M., Catov J.M., Simhan H.N. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92(9):3517–22. DOI: 10.1210/jc.2007-0718.
12. Maltseva L.I., Vasilyeva E.N., Denisova T.G. Vitamin D and preeclampsia. [Vitamin D i preeklampsiya]. Rossijskij vestnik akushera-ginekologa. 2016;16(1):79–83. (In Russ.).
13. Denisova T. G., Vasilyeva E.N., Shamitova E.N., Assanskiy V.G. Provision of vitamin D in the patients with preeclampsia. [Obespechennost' vitaminom D pacientok s preeklampsiej]. Sovremennye problemy nauki i obrazovaniya. 2015;(3). (In Russ.). Available at: http://science-education.ru/ru/article/view?id=17323.
14. Pigarova E.A., Rozhinskaya L.Ya., Belaya Zh.E. et al. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. [Klinicheskie rekomendacii Rossijskoj associacii endokrinologov po diagnostike, lecheniyu i profilaktike deficita vitamina D u vzroslyh]. Problemy endokrinologii. 2016;62(4):60–84. (In Russ.).
15. Savelieva G.M., Krasnopolskiy V.I., Radzinskiy V.E. et al. What classification of gestosis (preeclampsia) must a physician adhere to in his/her daily work? [Kakoj klassifikacii gestozov (preeklampsii) dolzhen priderzhivat'sya vrach v povsednevnoj rabote?]. Zhurnal akusherstva i zhenskih boleznej. 2013;62(1):5–9. (In Russ.).
16. Pozdnyakov I.M., Yuklyaeva N.V., Gulyaeva L.F., Krasilnikov S.E. Invasion of trophoblast and its role in the pathogenesis of gestosis. [Invaziya trofoblasta i ee rol' v patogeneze gestoza]. Akusherstvo i ginekologiya. 2008;(6):3–6. (In Russ.).
17. Haugen M., Brantsaeter A.L., Trogstad L. et al. Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology. 2009;20(5):720–6.
18. Mirzakhani H., Litonjua A.A., McElrath T.F. et al. Early pregnancy vitamin D status and risk of preeclampsia. J Clin Invest. 2016;126(12):4702–15. DOI: 10.1172/JCI89031.
19. WHO. Guideline: Vitamin D supplementation in pregnant women. Geneva: World Health Organization, 2012. 32 р. Available at: https://apps.who.int/iris/bitstream/handle/10665/85313/ 9789241504935_eng.pdf.
20. Canadian Pediatric Society. Vitamin D supplementation: recommendations for Canadian mothers and infants. Pediatr Child Health. 2007;12(7):583–9.
21. Bishoff-Ferrari H.A. Vitamin D – role in pregnancy and early childhood. Ann Nutr Metab. 2011;59(1):17–21.
22. Yu C.K., Sykes L., Sethi M. et al. Vitamin D deficiency and supplement during pregnancy. Clin Endocrinol (Oxf). 2009;70(5):685–90. DOI: 10.1111/j.1365-2265.2008.03403.x.
Review
For citations:
Vasilyeva E.N., Maltseva L.I., Denisova T.G., Gerasimova L.I. Therapeutic significance of vitamin D and calcium in reducing the risk of preeclampsia. Obstetrics, Gynecology and Reproduction. 2019;13(2):103-110. https://doi.org/10.17749/2313-7347.2019.13.2.103-110

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