Vitamin D and pre-eclampsia: original data, systematic review and meta-analysis

Elina Hyppönen, Alana Cavadino, David Williams, Abigail Fraser, Attila Vereczkey, William D Fraser, Ferenc Bánhidy, Deborah Lawlor, Andrew E Czeizel

Research output: Contribution to journalArticle (Academic Journal)peer-review

92 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Vitamin D may protect from pre-eclampsia through influences on immune modulation and vascular function. To evaluate the role of vitamin D in the development of pre-eclampsia, we conducted a systematic review and meta-analysis including novel data from 2 large-scale epidemiological studies.

METHODS: PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for prospective observational studies of association between vitamin D supplementation or status (measured by maternal 25-hydroxyvitamin D, 25(OH)D) with a subsequent risk of pre-eclampsia, or randomised controlled trials using vitamin D supplementation to prevent pre-eclampsia. The Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) and the Avon Longitudinal Study of Parents and Children (ALSPAC) were included in meta-analyses with published studies.

RESULTS: Mothers receiving vitamin D supplementation earlier in pregnancy had lower odds of pre-eclampsia [pooled odds ratios (OR) 0.81 and 95% confidence interval (CI) 0.75-0.87, p = 2.4 × 10(-8), 2 studies] in the meta-analysis of published studies with HCCSCA. The meta-analysis of published studies with ALSPAC suggested an association between higher serum 25(OH)D levels and a reduced risk of pre-eclampsia (pooled OR 0.52 and 95% CI 0.30-0.89, p = 0.02, 6 studies). Randomised trials of supplementation were suggestive of protective association (pooled OR 0.66 and 95% CI 0.52-0.83, p = 0.001, 4 studies).

CONCLUSIONS: This study suggests that low maternal serum 25(OH)D concentrations increase pre-eclampsia risk and that vitamin D supplementation lowers this risk. The quality of evidence is insufficient to determine a causal association, which highlights the need for adequately powered clinical trials.

Original languageEnglish
Pages (from-to)331-40
Number of pages10
JournalAnnals of Nutrition and Metabolism
Volume63
Issue number4
DOIs
Publication statusPublished - 2013

Keywords

  • Dietary Supplements
  • Female
  • Humans
  • Nutritional Status
  • Observational Study as Topic
  • Pre-Eclampsia
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Vitamin D

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