Association of maternal serum 25-hydroxyvitamin D concentrations with risk of preeclampsia: a nested case-control study and meta-analysis

Abstract

Objectives

Whether the maternal vitamin D deficiency is associated with preeclampsia is still an argument. We aimed to assess the association between maternal serum 25-hydroxyvitamin D [25(OH)D] concentrations and risk of preeclampsia in a Chinese population and systematically evaluate published evidence on this association.

Methods

We conducted a nested case-control study involving 122 pregnant women with preeclampsia and 488 pregnant women whose blood pressure was within the normal range (as controls). For further meta-analysis, 20 studies and our study were included for the final pooled analysis, involving 39,031 participants and 3305 preeclampsia cases with various ethnicities.

Results

The results showed that 65.6% of women with preeclampsia had serum 25(OH)D concentrations <50.0 nmol L⁻¹ compared with 55.3% of women in controls. The 25(OH)D concentrations were significantly lower in women with preeclampsia than controls [Median (IQR), women with preeclampsia versus controls: 43.3 (35.5, 55.2) versus 47.5 (37.6, 60.4) nmol L⁻¹, p = .014]. For women with 25(OH)D concentrations <50.0 nmol L⁻¹, they had a 65% increase in preeclampsia risk (95% CI = 1.02–2.69), as compared with women with 25(OH)D concentrations from 50.0 to 74.9 nmol L⁻¹. Further, meta-analysis showed that low 25(OH)D concentrations were associated with a significantly increased risk of preeclampsia by 62% (pooled OR = 1.62, 95%CI = 1.36–1.94), and the risk effect of low 25(OH)D concentrations existed in most subgroups.

Conclusions

Low 25(OH)D concentration in pregnancy was significantly associated with preeclampsia risk, and it may serve as biomarkers for the surveillance of high-risk pregnant women.

Keywords:

• 25(OH)D
• meta-analysis
• preeclampsia
• risk
• vitamin D

Disclosure statement

No potential conflict of interest is reported by the authors.

Additional information

Funding

This work was supported in part by the National Natural Science Foundation of China, grant No. [81600685], the Natural Science Foundation of Jiangsu Province, grant No. [BK20160141], Nanjing Medical Science and Technique Development Foundation, grant Nos. [YKK16201, QRX17163], 333 High Level Talents Training Project of Jiangsu Province, Six Talent Peaks Project in Jiangsu Province, grant No. [WSN-121], Wuxi Establishment Site for Key Medical Disciplines, grant No. [ZDXK12], Wuxi Young Medical Talents, grant No. [QNRC094], Wuxi Maternal and Child Health Research Project, grant No. [FYKY201507], and Wuxi Hospital Management Center Key Project, grant No. [YGZXZ1513].