Association of Gestational Vitamin E Status With Pre-eclampsia: A Retrospective, Multicenter Cohort Study

Shi, Hui; Jiang, Yuanhui; Yuan, Pengbo; Chen, Lian; Gong, Xiaoli; Yang, Yong; Wang, Yuanyuan; Jiang, Hai; Li, You; Sun, Mengxing; Zhao, Yangyu; Yuan, Wei

doi:10.3389/fnut.2022.911337

Cited by 5 publications

(7 citation statements)

References 39 publications

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“…Third-trimester serum vitamin E was significantly lower among women with pre-eclampsia (SMD − 0·42, 95% CI (−0·72, −0·13), 3398 participants, thirty-four studies, I 2 93 %) ( 34 ) . A recent large multicentre Chinese cohort study with 73 317 women found that low first-trimester serum vitamin E < 7·3 mg/l was also associated with higher risk of developing pre-eclampsia ( 74 ) . Moderate certainty of evidence resulted from the inclusion of some low-quality studies and potential publication bias.…”

Section: Resultsmentioning

confidence: 99%

“…Third-trimester serum vitamin E was significantly lower among women with pre-eclampsia (SMD -0.42, 95% CI: -0.72 to -0.13, 3,398 participants, 34 studies, I 2 93 %) (37). A recent large multicentre Chinese cohort study with 73,317 women found that low first trimester serum vitamin E <7.3mg/L was also associated with higher risk of developing pre-eclampsia (77).…”

Section: Probable Associationsmentioning

confidence: 99%

“…With growing understanding that increasing nutritional levels may only be effective in preeclampsia prevention when baseline levels are low (54,77), there is a need for future reviews to describe differences between HICs and LMICs more explicitly and future research in resourcelimited settings to further tease out the impact of underlying risk factors.…”

Section: Comparisons With Existing Literature and Implications For Pr...mentioning

confidence: 99%

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An evidence review and nutritional conceptual framework for pre-eclampsia prevention

et al. 2022

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Pre-eclampsia is a serious complication of pregnancy, and maternal nutritional factors may play protective roles or exacerbate risk. The tendency to focus on single nutrients as a risk factor obscures the complexity of possible interactions, which may be important given the complex nature of pre-eclampsia. An evidence review was conducted to compile definite, probable, possible and indirect nutritional determinants of pre-eclampsia to map a nutritional conceptual framework for pre-eclampsia prevention. Determinants of pre-eclampsia were first compiled through an initial consultation with experts. Secondly, an expanded literature review was conducted to confirm associations, elicit additional indicators and evaluate evidence. The strength of association was evaluated as definite RR<0.40 or ≥3.00, probable RR 0.40-0.69 or 1.50-2.99, possible RR 0.70-0.89 or 1.10-1.49 or not discernible RR 0.90-1.09. The quality of evidence was evaluated using GRADE. Twenty-five nutritional factors were reported in two umbrella reviews and 22 meta-analyses. Of these, 14 were significantly associated with pre-eclampsia incidence. Maternal vitamin D deficiency and higher serum iron emerged as definite nutritional risk factors for pre-eclampsia incidence across populations, while low serum zinc was a risk factor in Asia and Africa. Calcium and/or vitamin D supplementation were probable protective nutritional factors. Healthy maternal dietary patterns were possibly associated with lower risk of developing pre-eclampsia. Potential indirect pathways of maternal nutritional factors and pre-eclampsia may exist through obesity, maternal anaemia and gestational diabetes mellitus. Research gaps remain on the influence of household capacities and sociocultural, economic and political contexts, as well as interactions with medical conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Probable Associationsmentioning

confidence: 99%

Section: Comparisons With Existing Literature and Implications For Pr...mentioning

confidence: 99%

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An evidence review and nutritional conceptual framework for pre-eclampsia prevention

et al. 2022

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“…Our study has practical clinical application value. We recommend keeping a VE level of higher than 7 mg/L in the first trimester and avoiding gestational VE decrease when the first-trimester VE level is less than 11 mg/L to prevent GDM and other pregnancy complications, such as preeclampsia [ 26 , 27 ]. However, we could not recommend all pregnant women to test VE in the first trimester when the cost-effectiveness evaluation was insufficient.…”

Section: Discussionmentioning

confidence: 99%

Gestational Vitamin E Status and Gestational Diabetes Mellitus: A Retrospective Cohort Study

et al. 2023

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Objectives: To examine the association between vitamin E (VE) status and gestational diabetes mellitus (GDM). Methods: A retrospective cohort study was conducted by using data of 52,791 women at 137 hospitals across 22 provinces of China. A fasting plasma glucose (FPG) level of ≥5.1 mmol/L between the 24th and 40th weeks of gestation was used as the criteria for the diagnosis of GDM. Mean FPG level and GDM rate were calculated within each combination of the first-trimester VE concentration categories and gestational change categories. The associations of the first-trimester VE concentrations and gestational VE change with FPG and GDM were examined by employing generalized additive models (GAMs). Results: 7162 (13.57%) cases were diagnosed with GDM. The GDM rate was 22.44%, 11.50%, 13.41%, 12.87%, 13.17%, 13.44%, 12.64%, and 14.24% among women with the first-trimester VE concentrations of <7.2, 7.2–7.9, 8.0–9.3, 9.4–11.0, 11.1–13.2, 13.3–15.8, 15.9–17.7, and 17.8–35.9 mg/L, respectively. The GDM rate was 15.96%, 13.10%, 13.64%, and 12.87% among women with gestational VE change of <0, 0–0.19, 0.20–0.29, ≥0.30 mg/L per week, respectively. Multivariable adjusted GAM analyses found that the first-trimester VE concentration was associated with the FPG levels and GDM risk in an L-shaped pattern; the FPG levels and GDM risk decreased sharply to a threshold (around 7 mg/L), and then were keep flat. Gestational VE decreases when the first-trimester VE level was less than 11 mg/L were related to increased FPG levels and GDM risk. Conclusions: Both low first-trimester VE levels and subsequent gestational VE decrease were related with increased risk of GDM. The findings suggest the necessity of having VE-rich foods and appropriate VE supplementation to prevent GDM for pregnant women with low baseline VE levels.

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“…A recently conducted review showed that dietary VE or retinoic acid can protect women with low-risk pregnancies against developing PE (25). A previous retrospective study of 73,317 participants and 1,671 cases of PE found a positive correlation between a reduced serum VE concentration (<7.3 mg/L) and PE (26). However, that study only included cases of PE reported during the first trimester.…”

Section: Introductionmentioning

confidence: 99%

Dietary intake and serum concentrations of vitamin A and vitamin E and pre-eclampsia risk in Chinese pregnant women: A matched case-control study

Liu

Huang

et al. 2023

Front. Nutr.

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BackgroundMany studies have suggested that the serum concentrations of vitamin A (VA) and vitamin E (VE) influence preeclampsia (PE) risk in pregnant women. However, few studies have assessed whether dietary intake and serum concentrations of VA and VE are correlated with PE risk.MethodsA 1:1 matched case-control study was conducted to explore the association between the dietary intake and serum concentrations of VA and VE and the risk of PE in pregnant Chinese women. A total of 440 pregnant women with PE and 440 control pregnant women were included in the study. Dietary information was obtained using a 78-item semi-quantitative food frequency questionnaire. Serum concentrations of VA and VE were measured by liquid chromatography-tandem mass spectrometry.ResultsCompared with the lowest quartile, the multivariate-adjusted odds ratios [95% confidence interval (CI)] of the highest quartiles were 0.62 (95% CI: 0.40-0.96, P trend = 0.02) for VA, 0.51 (95% CI: 0.33–0.80, P trend =0.002) for β-carotene, and 0.70 (95% CI: 0.45–1.08, P trend = 0.029) for retinol. Additionally, for serum VA and VE concentrations, the multivariate-adjusted odds ratios (95% CI) were 2.75 (95% CI: 1.24–6.13, P trend = 0.002) and 11.97 (95% CI: 4.01–35.77, P trend < 0.001), respectively. No significant association was seen between VE intake and PE risk.ConclusionsDietary VA intake was negatively correlated with PE risk, and serum VA and VE concentrations were positively correlated with PE risk among pregnant Chinese women.

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Association of Gestational Vitamin E Status With Pre-eclampsia: A Retrospective, Multicenter Cohort Study

Cited by 5 publications

References 39 publications

An evidence review and nutritional conceptual framework for pre-eclampsia prevention

An evidence review and nutritional conceptual framework for pre-eclampsia prevention

Gestational Vitamin E Status and Gestational Diabetes Mellitus: A Retrospective Cohort Study

Dietary intake and serum concentrations of vitamin A and vitamin E and pre-eclampsia risk in Chinese pregnant women: A matched case-control study

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