Correlation between Serum Vitamin D levels and hypertensive disorders in pregnancy in primigravida in third trimester

Abstract

Background: Hypertension related to pregnancy is a common obstetric complication observed in 7-8% of the antenatal cases in India. Vitamin D is involved in the development of the placenta and feto-maternal wellbeing, thereby helping in prevention of obstetric complication like hypertension in pregnancy. It modulates various biochemical reactions in the body to prevent abnormal placentation preventing pregnancy related hypertension. Materials and methods: A cross sectional observational study was conducted on 120 antenatal women between April 2017 -March 2018 in Mahatma Gandhi Medical College and Research Institute. Based on blood pressure, primigravidas were classified as Mild (Group 1) and Severe (Group 2). Investigations for hypertensive disorders of pregnancy and serum Vitamin D were done. Serum Vitamin D levels were classified into deficiency, insufficiency (20-30ng/ml) and sufficiency (30-100ng/ml). Statistical analysis was done using SPSS-17. Results: In this study, among the primigravidas with hypertensive disorders of pregnancy 67.5% were Vitamin D deficient, 24.2% had insufficiency and 8.3% had sufficient serum Vitamin D levels. It was also observed that the serum Vitamin D levels were significantly low with an increase in the pre-pregnancy BMI (P value -0.002) and increase in blood pressure (P value -0.004). There was significant negative correlation seen between serum vitamin D and blood pressure as we moved from the mild to the severe hypertension group. Conclusion: With lower levels of serum vitamin D, more was the severity of hypertension in pregnancy. Obesity was also associated with severe vitamin D deficiency in the present study.

Association of Deficiency of Maternal Vitamin D Levels with Severity of Preeclampsia

“…15 Our study also demonstrated that though vitamin D deficiency was common in all antenatal patients but it was significantly more prevalent in preeclamptic women. This was comparable to the results were obtained by Rao et al (2018) who showed the women with preeclampsia with vitamin deficiency were 67.5 %, 17…”

“…The distribution of patients of preeclampsia with and without severe features in our study was similar to Baror S et al (2017), 16 Rao et al (2018), 17 Mehta S et al (2016) 18 and Arumaikannu J et al (2018) 19 55.55% subjects with preeclampsia with severe features and 21.6% controls were unbooked. It was statistically significant (p value<0.0001) indicating more patients with severe preeclampsia were unbooked than booked (55.55% and 44.44%).…”

“…None of the cases with severe preeclampsia had normal levels of Vitamin D which was statistically significant (p-value=0.046). This was comparable to studies by Rao et al (2018),17 Baror S et al (2017)16 and Mehta S et al (2016) 18. Ullah et al (2013)29 in his study concluded that the odds of developing preeclampsia and eclampsia increased upto 5 times in women with Vitamin D insufficiency.…”