Effect of Calcium-vitamin D Supplementation on Metabolic Profiles in Pregnant Women at Risk for Pre-eclampsia: A Randomized Placebo-controlled Trial

Abstract

Increased metabolic profiles during pregnancy are associated with an increased risk of maternal and neonatal morbidity and remain a significant medical challenge. To our knowledge, no reports are available indicating the effects of calcium-vitamin D supplementation on metabolic profiles among pregnant women at risk for pre-eclampsia. This study was designed to determine the effects of consumption calcium-vitamin D supplements on metabolic profiles among Iranian pregnant women at risk for pre-eclampsia. This randomized single-blind controlled clinical trial was performed among 49 pregnant women at risk for pre-eclampsia, primigravida, aged 18-35 year old who were carrying singleton pregnancy at their third trimester. Subjects were randomly assigned to consume the placebo (n = 25) or calcium-vitamin D supplements (n = 24) for 9 weeks. Calcium-vitamin D supplements were containing 500 mg carbonate calcium plus 200 IU vitamin D3. Fasting blood samples were taken at baseline and after 9 week intervention to measures of Fasting Plasma Glucose (FPG) and serum lipid profiles. Consumption of calcium-vitamin D supplements resulted in decreased FPG and serum triglycerides levels as compared to the placebo (-9.1 vs. 0.5 mg dL(-1); p = 0.03, -11.7 vs. 49.9 mg dL(-1); p = 0.001, respectively). No significant differences were found comparing calcium-vitamin D supplements and the placebo in terms of their effect on serum total-, HDL-, LDL-cholesterol levels. Within-group differences in the placebo group revealed a significant increase in serum triglycerides levels (+49.9 mg dL(-1), p < 0.0001). In conclusion, consumption of calcium-vitamin D supplements for 9 weeks during pregnancy among pregnant women at risk for pre-eclampsia resulted in decreased FPG and serum triglycerides levels as compared to the placebo group, but could not affect serum total-, HDL-, LDL-cholesterol levels.

Vitamin D supplementation during pregnancy: Updated meta-analysis on maternal outcomes

“…Trials were conducted in Bangladesh [52], Brasil [19], China [34], France [18], [38], India [41], [39], [53], Iran [6], [5], [61], New Zealand [23], Russia [42] and the United Kingdom [10]. The seasons varied among studies with some trials occurring during the winter-spring period [18]; winter [38]; summer [69] or in different seasons [10], [19], [23], [53] but most did not report the season.…”

“…In all the studies women were recruited and received the supplements at 20 or more weeks of gestation. Pre-gestational body mass index was only reported in one trial and was used as a stratification criterion prior to the randomization [6], [5], [19], [53], [61]. Most trials did not specify the ethnicity or skin pigmentation of participants.…”

“…The vitamin D dose used varied considerably. The daily doses ranged from 200 IU [6], [19], [34], [42], [61]; 400 IU [5], [34]; 800 IU [69], 1000 IU [10], [18], [23], [38]; 1200 IU [41] to 2000 IU [23]. Among the trials using large single doses, the dose varied from 50,000 IU [5]; 200,000 IU [69]; 60,000–480,000 IU [53]; 600,000 IU [39] to 35,000 IU vitamin D per week [52].…”

“…There were six trials with 1688 women for this comparison [6], [19], [34], [41], [42], [61]. There were no studies reporting on maternal 25(OH)D levels.…”

“…There were no studies reporting on maternal 25(OH)D levels. The effects on pre-eclampsia were assessed in three trials [6], [41], [61] with 1114 women. Results showed that vitamin D supplementation significantly reduced the risk of preeclampsia in those receiving vitamin D and calcium supplementation combined compared to those on placebo/control groups (5% versus 9%; average risk ratio 0.51; 95% CI 0.32, 0.80).…”