Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial

Hashemipour, Sima; Ziaee, Amir; Javadi, Amir; Movahed, Farideh; Elmizadeh, Khadijeh; Javadi, Ezzatalsadat Haji Seid; Lalooha, Fatemeh

doi:10.1016/j.ejogrb.2013.10.010

Cited by 57 publications

(59 citation statements)

References 26 publications

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“…Additionally, we found that VitD supplementation had no effect on bodyweight in either dams or pups. Overall, the present results are consistent with previous studies in that VitD may reduce the incidence of PE and improve fetal growth without causing any known adverse effects to either mother or neonate …”

Section: Discussionsupporting

confidence: 92%

Vitamin D restores angiogenic balance and decreases tumor necrosis factor‐α in a rat model of pre‐eclampsia

Jing

2016

J of Obstet and Gynaecol

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Section: Discussionsupporting

confidence: 92%

Vitamin D restores angiogenic balance and decreases tumor necrosis factor‐α in a rat model of pre‐eclampsia

Jing

2016

J of Obstet and Gynaecol

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“…While PE has a complex etiology that at this time is not fully elucidated, immune mechanisms are suggested to play a significant role in the currently accepted two-stage theory of the pathogenesis of PE (54). VD is a safe supplement in pregnant women with no known adverse effects to either mother or neonate and may reduce the incidence of PE and improve fetal growth (23,24,28,55).…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been suggested that VD deficiency (Ͻ50 nmol/l) in both mid-term and late-term gestation is associated with PE in pregnant women (4,7,66). Importantly, VD supplementation has been shown to reduce incidences of PE and improve fetal growth in some clinical studies; however, there remains a need for large-scale, standardized clinical trials to confirm these findings (23,24,28). There is little experimental data investigating the role of VD in placental ischemia and the immunoregulatory effects of VD in rodent models of PE have not been fully evaluated.…”

mentioning

confidence: 99%

Vitamin D supplementation improves pathophysiology in a rat model of preeclampsia

Faulkner

Cornelius

Amaral

et al. 2016

American Journal of Physiology-Regulatory, Integrative and Comp

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Deficiency of vitamin D (VD) is associated with preeclampsia (PE), a hypertensive disorder of pregnancy characterized by proinflammatory immune activation. We sought to determine whether VD supplementation would reduce the pathophysiology and hypertension associated with the reduced uterine perfusion pressure (RUPP) rat model of PE. Normal pregnant (NP) and RUPP rats were supplemented with VD2 or VD3 (270 IU and 15 IU/day, respectively) on gestation days 14 -18 and mean arterial pressures (MAPs) measured on day 19. MAP increased in RUPP to 123 Ϯ 2 mmHg compared with 102 Ϯ 3 mmHg in NP and decreased to 113 Ϯ 3 mmHg with VD2 and 115 Ϯ 3 mmHg with VD3 in RUPP rats. Circulating CD4ϩ T cells increased in RUPP to 7.90 Ϯ 1.36% lymphocytes compared with 2.04 Ϯ 0.67% in NP but was lowered to 0.90 Ϯ 0.19% with VD2 and 4.26 Ϯ 1.55% with VD3 in RUPP rats. AT1-AA, measured by chronotropic assay, decreased from 19.5 Ϯ 0.4 bpm in RUPPs to 8.3 Ϯ 0.5 bpm with VD2 and to 15.4 Ϯ 0.7 bpm with VD3. Renal cortex endothelin-1 (ET-1) expression was increased in RUPP rats (11.6 Ϯ 2.1-fold change from NP) and decreased with both VD2 (3.3 Ϯ 1.1-fold) and VD3 (3.1 Ϯ 0.6-fold) supplementation in RUPP rats. Plasma-soluble FMS-like tyrosine kinase-1 (sFlt-1) was also reduced to 74.2 Ϯ 6.6 pg/ml in VD2-treated and 91.0 Ϯ 16.1 pg/ml in VD3-treated RUPP rats compared with 132.7 Ϯ 19.9 pg/ml in RUPP rats. VD treatment reduced CD4ϩ T cells, AT1-AA, ET-1, sFlt-1, and blood pressure in the RUPP rat model of PE and could be an avenue to improve treatment of hypertension in response to placental ischemia. hypertension; immune activation; preeclampsia; vitamin D PREECLAMPSIA (PE) IS A CLINICAL condition occurring in up to 7% of pregnancies in the United States commonly manifesting in late gestation (Ͼ20 wk gestation) with hypertension, placental ischemia, and low birth weight (5,27,47,48,58). Current treatment strategies for preeclampsia are targeted at safely lowering blood pressure and alleviating maternal complications (5, 48). PE pregnancies are characterized by an abnormal immune profile compared with that seen in normal pregnancies. PE women exhibit an altered immune balance favoring proinflammatory factors, such as CD4ϩ T cells, B cells, inflammatory cytokines, and autoantibodies to the angiotensin type 1 receptor (AT 1 -AA), which are known to stimulate production of antiangiogenic protein-soluble FMS-like tyrosine kinase-1 (sFlt-1) (18,33,34,56,57). In contrast, anti-inflammatory T regulatory cells (TREGs) are decreased in PE (22,53,56). These immune alterations are recapitulated in the established experimental model of PE, the reduced uterine perfusion pressure (RUPP) rat (1,20,21). Adoptive transfer of CD4ϩ T cells from RUPP rats induces hypertension, AT 1 -AA, inflammatory cytokines and sFlt-1, and endothelin-1 (ET-1) in normal pregnant rats, indicating the significant role these cells play in the pathogenesis of this disease (63). Furthermore, AT 1 -AA and sFlt-1 play a significant role in the development of endothelial dysfunction and hyp...

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“…A suplementação materna da VD, particularmente em mães com níveis iniciais de 25[OH]D superiores a 30 ng/mL, diminui asma / sibilância recorrente na prole ao longo dos 3 primeiros anos de vida, sugerindo que é necessário um maior nível de VD iniciado no início da gravidez para prevenção da recorrência dessas doenças no início da vida 75 , mesmo que haja estudos conflitantes ou sem conclusão estatística [76][77][78] . Vários estudos não encontraram evidências positivas da suplementação materna de VD para otimizar a massa óssea da prole 39,[79][80] , embora apresentem evidente melhora das medidas antropométricas 76,81 . Além disso, estudos indicam a associação da hipovitaminose D com distúrbios do espectro do autismo 82 e hipoplasia do esmalte (EH) dentário 83 .…”

Section: Doenças Futuras Na Criançaunclassified

Implicações maternas e fetais da hipovitaminose D no período gestacional: uma revisão de literatura

Querido¹,

Moraes²,

Venturoso³

et al. 2017

Rev Pat Tocantins

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A vitamina D (VD) é uma vitamina lipossolúvel com fundamental desempenho em diversas funções fisiológicas. Suas fontes são alimentação, suplementação ou síntese na pele em resposta à exposição à luz solar. As complicações da hipovitaminose D na gestação podem afetar a mãe e o lactente , sendo que em casos mais graves levam a osteomalácia materna e raquitismo infantil. As mulheres podem apresentar alterações no período gestacional, periparto e pós-parto. Já em crianças, as complicações tendem a ser mais graves e afetar suas vidas por tempo mais prolongado. O objetivo desta revisão é apresentar evidências atuais da associação da hipovitaminose D gestacional e os desfechos adversos maternos e fetais. Foi realizada uma pesquisa nas bases Science Direct, PubMed e Google Scholar para publicações de janeiro de 2013 a outubro de 2017 utilizando-se combinações de palavras-chave: “vitamin D deficiency”, “pregnancy” e “prenatal care”. Em mulheres gestantes a deficiência de VD tem sido associada a pré-eclâmpsia, diabetes mellitus gestacional, vaginose bacteriana, trabalho de parto prematuro e sintomas depressivos pós-parto. Na prole, pode levar a baixo peso ao nascer e recém-nascidos para a idade gestacional, hipocalcemia neonatal, raquitismo, diabetes tipo I, cárie dentária, comprometimento de linguagem, esclerose múltipla, distúrbios neurológicos, infecções de vias aéreas superiores e asma. Portanto, a suplementação de VD é útil para evitar resultados adversos na gravidez, mas pode não ser sempre necessária, especialmente quando as recomendações de estilo de vida são boas o suficiente para preveni-las. A fim de tomar a decisão adequada sobre a suplementação com VD, cada situação clínica individual deve ser analisada e colocada no equilíbrio correto de risco e benefício antes de prescrever a suplementação de VD. Palavras-chave: Vitamina D, Deficiência de Vitamina D, Gravidez. ABSTRACT Vitamin D (VD) is a fat soluble vitamin with fundamental performance in various physiological functions. Its sources are diet, supplementation or synthesis in the skin in response to exposure to sunlight. Complications of hypovitaminosis D during pregnancy can affect the mother and infant, and in more severe cases lead to maternal osteomalacia and childhood rickets. Women may present changes during the gestational, peripartum and postpartum period. In children, complications tend to be more severe and affect their lives for a longer time. The objective of this review is to present current evidence of the association of gestational hypovitaminosis D and adverse maternal and fetal outcomes. A search was made at the bases Science Direct, PubMed and Google Scholar for publications from January 2013 to October 2017 using combinations of keywords: "vitamin D deficiency", "pregnancy" and "prenatal care". In pregnant women, VD deficiency has been associated with pre-eclampsia, gestational diabetes mellitus, bacterial vaginosis, preterm labor, and postpartum depressive symptoms. In offspring, it can lead to low birth weight and small babies for gestational age, neonatal hypocalcemia, rickets, type I diabetes, dental caries, language impairment, multiple sclerosis, neurological disorders, upper respiratory infections and asthma. Therefore, VD supplementation is useful to avoid adverse pregnancy outcomes, but may not always be necessary, especially when lifestyle recommendations are good enough to prevent them. In order to make the proper decision on VD supplementation, each individual clinical situation must be analyzed and placed in the correct balance of risk and benefit before prescribing VD supplementation. Keywords: Vitamin D, Vitamin D Deficiency, Pregnancy.

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Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial

Cited by 57 publications

References 26 publications

Vitamin D restores angiogenic balance and decreases tumor necrosis factor‐α in a rat model of pre‐eclampsia

Vitamin D restores angiogenic balance and decreases tumor necrosis factor‐α in a rat model of pre‐eclampsia

Vitamin D supplementation improves pathophysiology in a rat model of preeclampsia

Implicações maternas e fetais da hipovitaminose D no período gestacional: uma revisão de literatura

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