Vitamin D and pre-eclampsia: original data, systematic review and meta-analysis

Area of Science:

• Obstetrics and Gynecology
• Nutritional Science
• Epidemiology

Background:

• Pre-eclampsia is a major cause of maternal and infant mortality.
• Vitamin D's potential roles in immune modulation and vascular function suggest a link to pre-eclampsia.
• Existing research on vitamin D and pre-eclampsia requires further synthesis and novel data integration.

Purpose of the Study:

• To systematically review and meta-analyze the association between vitamin D status and supplementation with pre-eclampsia risk.
• To incorporate novel data from two large-scale epidemiological studies (HCCSCA and ALSPAC) into the analysis.
• To evaluate the protective role of vitamin D in the development of pre-eclampsia.

Main Methods:

• A systematic literature search was conducted across PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials.
• Included studies were prospective observational studies and randomized controlled trials on vitamin D and pre-eclampsia.
• Meta-analyses combined published data with novel data from the HCCSCA and ALSPAC studies.

Main Results:

• Vitamin D supplementation in early pregnancy was associated with lower odds of pre-eclampsia (OR 0.81, 95% CI 0.75-0.87).
• Higher maternal serum 25-hydroxyvitamin D (25(OH)D) levels showed a reduced risk of pre-eclampsia (OR 0.52, 95% CI 0.30-0.89).
• Randomized trials of vitamin D supplementation suggested a protective association (OR 0.66, 95% CI 0.52-0.83).

Conclusions:

• Low maternal serum 25(OH)D concentrations are linked to an increased risk of pre-eclampsia.
• Vitamin D supplementation may reduce the risk of developing pre-eclampsia.
• Further adequately powered clinical trials are necessary to establish a definitive causal association.