Gestational hypercalcemia: Prevalence and biochemical profile.

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Metabolic Disorders

Background:

• Gestational hypercalcemia poses risks to maternal and fetal health.
• Pregnancy can unmask or induce hypercalcemia due to altered calcium and vitamin D metabolism.
• The prevalence and underlying mechanisms of gestational hypercalcemia are not well understood.

Purpose of the Study:

• To investigate the prevalence of hypercalcemia in the third trimester of pregnancy.
• To explore potential alterations in calcium and vitamin D metabolism in hypercalcemic pregnant women.
• To identify the common causes of hypercalcemia during gestation.

Main Methods:

• Prospective cohort study of 1832 pregnant women in South-West Sweden.
• Measurement of serum calcium, phosphate, magnesium, albumin, creatinine, parathyroid hormone, and vitamin D metabolites in T1 and T3.
• Matching of 30 hypercalcemic cases with normocalcemic controls for comparative analysis.

Main Results:

• Hypercalcemia was identified in 1.7% of women in the third trimester.
• Hypercalcemic cases showed higher serum calcium in T1 and T3 compared to controls.
• Cases had lower parathyroid hormone levels in T3 but similar 1,25(OH)2D concentrations, suggesting abnormal gestational adaptations.

Conclusions:

• Common causes of hypercalcemia were excluded in most cases.
• The findings suggest abnormal gestational adaptations in vitamin D and calcium metabolism contribute to hypercalcemia.
• Further research is needed to fully elucidate the mechanisms of gestational hypercalcemia.