Comparison of Serum Vitamin D Levels in Patients with Severe Preeclampsia and Normal Pregnancy at Dr. Zainoel Abidin Regional General Hospital Banda Aceh

Cut Meurah  Yeni; Dara Meutia  Ayu; Tgk Puspa Dewi; Hasanuddin Hasanuddin; Hilwah  Nora

doi:10.3889/oamjms.2023.10885

Authors

Cut Meurah Yeni Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia https://orcid.org/0000-0002-6010-9791
Dara Meutia Ayu Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia https://orcid.org/0000-0002-6010-9791
Tgk Puspa Dewi Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia
Hasanuddin Hasanuddin Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia
Hilwah Nora Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia https://orcid.org/0000-0002-7635-4265

DOI:

https://doi.org/10.3889/oamjms.2023.10885

Keywords:

Pregnancy, Severe preeclampsia, vitamin D

Abstract

AIM: This study aims to assess differences in the mean maternal Vitamin D levels between severe preeclampsia (SPE) and normal pregnant women at the Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia.

METHODS: This research was a case–control study conducted at the Dr. Zainoel Abidin Regional General Hospital Banda Aceh. Pregnant women with confirmed SPE and normal pregnancies were involved in the study. The level of 25(OH)D3 was assessed by taking serum samples and examined by the enzyme immunoassay method. The Mann–Whitney U test analysis was conducted for bivariate analysis with a 95% confidence level.

RESULTS: A total of 82 participants were involved in this study, with 41 subjects in the case group and 41 patients in the control group. A total of 30 SPE patients (70.3%) showed moderate Vitamin D deficiency. The mean levels of 25(OH)D3 in the SPE and normal pregnancy groups, respectively, were 14.43 ng/mL and 27.94 ng/mL (p < 0.001). Based on the 20 ng/mL cutoff point, the difference in 25(OH)D3 levels between the two groups showed an odd ratio (OR) of 15.05.

CONCLUSION: Serum Vitamin D levels in SPE patients were two times lower than in the normal group. Evaluation of serum Vitamin D levels needs to be carried out periodically during pregnancy as a screening and diagnostic effort to prevent the potential development of SPE.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Logan VF, Gray AR, Peddie MC, Harper MJ, Houghton LA. Long-term Vitamin D3 supplementation is more effective than

Vitamin D2 in maintaining serum 25-hydroxyvitamin D status over the winter months. Br J Nutr. 2013;109(6):1082-8. https://doi.org/10.1017/S0007114512002851 PMid:23168298 DOI: https://doi.org/10.1017/S0007114512002851

Palacios C, Kostiuk LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019;7(7):CD008873. https://doi.org/10.1002/14651858.CD008873.pub4 PMid:31348529 DOI: https://doi.org/10.1002/14651858.CD008873.pub4

Palacios C, Gonzalez L. Is Vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014;144 Pt A:138-45. https://doi.org/10.1016/j.jsbmb.2013.11.003 PMid:24239505 DOI: https://doi.org/10.1016/j.jsbmb.2013.11.003

Lankes U, Elder PA, Lewis JG, George P. Differential extraction of endogenous and exogenous 25-OH-Vitamin D from serum makes the accurate quantification in liquid chromatography-tandem mass spectrometry assays challenging. Ann Clin Biochem. 2014;52(Pt 1):151-60. https://doi.org/10.1177/0004563214533316 PMid:24714680 DOI: https://doi.org/10.1177/0004563214533316

Salle BL, Delvin EE, Lapillonne A, Bishop NJ, Glorieux FH. Perinatal metabolism of Vitamin D. Am J Clin Nutr. 2000;71(5 Suppl):1317S-24S. https://doi.org/10.1093/ajcn/71.5.1317s PMid:10799409 DOI: https://doi.org/10.1093/ajcn/71.5.1317s

Leffelaar ER, Vrijkotte TG, van Eijsden M. Maternal early pregnancy Vitamin D status in relation to fetal and neonatal growth: Results of the multi-ethnic Amsterdam born children and their development cohort. Br J Nutr. 2010;104(1):108-17. https://doi.org/10.1017/S000711451000022X PMid:20193097 DOI: https://doi.org/10.1017/S000711451000022X

Wei SQ. Vitamin D and pregnancy outcomes. Current Opin Obstet Gynecol. 2014;26(6):438-47. https://doi.org/10.1097/GCO.0000000000000117 PMid:25310531 DOI: https://doi.org/10.1097/GCO.0000000000000117

Weinert LS, Silveiro SP. Maternal-fetal impact of Vitamin D deficiency: A critical review. Matern Child Health J. 2015;19(1):94-101. https://doi.org/10.1007/s10995-014-1499-7 PMid:24748216 DOI: https://doi.org/10.1007/s10995-014-1499-7

Ross AC, Taylor CL, Yaktine AL, Del Valle HB. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. Vol. 10. Washington, DC: National Academies Press; 2011. p. 13050. https://doi.org/10.17226/13050 PMid:21796828 DOI: https://doi.org/10.17226/13050

Van Schoor NM, Lips P. Worldwide Vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011;25(4):671-80. https://doi.org/10.1016/j.beem.2011.06.007 PMid:21872807 DOI: https://doi.org/10.1016/j.beem.2011.06.007

Singla R, Gurung P, Aggarwal N, Dutta U, Kochhar R. Relationship between preeclampsia and Vitamin D deficiency: A case control study. Arch Gynecol Obstet. 2015;291(6):1247-51. https://doi.org/10.1007/s00404-014-3550-8 PMid:25476065 DOI: https://doi.org/10.1007/s00404-014-3550-8

Xu L, Lee M, Jeyabalan A, Roberts JM. The relationship of hypovitaminosis D and IL-6 in preeclampsia. Am J Obstet Gynecol. 2014;210(2):149.e1-7. https://doi.org/10.1016/j.ajog.2013.09.037 PMid:24080305 DOI: https://doi.org/10.1016/j.ajog.2013.09.037

Møller UK, Streym S, Mosekilde L, Heickendorff L, Flyvbjerg A, Frystyk J, et al. Changes in calcitropic hormones, bone markers and insulin-like growth factor I (IGF-I) during pregnancy and postpartum: A controlled cohort study. Osteoporos Int. 2013;24(4):1307-20. https://doi.org/10.1007/s00198-012-2062-2 PMid:22855199 DOI: https://doi.org/10.1007/s00198-012-2062-2

Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. Am J Obstet Gynecol. 2010;203(4):366. e1-6. https://doi.org/10.1016/j.ajog.2010.06.036 PMid:20692641 DOI: https://doi.org/10.1016/j.ajog.2010.06.036

Tabesh M, Salehi-Abargouei A, Tabesh M, Esmaillzadeh A. Maternal Vitamin D status and risk of pre-eclampsia: A systematic review and meta-analysis. J Clin Endocrinol Metab. 2013;98(8):3165-73. https://doi.org/10.1210/jc.2013-1257 PMid:23783101 DOI: https://doi.org/10.1210/jc.2013-1257

Van der Pligt P, Willcox J, Szymlek-Gay EA, Murray E, Worsley A, Daly RM. Associations of maternal Vitamin D deficiency with pregnancy and neonatal complications in developing countries: A systematic review. Nutrients. 2018;10(5):640. https://doi.org/10.3390/nu10050640 PMid:29783717 DOI: https://doi.org/10.3390/nu10050640

Akbari S, Khodadadi B, Ahmadi SA, Abbaszadeh S, Shahsavar F. Association of Vitamin D level and Vitamin D deficiency with risk of preeclampsia: A systematic review and updated meta- analysis. Taiwan J Obstet Gynecol. 2018;57(2):241-7. https://doi.org/10.1016/j.tjog.2018.02.013 PMid:29673668 DOI: https://doi.org/10.1016/j.tjog.2018.02.013

Zhao X, Fang R, Yu R, Chen D, Zhao J, Xiao J. Maternal Vitamin D Status in the late second trimester and the risk of severe preeclampsia in Southeastern China. Nutrients. 2017;9(2):138. https://doi.org/10.3390/nu9020138 PMid:28216561 DOI: https://doi.org/10.3390/nu9020138

Kementrian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia 2020. Indonesia: Kementrian Kesehatan Republik Indonesia; 2021.

Silvestro D, Villette C, Delecolle J, Olsen CE, Motawia MS, Geoffroy P, et al. Vitamin D5 in Arabidopsis thaliana. Sci Rep. 2018;8(1):16348. https://doi.org/10.1038/s41598-018-34775-z PMid:30397227 DOI: https://doi.org/10.1038/s41598-018-34775-z

Yousefzadeh P, Shapses SA, Wang X. Vitamin D binding protein impact on 25-hydroxyvitamin D levels under different physiologic and pathologic conditions. Int J Endocrinol. 2014;2014:981581. https://doi.org/10.1155/2014/981581 PMid:24868205 DOI: https://doi.org/10.1155/2014/981581

Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, et al. Global prevalence and disease burden of Vitamin D deficiency: A roadmap for action in low-and middle- income countries. Ann N Y Acad Sci. 2018;1430(1):44-79. https://doi.org/10.1111/nyas.13968 PMid:30225965 DOI: https://doi.org/10.1111/nyas.13968

Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Berisha AT, et al. Vitamin D deficiency 2.0: An update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498-513. https://doi.org/10.1038/s41430-020-0558-y PMid:31959942 DOI: https://doi.org/10.1038/s41430-020-0558-y

Woo J, Giurgescu C, Wagner CL. Evidence of an association between Vitamin D deficiency and preterm birth and preeclampsia: A critical review. J Midwifery Womens Health. 2019;64(5):613-29. https://doi.org/10.1111/jmwh.13014 PMid:31411387 DOI: https://doi.org/10.1111/jmwh.13014

Aji AS, Erwinda E, Yusrawati Y, Malik SG, Lipoeto NI. Vitamin D deficiency status and its related risk factors during early pregnancy: A cross-sectional study of pregnant Minangkabau women, Indonesia. BMC Pregnancy Childbirth. 2019;19(1):183. https://doi.org/10.1186/s12884-019-2341-4 PMid:31117971 DOI: https://doi.org/10.1186/s12884-019-2341-4

Aji AS, Yerizel E, Lipoeto NI. The association between lifestyle and maternal Vitamin D during pregnancy in West Sumatra, Indonesia. Asia Pac J Clin Nutr. 2018;27(6):1286-93. https://doi.org/10.6133/apjcn.201811_27(6).0016 PMid:30485928

Judistiani RT, Nirmala SA, Rahmawati M, Ghrahani R, Natalia YA, Sugianli AK, et al. Optimizing ultraviolet B radiation exposure to prevent Vitamin D deficiency among pregnant women in the tropical zone: Report from cohort study on Vitamin D status and its impact during pregnancy in Indonesia. BMC Pregnancy Childbirth. 2019;19(1):209. https://doi.org/10.1186/s12884-019-2306-7 PMid:31226954 DOI: https://doi.org/10.1186/s12884-019-2306-7

Dhamayanti M, Noviandhari A, Supriadi S, Judistiani RT, Setiabudiawan B. Association of maternal Vitamin D deficiency and infants’ neurodevelopmental status: A cohort study on Vitamin D and its impact during pregnancy and childhood in Indonesia. J Paediatr Child Health. 2020;56:16-21. https://doi.org/10.1111/jpc.14481 PMid:31062441 DOI: https://doi.org/10.1111/jpc.14481

Yakub AS, Sain I, Saeni S. Study of correlation of age and parity of mothers with preeclampsia in pregnant women in the working area of Mangasa health center in Makassar city. Media Kesehatan Politeknik Kesehatan Makassar. 2019;14(2):163-71. https://doi.org/10.32382/medkes.v14i2.749 DOI: https://doi.org/10.32382/medkes.v14i2.749

Ghafarzadeh M, Shakarami A, Tarhani F, Yari F. Evaluation of the prevalence of Vitamin D deficiency in pregnant women and its correlation with neonatal Vitamin D levels. Clin Nutr Open Sci. 2021;36:91-7. https://doi.org/10.1016/j.nutos.2021.02.007 DOI: https://doi.org/10.1016/j.nutos.2021.02.007

Tessema GA, Tekeste A, Ayele TA. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: A hospital- based study. BMC Pregnancy Childbirth. 2015;15:73. https:// doi.org/10.1186/s12884-015-0502-7 PMid:25880924 DOI: https://doi.org/10.1186/s12884-015-0502-7

Shan D, Qiu PY, Wu YX, Chen Q, Li AL, Ramadoss S, et al. Pregnancy outcomes in women of advanced maternal age: A retrospective cohort study from China. Sci Rep. 2018;8:12239. https://doi.org/10.1038/s41598-018-29889-3 PMid:30115949 DOI: https://doi.org/10.1038/s41598-018-29889-3

Mithal A, Kalra S. Vitamin D supplementation in pregnancy. Indian J Endocrinol Metab. 2014;18(5):593-6. https://doi.org/10.4103/2230-8210.139204 PMid:25285272 DOI: https://doi.org/10.4103/2230-8210.139204

Dumais C, Lengkong RA, Mewengkang ME. Hubungan obesitas pada kehamilan dengan preeklampsia. e-CliniC. 2016;4(1). https://doi.org/10.35790/ecl.4.1.2016.11686 DOI: https://doi.org/10.35790/ecl.4.1.2016.11686

Arwan B, Sriyanti R. Relationship between gravida status, age, BMI (Body Mass Index) and preeclampsia. Andalas Obstet Gynecol J. 2020;4(1):13-21. DOI: https://doi.org/10.25077/aoj.4.1.13-21.2020

Grum T, Seifu A, Abay M, Angesom T, Tsegay L. Determinants of pre-eclampsia/eclampsia among women attending delivery services in selected public hospitals of Addis Ababa, Ethiopia: A case control study. BMC Pregnancy Childbirth. 2017;17(1):307. https://doi.org/10.1186/s12884-017-1507-1 PMid:28915802 DOI: https://doi.org/10.1186/s12884-017-1507-1

Vincent NT, Darmayasa IM, Suardika A. Risk factors of preeclampsia and eclampsia in Sanglah general hospital from March 2016 to March 2017. Intisari Sains Medis. 2018;9(2):131-6. DOI: https://doi.org/10.15562/ism.v9i2.162

Seifer DB, Lambert-Messerlian G, Palomaki GE, Silver RM, Parker C, Hogue CJ, et al. Preeclampsia at delivery is associated with lower serum Vitamin D and higher antiangiogenic factors: A case control study. Reprod Biol Endocrinol. 2022;20(1):8. https://doi.org/10.1186/s12958-021-00885-z PMid:34991614 DOI: https://doi.org/10.1186/s12958-021-00885-z

Schulz EV, Cruze L, Wei W, Gehris J, Wagner CL. Maternal Vitamin D sufficiency and reduced placental gene expression in angiogenic biomarkers related to comorbidities of pregnancy. J Steroid Biochem Mol Biol. 2017;173:273-9. https://doi.org/10.1016/j.jsbmb.2017.02.003 PMid:28216083 DOI: https://doi.org/10.1016/j.jsbmb.2017.02.003

Sahu M, Tripathy S, Bhuyan P. Association of maternal serum Vitamin D level with preeclampsia or eclampsia and its relationship with neonatal outcome and neonatal serum calcium level. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5580-7. https://doi.org/10.18203/2320-1770.ijrcog20175285 DOI: https://doi.org/10.18203/2320-1770.ijrcog20175285

Sasan SB, Zandvakili F, Soufizadeh N, Baybordi E. The effects of Vitamin D supplement on prevention of recurrence of preeclampsia in pregnant women with a history of preeclampsia. Obstet Gynecol Int. 2017;2017:8249264. https://doi.org/10.1155/2017/8249264 PMid:28912817 DOI: https://doi.org/10.1155/2017/8249264

Emini-Sadiku M, Morina-Kuqi N. Concealing clothing leading to severe Vitamin D deficiency, osteomalacia and muscle

weakness. Open Access Maced J Med Sci. 2019;7(13):2146-9. https://doi.org/10.3889/oamjms.2019.584 PMid:31456842 DOI: https://doi.org/10.3889/oamjms.2019.584

Purswani JM, Gala P, Dwarkanath P, Larkin HM, Kurpad A, Mehta S. The role of Vitamin D in pre-eclampsia: A systematic review. BMC Pregnancy Childbirth. 2017;17(1):231. https://doi.org/10.1186/s12884-017-1408-3 PMid:28709403 DOI: https://doi.org/10.1186/s12884-017-1408-3

Hutabarat M, Wibowo N, Obermayer-Pietsch B, Huppertz B. Impact of Vitamin D and Vitamin D receptor on the trophoblast survival capacity in preeclampsia. PLoS One. 2018;13(11):e0206725. https://doi.org/10.1371/journal.pone.0206725 PMid:30408071 DOI: https://doi.org/10.1371/journal.pone.0206725

Wibowo N, Irwinda R, Handoko Y. Vitamin D3 levels in the maternal serum, cord blood, and placenta of preeclamptic pregnant women. Med J Indones. 2020;29(2):149-53. https://doi.org/10.13181/mji.oa.202951 DOI: https://doi.org/10.13181/mji.oa.202951