Vitamin D status and hypertensive disorders in pregnancy |
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| Institution: | 1. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA;2. Division of Newborn Medicine, Boston Children''s Hospital, MA;3. Harvard Medical School, Boston, MA;4. Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA;5. Division of Gastroenterology and Nutrition, Boston Children''s Hospital, MA;6. Channing Division of Network Medicine, Department of Medicine, Brigham and Women''s Hospital, Boston, MA;7. Division of Pulmonary and Critical Care, Brigham and Women''s Hospital, Boston, MA;8. Division of Women''s Health, Department of Medicine, Brigham and Women''s Hospital, Boston, MA;9. Department of Epidemiology, Harvard School of Public Health, Boston, MA;10. Department of Emergency Medicine, Massachusetts General Hospital, Boston;11. Department of Nutrition, Harvard School of Public Health, Boston, MA;1. Department of Neurology, Mount Sinai School of Medicine, New York, NY;2. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY;3. Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, FL;4. Department of Public Health Sciences and Human Genetics, Miller School of Medicine, University of Miami, FL;5. Department of Human Genetics, Miller School of Medicine, University of Miami, FL;6. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY;1. The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI;2. Kuakini Medical Center, Honolulu, HI;3. Research and Development Service, Veterans Affairs Pacific Islands Health Care System, Honolulu, HI;4. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Shiga, Japan;1. University of Wisconsin Carbone Cancer Center, Madison;2. Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison;3. Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD;4. Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison;5. Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH;6. Division of Cancer Prevention and Control, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL;7. Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA;1. HansChristian Andersen Children''s Hospital, Odense University Hospital, Odense, Denmark;2. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark;3. Experimental and Clinical Research Center, a joint cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and the Charité—Universitäsmedizin Berlin, Berlin, Germany;4. Department of Obstetrics, Charité—Universitätsmedizin Berlin, Berlin, Germany;5. Department of Gynecology, Charité—Universitätsmedizin Berlin, Berlin, Germany;6. Berlin Institute of Health, Berlin, Germany;7. Charité—Universitätsmedizin Berlin, Campus Berlin Buch, Berlin, Germany;8. Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark;9. Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark;10. Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark;11. Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany;12. Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany;13. Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark;14. Department of Cardiology and Nephrology, HELIOS Klinikum Berlin, Berlin, Germany;1. Centre for Women''s & Children''s Health and the School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK;2. Women, Children and Sexual Health Directorate, Walsall Hospitals NHS Trust, Walsall, WS2 9PS, UK;3. Centre for Endocrinology, Diabetes and Metabolism, and the School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, B15 2TT, UK;4. Fetal Medicine Centre, Birmingham Women''s NHS Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK |
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| Abstract: | PurposeSeveral studies have reported increased risk of preeclampsia when 25-hyrdoxyvitamin D (25OH]D) levels are low. The extent to which 25(OH)D may lower risk for hypertensive disorder during pregnancy remains unclear.MethodsAmong women enrolled in the Project Viva prenatal cohort in Massachusetts, we examined associations of 25(OH)D levels obtained at 16.4–36.9 weeks of gestation (mean 27.9 weeks) with hypertensive disorders of pregnancy, including preeclampsia (56/1591, 3.5%) and gestational hypertension (109/1591, 6.9%).ResultsWe did not detect an association between plasma 25(OH)D concentration (mean 58, standard deviation 22 nmol/L) and preeclampsia. For each 25 nmol/L increase in 25(OH)D, the adjusted odds ratio for preeclampsia was 1.14 (95% confidence interval, 0.77–1.67). By contrast and contrary to hypothesis, higher 25(OH)D concentrations were associated with higher odds of gestational hypertension: adjusted odds ratio for gestational hypertension was 1.32 (95% confidence interval, 1.01–1.72) per each 25 nmol/L increment in 25(OH)D. Vitamin D intake patterns suggest that this association was not because of reverse causation. Although the elevated hypertension risk may be due to chance, randomized trials of vitamin D supplementation during pregnancy should monitor for gestational hypertension.ConclusionsThese data do not support the hypothesis that higher 25(OH)D levels lower the overall risk of hypertensive disorders of pregnancy. |
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| Keywords: | Pregnancy Preeclampsia Hypertension Pregnancy-induced Vitamin D 25-Hydroxyvitamin D |
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