819: Maternal vitamin d deficiency and the risk of preeclampsia

Abstract

Vitamin D deficiency has been associated with several systemic conditions and adverse perinatal outcomes. Our objective was to determine whether low maternal serum 25-hydroxyvitamin D 25(OH)D levels prior to 16 weeks’ gestation are associated with development of preeclampsia. This was a secondary analysis of the NICHD and the W.K. Kellogg Foundation-sponsored randomized controlled trials of vitamin D supplementation to women with singleton gestations who delivered at our institution between 2004-2009 and 2013-2015, respectively. Women with pre-existent calcium or parathyroid disorders, uncontrolled thyroid disease, and cardiac conditions on diuretics or calcium channel blockers were excluded from the study. Maternal 25(OH)D serum levels prior to 16 weeks’ gestation were compared between women who subsequently developed preeclampsia and those who remained healthy. Multivariable regression analysis was conducted to adjust for potential confounders. Level of significance was defined as P < 0.05. Of the 555 women enrolled, 26 (4.68%) patients were diagnosed with preeclampsia and 529 (95.32%) remained healthy. Race/ethnicity did not vary significantly among the groups. Maternal 25(OH)D serum level (mean standard deviation (SD)) prior to 16 weeks’ gestation was significantly lower in the preeclamptic than in the non-preeclamptic group (19.28 +/- 7.66 versus 24.73 +/- 9.52; P=0.0042; Figure 1). The difference remained significant after adjusting for prepregnancy maternal weight, chronic hypertension, pregestational diabetes, and timing of 25(OH)D testing (P=0.02). In this study, decreased levels of maternal vitamin D during early gestation were significantly associated with the subsequent development of preeclampsia. The potential beneficial effect of prepregnancy and early first trimester vitamin D supplementation to reduce preeclampsia should be investigated.