Association of Maternal Serum Vitamin D Level with Hydatidiform Mole-A Systemic Review

Abstract

Hydatidiform mole is an abnormal type of pregnancy, in which a potentially anomalous ovum is abnormally fertilized resulting in a subsequently non-viable conceptus becoming an enlarged growth in the uterus with dangerous complications. These moles can occur as either complete or partial, each with its own unique features. Like other risk factor, nutritional risk factors are associated with increased likelihood of development of HM. Low dietary intake of carotene, inadequate protein and animal fats are thought to be associated with increased risk of HM. Vitamin D is a steroid hormone with receptors found throughout the body including ovary, uterus, and placenta and has natural immunomodulator with anti-inflammatory properties. At the ovarian level, vitamin D has been shown to enhance ovulation. In the human syncytiotrophoblast, vitamin D and its components act together to enhance the expressions of human chorionic gonadotropin (hCG), human placental lactogen, estrogen and progesterone. Furthermore, vitamin D co-regulates cell proliferation, differentiation and apoptosis in numerous tissues and 1,25(OH)2D3 also inhibits angiogenesis and metastasis. Deficiency of vitamin D may lead to increased ROS and decreased antioxidative defense systems that could lead to oxidative injury in patients with HM. In the human syncytiotrophoblast, vitamin D and its components act together to enhance the expressions of human chorionic gonadotropin (hCG), human placental lactogen, estrogen and progesterone. Furthermore, vitamin D co-regulates cell proliferation, differentiation and apoptosis in numerous tissues and 1,25(OH)2D3 also inhibits angiogenesis and metastasis. Deficiency of vitamin D may lead to increased ROS and decreased antioxidative defense systems that could lead to oxidative injury in patients with HM. Studies showed there is significant association of low vitamin D level and obstetric complications like early pregnancy loss, premature rupture of membrane, fetal growth restriction and also many extra-skeletal diseases like ovary and colon cancer. In developing countries like-Bangladesh, vitamin D deficiency is much more common and starting in early life and persisting across the life span due to limited exposure to sunlight and low consumption of animal sources food. Therefore, this study was intended to determine the association of vitamin D and hydatidiform mole in a Bangladeshi woman, which may help in deciding about vitamin D supplementation as a preventive measure of hydatidiform mole.