Serum Calcium and 25-Hydroxy Vitamin D Level in Normal and Early Onset Pre-eclamptic Pregnant Women: A Study from Indonesia

Abstract

Introduction: Pre-eclampsia is one of the most common causes of fetomaternal morbidity and mortality worldwide. This disorder is categorised into Early Onset Pre-eclampsia (EOPE) and Late-Onset Pre-eclampsia (LOPE). EOPE is usually accompanied by severe complications for both the mother and fetus, while LOPE is accompanied by relatively mild fetomaternal complications. Although the pathogenesis of EOPE is not yet fully elucidated, recent studies indicate that serum calcium and 25 Hydroxy Vitamin D (25(OH)D) levels may play a role in its pathogenesis. Aim: To find out the relationship of calcium and 25(OH)D serum levels in pregnant women with normal pregnancy and with EOPE in Indonesia. Materials and Methods: This study was a case-control study, conducted in Dr. Soetomo General Hospital from July to October 2017. A total of 36 women with EOPE and 64 women with normal pregnancy were included in this study. Inclusion criteria were pregnant women in 2nd or 3rd-trimester with BMI > 18 kg/m(2). Blood sample analysis was done to measure serum calcium and 25(OH)D level. Data were expressed as Mean +/- Standard Deviation. Data distribution was analysed using Shappiro-Wilk test. Comparison of serum calcium and 25(OH)D level between groups was analysed using Independent t-test. Correlation between serum calcium and 25(OH)D level was analysed using Pearson's correlation test. The p-value of Results: There was a significant difference in serum calcium level between case and control group (8.294 +/- 0.725 vs 8.670 +/- 0.405 mg/dL; p=0.006). In 25(OH)D level, there was no difference between both groups (16.128 +/- 7.5463 vs 17.325 +/- 6.4992 ng/mL; p=0.406). No correlation was found between calcium and 25(OH)D level (r=0.165; p=0.101). Conclusion: Calcium deficiency plays a role in the incidence of EOPE among pregnant women in Indonesia. The actual role of calcium deficiency in EOPE needs further investigation.