Almost 3X more likely to get preeclampsia if low vitamin D and high PTH– July 2013

Vitamin D, secondary hyperparathyroidism, and preeclampsia.

Am J Clin Nutr. 2013 Jul 24.
Scholl TO, Chen X, Stein TP.
Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, Stratford, NJ.

BACKGROUND:
Secondary hyperparathyroidism, which is defined by a high concentration of intact parathyroid hormone when circulating 25-hydroxyvitamin D [25(OH)D] is low, is a functional indicator of vitamin D insufficiency and a sign of impaired calcium metabolism. Two large randomized controlled trials examined effects of calcium supplementation on preeclampsia but did not consider the vitamin D status of mothers.

OBJECTIVE: We examined the association of secondary hyperparathyroidism to risk of preeclampsia.

DESIGN:
Circulating maternal 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone were measured at entry to care (mean ± SD: 13.7 ± 5.7 wk) using prospective data from a cohort of 1141 low income and minority gravidae.

RESULTS:
Secondary hyperparathyroidism occurred in 6.3% of the cohort and 18.4% of women whose 25(OH)D concentrations were <20 ng/mL. Risk of preeclampsia was increased 2.86-fold (95% CI: 1.28-, 6.41-fold) early in gestation in these women. Gravidae with 25(OH)D concentrations <20 ng/mL who did not also have high parathyroid hormone and women with high parathyroid hormone whose 25(OH)D concentrations were >20 ng/mL were not at increased risk. Intact parathyroid hormone was related to higher systolic and diastolic blood pressures and arterial pressure at week 20 before clinical recognition of preeclampsia. Energy-adjusted intakes of total calcium and lactose and circulating 25(OH)D were correlated inversely with systolic blood pressure or arterial pressure and with parathyroid hormone.Conclusion: Some women who are vitamin D insufficient develop secondary hyperparathyroidism, which is associated with increased risk of preeclampsia.

PMID: 23885046

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See also VitaminDWiki

• Risk of preeclampsia might be cut in half if take an amount of Vitamin D – meta-analysis Sept 2017
• Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
• 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
• Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
• Overview Pregnancy and vitamin D which has the following summary
  

  IU	Cumulative Benefit	Blood level	Cofactors	Calcium	$*/month
  200	Better bones for mom with 600 mg of Calcium	6 ng/ml increase	Not needed	No effect	$0.10
  400	Less Rickets (but not zero with 400 IU) 3X less adolescent Schizophrenia Fewer child seizures	20-30 ng/ml	Not needed	No effect	$0.20
  2000	2X More likely to get pregnant naturally/IVF 2X Fewer dental problems with pregnancy 8X less diabetes 4X fewer C-sections (>37 ng) 4X less preeclampsia (40 ng vs 10 ng) 5X less child asthma 2X fewer language problems age 5	42 ng/ml	Desirable	< 750 mg	$1
  4000	2X fewer pregnancy complications 2X fewer pre-term births	49 ng/ml	Should have cofactors	< 750 mg	$3
  6000	Probable: larger benefits for above items Just enough D for breastfed infant More maternal and infant weight		Should have cofactors	< 750 mg	$4