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
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 Calcium6 ng/ml increase Not needed No effect $0.10 400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures20-30 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 542 ng/ml Desirable < 750 mg $1 4000 2X fewer pregnancy complications
2X fewer pre-term births49 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 weightShould have
cofactors< 750 mg $4