期刊
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
卷 124, 期 12, 页码 1874-1882出版社
WILEY
DOI: 10.1111/1471-0528.14372
关键词
High-risk; pre-eclampsia; preterm birth; vitamin D
资金
- NIH [R01 HD056999]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [HD27869, HD21410, HD40512, HD34136, HD34208, HD40485, HD27915, HD40544, HD40560, HD27917, HD40500, HD34116, HD40545, HD27860, HD36801]
- National Center for Research Resources [M01 RR00080, UL1 RR024989]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under BIRCWH [K12HD055882]
Objective To examine the relation between maternal vitamin D status and risk of pre-eclampsia and preterm birth in women at high risk for pre-eclampsia. Design Analysis of prospectively collected data and blood samples from a trial of prenatal low-dose aspirin. Setting Thirteen sites across the USA. Population Women at high risk for pre-eclampsia. Methods We measured 25-hydroxyvitamin D [25(OH)D] concentrations in stored maternal serum samples drawn at 12-26 weeks' gestation (n = 822). We used mixed effects models to examine the association between 25(OH)D and risk of pre-eclampsia and preterm birth, controlling for confounders including prepregnancy BMI and race. Main outcome measures Pre-eclampsia and preterm birth. Results Twelve percent of women were vitamin D deficient [25(OH)D <30 nmol/l]. Women with 25(OH)D <30 versus 75 nmol/l had a 2.4-fold (95% CI 1.0-5.6) higher risk of early-onset pre-eclampsia (<35 weeks' gestation) after confounder adjustment. Women with 25(OH)D <50 nmol/l had a 1.8-fold (95% CI 1.0-3.2) increased risk of preterm birth at <35 weeks compared with women who had 25(OH)D 75 nmol/l, which was driven by indicated preterm births at <35 weeks' gestation [25(OH)D <50 versus 75 nmol/l adjusted RR 2.5 (95% CI 1.1-5.8)]. There was no association between vitamin D status and pre-eclampsia or preterm birth at <37 weeks. Conclusion Maternal vitamin D status in the second trimester was inversely associated with risk of early-onset pre-eclampsia and preterm birth at <35 weeks in women at high risk for pre-eclampsia.
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