Vitamin D status in mothers with pre-eclampsia and their infants: a case–control study from Serbia, a country without a vitamin D fortification policy

• Published in: Public health nutrition Vol. 20; no. 10; pp. 1825 - 1835
• Main Authors: Djekic-Ivankovic, Marija, Weiler, Hope, Jones, Glenville, Kaufmann, Martin, Kaludjerovic, Jovana, Aleksic-Velickovic, Vesna, Mandić, Ljuba M, Glibetic, Maria
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.07.2017
• Subjects: 25-Hydroxyvitamin D; Adult; Age; Babies; Birth weight; Blood pressure; Case studies; Case-Control Studies; Comorbidity; Cord blood; Dietary Supplements; Female; Food; Food fortification; Food, Fortified; Gestational age; Humans; Hypertension; Infant; Infants; Mothers - statistics & numerical data; Newborn babies; Nutrition; Nutrition Policy; Nutritional Epidemiology; Pre-eclampsia; Pre-Eclampsia - epidemiology; Preeclampsia; Pregnancy; Prenatal experience; Prevalence; Research Papers; Rope; Serbia - epidemiology; Studies; Variance analysis; Vitamin D; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - epidemiology; Vitamin deficiency; Womens health; Serbia; Pregnancy; Vitamin D status; Maternal and cord blood; C3-epi-25-hydroxycholecalciferol; LC–MS/MS; Pre-clampsia
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980016000409

The objective of the present study was to determine if vitamin D intake and status are associated with pre-eclampsia in a country without a vitamin D fortification policy. A case-control study of pregnancies with (case) and without (control) pre-eclampsia was conducted from January to April when UVB is minimal. Maternal and cord blood obtained at delivery were measured for plasma 25-hydroxycholecalciferol (25-OH-D3), 3-epimer of 25-OH-D3 (3-epi-25-OH-D3) and 24,25-dihydroxycholecalciferol (24,25-(OH)2D3) by LC-MS/MS and maternal 1,25-dihydroxyvitamin D (1,25-(OH)2D). Differences between groups were tested with ANOVA and Bonferroni post hoc tests (P<0·05). Clinical Center of Serbia. Pregnant women with and without pre-eclampsia (n 60) and their infants. Exogenous vitamin D intake (0·95-16·25 µg/d (38-650 IU/d)) was not significantly different between groups. Women with pre-eclampsia delivered infants at an earlier gestational age and had significantly lower mean total plasma 25-hydroxyvitamin D (25-OH-D; case: 11·2 (sd 5·1); control: 16·1 (sd 5·7) ng/ml; P=0·0006), 25-OH-D3 (case: 10·0 (sd 4·9); control: 14·2 (sd 5·8) ng/ml; P=0·002), 3-epi-25-OH-D3 (case: 0·5 (sd 0·2); control: 0·7 (sd 0·2) ng/ml; P=0·0007) and 1,25-(OH)2D (case: 56·5 (sd 26·6); control: 81·0 (sd 25·7) pg/ml; P=0·018), while 24,25-(OH)2D3 was not different between groups. Infants did not differ in total plasma 25-OH-D, 25-OH-D3, 3-epi-25-OH-D3 and 24,25-(OH)2D3, but the mean proportion of 3-epi-25-OH-D3 was higher in the infant case group (case: 7·9 (sd 1·1); control: 7·0 (sd 1·4) % of total 25-OH-D3; P=0·005). A high prevalence of vitamin D deficiency, as defined by plasma 25-OH-D<12 ng/ml, was observed in 47 % of all mothers and 77 % of all infants. These data underscore the need for prenatal vitamin D supplementation and a food fortification policy in Serbia.