Vitamin D₃ levels in the maternal serum, cord blood, and placenta of preeclamptic pregnant women

  • Noroyono Wibowo Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Rima Irwinda Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-6260-6273
  • Yohanes Handoko Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Keywords: cord blood, serum, placenta, preeclampsia, vitamin D₃
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Abstract

BACKGROUND Preeclampsia is affected by oxidative stress, a free-radical produced as a by-product of endothelial damage, and antioxidant imbalance, such as vitamin D₃. This study was aimed to compare the vitamin D₃ levels in the placenta, cord blood, and maternal serum between patients with and without preeclampsia.

METHODS This cross-sectional study included 86 patients from Cipto Mangunkusumo Hospital and Tangerang District Hospital, in which 47 had preeclampsia (13 early-onset and 16 late-onset preeclampsia cases) and 39 had no preeclampsia. The placenta, cord blood, and maternal serum were taken after labor, then were analyzed according to preeclampsia and non-preeclampsia; furthermore, the preeclampsia group was analyzed in a subgroup of early- and late-onset preeclampsia. This is analyzed with either unpaired t-test, Mann–Whitney U test, or Kruskal–Wallis test.

RESULTS The maternal serum, cord blood, and placental tissue vitamin D₃ levels (16.30 [6.20–49.00], 11.80 [3.50–38.60], and 49.00 [22.00–411.00] ng/ml, respectively) of the preeclampsia group were similar to those of the non-preeclampsia group (13.50 [4.80–29.20], 11.70 [1.00–28.80], and 43.40 [11.80–153.00] ng/ml, respectively) (p = 0.459, 0.964, and 0.354, respectively). However, the placental tissue vitamin D₃ levels in early-onset preeclampsia (79.00 [36.00–411.00] ng/ml) were higher than those in late-onset preeclampsia (40.00 [22.00–171.00] ng/ml) (p = 0.006). 

CONCLUSIONS The vitamin D₃ levels between patients with and without preeclampsia were similar. However, the placental tissue vitamin D₃ levels in early-onset preeclampsia were higher than those in late-onset preeclampsia, possibly because of the different pathophysiology between early- and late-onset preeclampsia.

References

  1. Staff AC, Braekke K, Johnsen GM, Karumanchi SA, Harsem NK. Circulating concentrations of soluble endoglin (CD105) in fetal and maternal serum and in amniotic fluid in preeclampsia. Am J Obstet Gynecol. 2007;197(2):176.e1-6. https://doi.org/10.1016/j.ajog.2007.03.036

  2. Wen SW, Guo Y, Rodger M, White RR, Yang Q, Smith GN, et al. Folic acid supplementation in pregnancy and the risk of preeclampsia-a cohort study. PLoS One. 2016;11(2):e0149818. https://doi.org/10.1371/journal.pone.0149818

  3. Fetomaternal Division, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital. 2008 maternal mortality and morbodity data in Cipto Mangunkusumo Hospital. Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital; 2008. Indonesian.

  4. Rajakumar A, Michael HM, Daftary A, Jeyabalan A, Gilmour C, Conrad KP. Proteasomal activity in placentas from women with preeclampsia and intrauterine growth restriction: implications for expression of HIF-alpha proteins. Placenta. 2008;29(3):290-9. https://doi.org/10.1016/j.placenta.2007.11.015

  5. Kimura C, Watanabe K, Iwasaki A, Mori T, Matsushita H, Shinohara K, et al. The severity of hypoxic changes and oxidative DNA damage in the placenta of early-onset preeclamptic women and fetal growth restriction. J Matern Fetal Neonatal Med. 2013;26(5):491-6. https://doi.org/10.3109/14767058.2012.733766

  6. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Preeclampsia. Lancet. 2010;376(9741):631-44. https://doi.org/10.1016/S0140-6736(10)60279-6

  7. Lewis S, Lucas RM, Halliday J, Ponsonby AL. Vitamin D deficiency and pregnancy: from preconception to birth. Mol Nutr Food Res. 2010;54(8):1092-102. https://doi.org/10.1002/mnfr.201000044

  8. Evans KN, Nguyen L, Chan J, Innes BA, Bulmer JN, Kilby MD, et al. Effects of 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 on cytokine production by human decidual cells. Biol Reprod. 2006;75(6):816-22. https://doi.org/10.1095/biolreprod.106.054056

  9. Nassar N, Halligan GH, Roberts CL, Morris JM, Ashton AW. Systematic review of first-trimester vitamin D normative levels and outcomes of pregnancy. Am J Obstet Gynecol. 2011;205(3):208.e1-7. https://doi.org/10.1016/j.ajog.2011.03.058

  10. Wibowo N, Irwinda R. The effect of multi-micronutrient and protein supplementation on iron and micronutrients status in pregnant women. Med J Indones. 2015;24(3):168-75. https://doi.org/10.13181/mji.v24i3.1209

  11. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O'Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ. 2013;346:f1169. https://doi.org/10.1136/bmj.f1169

  12. Mistry HD, Gill CA, Kurlak LO, Seed PT, Hesketh JE, Méplan C, et al. Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks' gestation in nulliparous women who subsequently develop preeclampsia. Free Radic Biol Med. 2015;78:147-55. https://doi.org/10.1016/j.freeradbiomed.2014.10.580

  13. Tabesh M, Salehi-Abargouei A, Tabesh M, Esmaillzadeh A. Maternal vitamin D status and risk of pre-eclampsia: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2013;98(8):3165-73. https://doi.org/10.1210/jc.2013-1257

  14. Hyppönen E, Cavadino A, Williams D, Fraser A, Vereczkey A, Fraser WD, et al. Vitamin D and pre-eclampsia: original data, systematic review and meta-analysis. Ann Nutr Metab. 2013;63(4):331-40. https://doi.org/10.1159/000358338

  15. Wei SQ, Qi HP, Luo ZC, Fraser WD. Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and metaanalysis. J Matern Fetal Neonatal Med. 2013;26(9):889-99. https://doi.org/10.3109/14767058.2013.765849

  16. Achkar M, Dodds L, Giguère Y, Forest JC, Armson BA, Woolcott C, et al. Vitamin D status in early pregnancy and risk of preeclampsia. Am J Obstet Gynecol. 2015;212(4):511 e1-7. https://doi.org/10.1016/j.ajog.2014.11.009

  17. Yu CK, Ertl R, Skyfta E, Akolekar R, Nicolaides KH. Maternal serum vitamin D levels at 11-13 weeks of gestation in preeclampsia. J Hum Hypertens. 2013;27(2):115-8. https://doi.org/10.1038/jhh.2012.1

  18. Robinson CJ, Wagner CL, Hollis BW, Baatz JE, Johnson DD. Association of maternal vitamin D and placenta growth factor with the diagnosis of early onset severe preeclampsia. Am J Perinatol. 2013;30(3):167-72. https://doi.org/10.1055/s-0032-1322514

  19. Álvarez-Fernández I, Prieto B, Rodríguez V, Ruano Y, Escudero AI, Álvarez FV. Escudero AI, Ãlvarez FV. Role of vitamin D and sFlt-1/PlGF ratio in the development of early- and late-onset preeclampsia. Clin Chem Lab Med. 2015;53(7):1033-40. https://doi.org/10.1515/cclm-2014-1039

Published
2020-06-30
How to Cite
1.
Wibowo N, Irwinda R, Handoko Y. Vitamin D₃ levels in the maternal serum, cord blood, and placenta of preeclamptic pregnant women. Med J Indones [Internet]. 2020Jun.30 [cited 2024Apr.20];29(2):149-53. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/2951
Section
Clinical Research