Effect of vitamin D supplementation in the reduce risk of preeclampsia in nulliparous women


Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran


Background: The exact role of vitamin D in the development and severity of preeclampsia is still unclear. The aim of the present study was to investigate the association between vitamin D supplement and preeclampsia in pregnant women.
Materials and Methods: In this randomized controlled trial, in 2012, 140 nulliparous pregnant women in two groups received supplementation with 600 IU/day of vitamin D or supplementation free of vitamin D at 16 week gestation until the delivery. The main outcomes included the frequency of preeclampsia and subtypes by clinical severity and infant birth weight.
Results: Mean of maternal age and gestational age at the delivery in all studied subjects were 25 ± 4.1 years and 37.4 ± 3 weeks, respectively, which were not statistically significant between the groups. Preeclampsia was observed in two subjects in case group compared to seven subjects in control group, which was not significant (P-value = 0.09). In case group, subjects with preeclampsia diagnosed as mild preeclampsia and in control group four subjects were mild, and three were severe. No significant differences were noted between the case and control groups in the frequency of preeclampsia subtypes by clinical severity. Infant birth weight in case group who was significantly higher than control group, which was statistically significant between groups (P-value = 0.09).
Conclusion: In summary, our results demonstrated that vitamin D supplementation during the third trimester of pregnancy; despite the non-significant association between vitamin D supplementation and preeclampsia, reduce the risk of preeclampsia. However, further studies needs to be done.


Lise Brantsæter A, Myhre R, Haugen M, Myking S, Sengpiel V, Magnus P, et al. Intake of Probiotic Food and Risk of Preeclampsia in Primiparous Women The Norwegian Mother and Child Cohort Study. Am J Epidemiol 2011;174:807-15.  Back to cited text no. 1
Geographic variation in the incidence of hypertension in pregnancy. World Health Organization International Collaborative Study of Hypertensive Disorders of Pregnancy. Am J Obstet Gynecol 1988;158:80-3.  Back to cited text no. 2
Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet 2005;365:785-99.  Back to cited text no. 3
Fischer D, Schroer A, Lüdders D, Cordes T, Bücker B, Reichrath J, et al. Metabolism of vitamin D3 in the placental tissue of normaland preeclampsia complicated pregnancies and premature births. Clin Exp Obstet Gynecol 2007;34:80-4.  Back to cited text no. 4
Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab 2007;92:3517-22.  Back to cited text no. 5
August P, Marcaccio B, Gertner JM, Druzin ML, Resnick LM, Laragh JH. Abnormal 1,25-dihydroxyvitamin D metabolism in preeclampsia. Am J Obstet Gynecol 1992;166:1295-9.  Back to cited text no. 6
Frolich A, Rudnicki M, Storm T, Rasmussen N, Hegedus L. Impaired 1,25-dihydroxy vitamin D production in pregnancy-induced hypertension. Eur J Obstet Gynecol Reprod Biol 1992;47:25-9.  Back to cited text no. 7
Haugen M, Brantsaeter AL, Trogstad L, Alexander J, Roth C, Magnus P, et al. Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology 2009;20:720-6.  Back to cited text no. 8
Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxy vitamin D levels in early-onset severe preeclampsia. Am J Obstet Gynecol 2010;203:361-6.  Back to cited text no. 9
Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81.  Back to cited text no. 10
Mulligan ML, Felton SK, Riek AE, Bernal-Mizrachi C. Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol 2009;202:429.  Back to cited text no. 11
Davis LM, Chang SC, Mancini J, Nathanson MS, Witter FR, O'Brien KO. Vitamin D insufficiency is prevalent among pregnant African American adolescents. J Pediatr Adolesc Gynecol 2010;23:45-52.  Back to cited text no. 12
Nesby-O'Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: Third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr 2002;76:187-92.  Back to cited text no. 13
Dawodu A, Wagner CL. Mother-child vitamin D deficiency: An international perspective. Arch Dis Child 2007;92:737-40.   Back to cited text no. 14
van der Meer IM, Karamali NS, Boeke AJ, Lips P, Middelkoop BJ, Verhoeven I, et al. High prevalence of vitamin D deficiency in pregnant non-Western women in The Hague, Netherlands. Am J Clin Nutr 2006;84:350-9.  Back to cited text no. 15
Bassir M, Laborie S, Lapillonne A, Claris O, Chappuis MC, Salle BL. Vitamin D deficiency in Iranian mothers and their neonates: A pilot study. Acta Paediatr 2001;90:577-9.   Back to cited text no. 16
Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr 2005;81:1060-4.  Back to cited text no. 17
Lee JM, Smith JR, Philipp BL, Chen TC, Mathieu J, Holick MF. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr 2007;46:42-4.  Back to cited text no. 18
Mahomed K, Gülmezoglu AM. Vitamin D supplementation in pregnancy. Cochrane Database Syst Rev 2011;2:CD000228.  Back to cited text no. 19
Hypponen E, Hartikainen AL, Sovio U, Jarvelin MR, Pouta A. Does vitamin D supplementation in infancy reduce the risk of pre-eclampsia? Eur J Clin Nutr 2007;61:1136-9.  Back to cited text no. 20
Olsen SF, Secher NJ. A possible preventive effect of low-dose fish oil onearly delivery and pre-eclampsia: Indications from a 50-year-old controlled trial. Br J Nutr 1990;64:599-609.  Back to cited text no. 21
Marya RK, Rathee S, Manrow M. Effect of calcium and vitamin Dsupplementation on toxaemia of pregnancy. Gynecol Obstet Invest 1987;24:38-42.  Back to cited text no. 22
Kimball S, El-Hajj Fuleihan G, Vieth R. VITAMIN D: A Growing Perspective. Crit Rev Clin Lab Sci 2008;45:339-415.  Back to cited text no. 23
Mannion CA, Gray-Donald K, Koski KG. Association of low intake of milk and vitamin D during pregnancy with decreased birth weight. CMAJ 2006;174:1273-7.  Back to cited text no. 24
Maxwell JD, Ang L, Brooke OG, Brown IR. Vitamin D supplements enhance weight gain and nutritional status in pregnant Asians. Br J Obstet Gynaecol 1981;88:987-91.  Back to cited text no. 25