Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy.
Study Goal
The researchers aimed to evaluate the association between low maternal vitamin D status and hypertensive disorders, including the protective effect of combined vitamin D and calcium supplementation against preeclampsia.
Results Summary
The study found that combined vitamin D and calcium supplementation has a protective effect against preeclampsia, though evidence for vitamin D alone is conflicting due to heterogeneity in study designs and inconsistent data reporting. The risk of gestational hypertensive disorders appears higher at 25(OH)D concentrations below 50 nmol/L, but long-term safety data on dosing is lacking.
Population
Pregnant women at risk of hypertensive disorders.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low maternal vitamin D status | increase | hypertensive disorders | maternal | - | increased risk | #1 |
combined vitamin D and calcium supplementation | decrease | preeclampsia | - | - | protective effect | #2 |
vitamin D | neutral | gestational hypertensive disorders | - | - | association | #3 |
25(OH)D concentrations <50 nmol/L | increase | gestational hypertensive disorders | - | - | increased risk | #4 |
vitamin D status | neutral | all terms of hypertension in pregnancy | - | - | relationship | #5 |
This narrative systematic review evaluates growing evidence of an association between low maternal vitamin D status and increased risk of hypertensive disorders. The inclusion of interventional, observational, and dietary studies on vitamin D and all hypertensive disorders of pregnancy is a novel aspect of this review, providing a unique contribution to an intensively-researched area that still lacks a definitive conclusion. To date, trial evidence supports a protective effect of combined vitamin D and calcium supplementation against preeclampsia. Conflicting data for an association of vitamin D with gestational hypertensive disorders in observational studies arises from a number of sources, including large heterogeneity between study designs, lack of adherence to standardized perinatal outcome definitions, variable quality of analytical data for 25-hydroxyvitamin D (25(OH)D), and inconsistent data reporting of vitamin D status. While evidence does appear to lean towards an increased risk of gestational hypertensive disorders at 25(OH)D concentrations <50 nmol/L, caution should be exercised with dosing in trials, given the lack of data on long-term safety. The possibility that a fairly narrow target range for circulating 25(OH)D for achievement of clinically-relevant improvements requires further exploration. As hypertension alone, and not preeclampsia specifically, limits intrauterine growth, evaluation of the relationship between vitamin D status and all terms of hypertension in pregnancy is a clinically relevant area for research and should be prioritised in future randomised trials.