Systematic review of vitamin D and hypertensive disorders of pregnancy
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Published Version
Date
2018
Authors
O'Callaghan, Karen M.
Kiely, Mairead E.
Journal Title
Journal ISSN
Volume Title
Publisher
MDPI AG
Published Version
Abstract
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.
Description
Keywords
25-hydroxyvitamin D , Gestational hypertension , Preeclampsia , Vitamin D
Citation
O’Callaghan, K. and Kiely, M. (2018) 'Systematic review of vitamin D and hypertensive disorders of pregnancy', Nutrients, 10(3), 294 (18pp). doi: 10.3390/nu10030294