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

Abstract

AbstractObjectiveThe 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.DesignA 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 Bonferronipost hoctests (P<0·05).SettingClinical Center of Serbia.SubjectsPregnant women with and without pre-eclampsia (n60) and their infants.ResultsExogenous 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 (sd5·1); control: 16·1 (sd5·7) ng/ml;P=0·0006), 25-OH-D3(case: 10·0 (sd4·9); control: 14·2 (sd5·8) ng/ml;P=0·002), 3-epi-25-OH-D3(case: 0·5 (sd0·2); control: 0·7 (sd0·2) ng/ml;P=0·0007) and 1,25-(OH)2D (case: 56·5 (sd26·6); control: 81·0 (sd25·7) pg/ml;P=0·018), while 24,25-(OH)2D3was not different between groups. Infants did not differ in total plasma 25-OH-D, 25-OH-D3, 3-epi-25-OH-D3and 24,25-(OH)2D3, but the mean proportion of 3-epi-25-OH-D3was higher in the infant case group (case: 7·9 (sd1·1); control: 7·0 (sd1·4) % of total 25-OH-D3;P=0·005).ConclusionsA 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.