Vitamin D status and hypertensive disorders in pregnancy
Vitamin D status and hypertensive disorders in pregnancy
复制标题
DOI：
10.1016/j.annepidem.2014.02.001
复制
发表时间：
2014-05-01
影响因子：
5.6
通讯作者：
Gillman, Matthew W.
中科院分区：
文献类型：
--
作者：
Burris, Heather H.;Rifas-Shiman, Sheryl L.;Gillman, Matthew W.
目的：几项研究报道了25-羟基维生素D （25 [OH]D）水平低时子痫前期的风险增加。25(OH)D能在多大程度上降低妊娠期高血压疾病的风险尚不清楚。方法：在马萨诸塞州的Viva项目产前队列中，我们研究了妊娠16.4-36.9周（平均27.9周）25(OH)D水平与妊娠高血压疾病的关系，包括先兆子痫（56/1591,3.5%）和妊娠高血压（109/1591,6.9%）。结果：我们未检测到血浆25(OH)D浓度（平均值58，标准差22 nmol/L）与子痫前期之间的关联。25(OH)D每增加25 nmol/L，子痫前期的校正优势比为1.14（95%可信区间为0.77-1.67）。相反，与假设相反，较高的25(OH)D浓度与较高的妊娠高血压发生率相关：25(OH)D浓度每增加25 nmol/L，妊娠高血压的校正优势比为1.32（95%可信区间为1.01-1.72）。维生素D的摄入模式表明这种联系不是因为反向因果关系。虽然高血压风险升高可能是偶然的，但在妊娠期间补充维生素D的随机试验应该监测妊娠期高血压。结论：这些数据不支持高25(OH)D水平降低妊娠期高血压疾病总体风险的假设。(C) 2014爱思唯尔公司版权所有。
Purpose: Several studies have reported increased risk of preeclampsia when 25-hyrdoxyvitamin D (25 [OH]D) levels are low. The extent to which 25(OH)D may lower risk for hypertensive disorder during pregnancy remains unclear.Methods: Among women enrolled in the Project Viva prenatal cohort in Massachusetts, we examined associations of 25(OH)D levels obtained at 16.4-36.9 weeks of gestation (mean 27.9 weeks) with hypertensive disorders of pregnancy, including preeclampsia (56/1591, 3.5%) and gestational hypertension (109/1591, 6.9%).Results: We did not detect an association between plasma 25(OH)D concentration (mean 58, standard deviation 22 nmol/L) and preeclampsia. For each 25 nmol/L increase in 25(OH)D, the adjusted odds ratio for preeclampsia was 1.14 (95% confidence interval, 0.77-1.67). By contrast and contrary to hypothesis, higher 25(OH)D concentrations were associated with higher odds of gestational hypertension: adjusted odds ratio for gestational hypertension was 1.32 (95% confidence interval, 1.01-1.72) per each 25 nmol/L increment in 25(OH)D. Vitamin D intake patterns suggest that this association was not because of reverse causation. Although the elevated hypertension risk may be due to chance, randomized trials of vitamin D supplementation during pregnancy should monitor for gestational hypertension.Conclusions: These data do not support the hypothesis that higher 25(OH)D levels lower the overall risk of hypertensive disorders of pregnancy. (C) 2014 Elsevier Inc. All rights reserved.