Association of Low Vitamin D Level Status and Risk of Pre-Eclampsia and Preterm Birth in Women Using Low-Dose Aspirin

Abstract

Objective: To determine the association between low Vitamin-D status and risk of pre-eclampsia and preterm birth in women using low-dose Aspirin in the tertiary care setting. Study Design: Prospective comparative study. Place and Duration of Study: Gynecology and Obstetrics Department, Pak Emirates Military Hospital, Rawalpindi Pakistan from Sep 2018 to Sep 2019. Methodology: A total of 383 pregnant women were divided into three Groups. Pregnant women were included based on the criteria; if one of the five high-risk factors or more than one moderate risk factors were met. High-risk factors were; 1) Type-1 or 2 diabetes mellitus, 2) chronic hypertension, 3) hypertensive disease in previous pregnancy, 4) autoimmune disease such as systemic lupus erythematous or antiphospholipid syndrome, 5) chronic kidney disease. Results: There were 127 pregnant women in Group-1 with Vitamin-D deficiency. In Group-2, there were pregnant women with Vitamin-D insufficiency; in Group-3, there were 18 pregnant women with Vitamin-D sufficiency. The mean Vitamin-D level in Group-1 was 22.40±1.50 nmol/L, the mean Vitamin-D level in Group-2 was 32.82±9.80nmol/L and in Group-3 mean Vitamin-D level was 76.63±8.00 nmol/L. Early onset pre-eclampsia, chronic hypertension with superimposed pre-eclampsia, gestational diabetes, spontaneous-vaginal delivery and delivery at term were found to statistically significant among the Groups (p<0.05). Conclusion: We aimed to determine whether vitamin D status was linked with high-risk pregnancies, which could overshadow the impact of vitamin D under existing conditions. Our findings help relate the status and pre-eclampsia of maternal vitamin D to preterm birth.