The Relationship of First Trimester Vitamin D, Vitamin B12 and Ferritin Levels with Preeklampsia

Year 2021, Volume: 5 Issue: 3, 229 - 235, 22.12.2021

Selim Gülücü , Mehmet Güçlü , Sebahattin Çelik , İlkin Seda Can , Canan Soyer Çalışkan , Samettin Çelik

https://doi.org/10.46332/aemj.865619

Cited By: 1

Abstract

Purpose: We aimed to investigate the relationship between first trimester vitamin D, vitamin B12 and ferritin levels with preeclampsia and neonatal outcomes.

Materials and Methods: 191 patients diagnosed with preeclampsia (PE) and 99 healthy pregnant women were included in the study. Age, gravida, parity, body mass index (BMI), mode of delivery, birth weight, APGAR score, neonatal intensive care unit (NICU) admission and delivery week were recorded. First trimester vitamin D, vitamin B12 and ferritin levels were determined in laboratory analyzes. Evaluation was made by separating three groups as without PE, with PE and with severe PE.

Results: Differences were found between BMI measurements, birth weeks, birth weights and NICU acceptance values (p=0.003; 0.001; 0.001; 0.001 respectively). Babies in the PE group had lower mean birth weeks, birth weights and APGAR scores. In the PE group had a higher rate of cesarean section (p=0.001). The vitamin D level of the PE group was lower than the group without PE. It was found that the vitamin D level decreased in proportion to the severity of PE. The B12 level of the non-PE group was higher than PE group (p=0.001). The ferritin level of the non-PE group was found to be lower than the PE group (p=0.001).

Conclusion: Low vitamin D and B12 levels and high ferritin levels in the first trimester may be beneficial in predicting preeclampsia. We think that especially vitamin D, B12 and iron supplementation is a simple but effective approach to reduce perinatal morbidity and mortality in preeclampsia.

Keywords

Preeclampsia, vitamin D, vitamin B12, ferritin, newborn

İlk Trimester Vitamin D, Vitamin B12 ve Ferritin Seviyelerinin Preeklampsi ile İlişkisi

Abstract

Amaç: İlk trimester vitamin D, vitamin B12 ve ferritin seviyelerinin preeklampsi ve yenidoğan sonuçlarıyla olan ilişkisini araştırmayı amaçladık.

Araçlar ve Yöntem: Çalışmaya preeklampsi (PE) tanısı almış 191 hasta ve 99 sağlıklı gebe kadın dahil edildi. Hastaların yaş, gravida, parite, beden kitle indeksi (BKI), doğum şekli, doğum kilosu, APGAR skoru, yenidoğan yoğun bakım ünitesi (YYBÜ) kabulü ve doğum haftası kaydedildi. Laboratuvar analizlerinde ilk trimester vitamin D, vitamin B12 ve ferritin düzeyleri tespit edildi. PE’siz, PE’li ve şiddetli PE’li olmak üzere üç grup ayrılarak değerlendirme yapıldı.

Bulgular: BKI ölçümleri, doğum haftaları, doğum kiloları, YYBÜ kabulü değerleri arasında farklılık saptandı (p değeri sırasıyla= 0.003; 0.001; 0.001; 0.001). PE grubundaki bebeklerin ortalama doğum haftaları, doğum kiloları ve APGAR skorları PE’siz gruba göre düşük bulundu. PE grubundaki gebelerin sezaryen olma oranı yüksekti (p=0.001) . PE grubunun vitamin D düzeyi, PE’siz gruba göre anlamlı düzeyde düşüktü (p=0.001). Vitamin D düzeyinin PE şiddetiyle orantılı olarak azaldığı tespit edildi. PE’siz grubun B12 düzeyi, PE’li gruba göre yüksekti (p=0.001). PE’siz grubun ferritin düzeyi PE’li gruba göre düşük tespit edildi (p=0.001).

Sonuç: İlk trimesterde vitamin D ve B12 düşüklüğü, ferritin yüksekliği preeklampsi öngörüsünde faydalı olabilir. Özellikle D vitamini, B12 ve demir desteğinin preeklempside perinatal morbidite ve mortaliteyi azaltacak basit ama etkili bir yaklaşım olduğunu düşünmekteyiz.

Keywords

Preeklampsi, vitamin D, vitamin B12, ferritin, yenidoğan

References

• 1. Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, De Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(10022):999-1011.
• 2. Başol G, Uzun ND, Uzun F, Kale A, Terzi H. Retrospective analysis of the preeclampsia cases delivered in our clinic between 2013 and 2017. Perinatal Journal. 2018;26(3):135-140.
• 3. American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-1231.
• 4. Roberts JM, Cooper DW. Pathogenesis and genetics of preeclampsia. Lancet. 2001;357(9249):53-56.
• 5. Weel CI, Romão-Veiga M, Matias ML ve ark. Increased expression of NLRP3 inflammasome in placentas from pregnant women with severe preeclampsia. J Reprod Immunol. 2017;123:40-47.
• 6. Guerra-Shinohara EM, Paiva AA, Rondo PH, Yamasaki K, Terzi CA, D'Almeida V. Relationship between total homocysteine and folate levels in pregnant women and their newborn babies according to maternal serum levels of vitamin B12. BJOG Int J Obstet Gy. 2002;109(7):784-791.
• 7. Van der Molen EF, Verbruggen B, Novakova I, Eskes TKAB, Monnens LAH, Blom HJ. Hyperhomocysteinaemia and other thrombotic risk factors in women with placental vasculopathy, BJOG Int J Obstet Gy. 2000;107(6):785-791.
• 8. Ulular EN. Serum ferritin levels in preterm labor and preterm rupture of membranes. Selcuk Tıp Derg. 2013;29(4):157-160.
• 9. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080-1086.
• 10. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab. 2010;95(2):471-478.
• 11. Lapillonne A. Vitamin D deficiency during pregnancy may impair maternal and fetal outcomes. Med Hypotheses. 2010;74(1):71-75.
• 12. Stone CD, Dıallo O, Shyken J, Leet T. The combined effect of maternal smoking and obesity on the risk of preeclampsia. J Perinat Med. 2007;35(1):28-31.
• 13. Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts RW. Maternal vitamin D defiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92(9):3517-3522.
• 14. Baker AM, Haeri S, Camargo CA Jr, Espinola JA, Stuebe AM. A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia. J Clin Endocrinol Metab. 2010;95(11):5105-5109.
• 15. Elizabeth VS, Lori C, Wei W, Gehris J, Carol LW. Maternal vitamin D sufficiency and reduced placental gene expression in angiogenic biomarkers related to comorbidities of pregnancy. J Steroid Biochem Mol Biol. 2017;173:273-279.
• 16. Nema J, Sundranı D, Joshi S. Prenatal vitamin D supplementation reduces blood pressure and improves placental angiogenesis in an animal model of preeclampsia. Food Funct. 2020;11(12):10413-10422.
• 17. Lee CL, Ng KB, Wu LL, Cheah FC, Othman H, Ismail NAM. Vitamin D deficiency in pregnancy at term: risk factors and pregnancy outcomes. Horm Mol Biol Clin Investig. 2017;31(3):1-8.
• 18. Wetta LA, Biggio JR, Cliver S, Abramovici A, Barnes S, Tita ATN. Is midtrimester vitamin D status associated with spontaneous preterm birth and preeclampsia? Am J Perinatol. 2014;31(6):541-546.
• 19. Azar M, Basu Arpita, Jenkins AJ ve ark. Serum carotenoids and fat-soluble vitamins in women with type 1 diabetes and preeclampsia: a longitudinal study. Diabetes Care. 2011;34(6):1258-1264.
• 20. Aguilar-Cordero MJ, Lasserrot-Cuadrado A, Mur-Villar N, León-Ríos XA, Rivero-Blanco T, Pérez-Castillo IM. Vitamin D, preeclampsia and prematurity: A systematic review and meta-analysis of observational and interventional studies. Midwifery 2020;87:102707.
• 21. Benachi A, Baptiste A, Taieb J ve ark. Relationship between vitamin D status in pregnancy and the risk for preeclampsia: A nested case-control study. Clin Nutr. 2020;39(2):440-446.
• 22. Tous M, Villalobos M, Iglesias L, Fernández-Barrés S, Arija V. Vitamin D status during pregnancy and offspring outcomes: a systematic review and meta-analysis of observational studies. Eur. J. Clin Nutr. 2020;74(1):36-53.
• 23. Onalan R, Onalan G, Gunenc Z, Karabulut E. Combining 2nd-trimester maternal serum homocysteine levels and uterine artery Doppler for prediction of preeclampsia and isolated intrauterine growth restriction. Gynecol Obstet Invest. 2006;61(3):142-148.
• 24. Acilmis YG, Dikensoy E, Kutlar AI ve ark. Homocysteine, folic acid and vitamin B12 levels in maternal and umbilical cord plasma and homocysteine levels in placenta in pregnant women with pre-eclampsia. J Obstet Gynaecol Res. 2011;37(1):45-50.
• 25. Park H, Kim YJ, Ha EH, Kim KN, Chang N. The risk of folate and vitamin B12 deficiencies associated with hyperhomocysteinemia among pregnant women. Am J Perinatol. 2004;21(8):469-475.
• 26. Herrmann W, Isber S, Obeid R, Herrmann M, Jouma M. Concentrations of homocysteine, related metabolites and asymmetric dimethylarginine in preeclamptic women with poor nutritional status. Clin Chem Lab Med. 2005;43(10):1139-1146.
• 27. Lopez-Quesada E, Vilaseca MA, Lailla JM. Plasma total homocysteine in uncomplicated pregnancy and in preeclampsia. Eur J Obstet Gynecol Reproduct Biol. 2003;108(1):45-49.
• 28. Kirke PN, Molloy AM, Daly LE, Burke H, Weir DC, Scott JM. Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects. Q J Med. 1993;86(11):703-708.
• 29. Anderson OS, Sant KE, Dolinoy DC. Nutrition and epigenetics: an interplay of dietary methyl donors, one-carbon metabolism and DNA methylation. J Nutr Biochem. 2012;23(8):853-859.
• 30. Mignini LE, Latthe PM, Villar J, Kilby MD, Carroli G, Khan K. Mapping the theories of preeclampsia: the role of homocysteine. Obstet Gynecol. 2005;105(2):411-425.
• 31. Masoura S, Kalogiannidis IA, Gitas G ve ark. Biomarkers in pre-eclampsia: a novel approach to early detection of the disease. J. Obstet. Gynaecol. 2012;32(7):609-616.
• 32. Sanchez SE, Zhang C, Rene Malinow MR, Ware-Jauregui S, Larrabure G, Williams MA. Plasma folate, vitamin B12 and homocyst(e)ine concentrations in preeclamptic and normotensive Peruvian women. Am J Epidemiol. 2001;153(5):474-480.
• 33. Makedos G, Papanicolaou A, Hitoglou A ve ark. Homocysteine, folic acid and B12 serum levels in pregnancy complicated with preeclampsia. Arch Gynecol Obstet. 2007;275(2):121-124.
• 34. Mardali F, Fatahi S, Alinaghizadeh M, ve ark. Association between abnormal maternal serum levels of vitamin B12 and preeclampsia: a systematic review and meta-analysis. Nutr. Rev. 2021;79(5):518-528.
• 35. Bodnar LM, Tang G, Ness RB, Harger G, Roberts JM. Periconceptional multivitamin use reduces the risk of preeclampsia. Am. J. Epidemiol. 2006;164(5):470-477.
• 36. Maitra S, Mukthapuram A, Huligol G, Sreelatha G, Vishwanath H. Increased serum ferritin and iron levels in preeclampsia. IOSR J. Biotechnol. Biochem. 2019;5(2):50-52.
• 37. Silva JVF, Ferreira RC, Tenório MB ve ark. Hyperferritinemia worsens the perinatal outcomes of conceptions of pregnancies with preeclampsia. Pregnancy Hypertens. 2020;19;233-238.
• 38. Ray JG, Berger H, Park AL. Population‐based study of serum ferritin in early pregnancy and adverse perinatal outcomes. Paediatr Perinat Epidemiol. 2020;34(6):706-712.