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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Pre-Eclampsia | Research

Effect of early vitamin D supplementation on the incidence of preeclampsia in primigravid women: a randomised clinical trial in Eastern Democratic Republic of the Congo

Authors: Richard Kabuseba Kabuyanga, Pierrot Lundimu Tugirimana, Balungwe Sifa, Mwanga Balezi, Michel Ekanga Dikete, Prudence Ndeba Mitangala, Jean Pierre Moyene Elongi, Xavier Kalume Kinenkinda, Jean-Baptiste Sakatolo Zambeze Kakoma

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

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Abstract

Background

Previous studies have reported the association between maternal vitamin D deficiency and preeclampsia. However, the efficacy of vitamin D supplementation in reducing the occurrence of preeclampsia remains unclear. The objective of this study was to evaluate the effect of cholecalciferol supplementation on the incidence of preeclampsia in primigravid women and its related maternal and foetal outcomes.

Methods

A single-blinded clinical trial was conducted in fourteen antenatal care health facilities in the North (Goma, Mwesso, Nyiragongo) and South Kivu (Bukavu-Panzi) provinces of the Democratic Republic of Congo from March 1, 2020, to June 30, 2021. A total of 1300 primigravid women not exceeding 16 weeks of gestation were randomised with a 1:1 ratio to either the supplemented (A) or control (B) group. Each pregnant woman (A) presenting for antenatal care received a single monthly dose of cholecalciferol (60,000 IU) orally for 6 months. The control group received no vitamin D supplementation or placebo. Serum 25(OH)D was measured at recruitment and at 34 weeks of gestation. Outcomes were assessed monthly until delivery.

Results

The median maternal age was 21 years (14–40), while the median gestational age was 15 weeks (5.4–29.0). A significant reduction in the risk of preeclampsia [RR = 0.36 (0.19–0.69); p = 0.001] and preterm delivery [RR = 0.5 (0.32–0.78); p = 0.002] was observed in the intervention group. An RR of 0.43 [(0.27–0.67); p < 0.001] was found for low birth weight. The RR for caesarean section was 0.63 [(0.52–0.75); p < 0.001]. The APGAR score at the 5th minute (p = 0.021) and the size of the newborn were significantly higher in the supplemented group (p = 0.005).

Conclusion

A single monthly dose (60,000 IU) of vitamin D supplementation, started in earlypregnancy, significantly reduced the incidence of preeclampsia and its maternal and foetal complications.

Trial registration

ISRCTN Register with ISRCTN46539495 on 17 November 2020.
Literature
1.
Lo JO, Mission JF, Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Curr Opin Obstet Gynecol. 2013;25(2):124–32.CrossRefPubMed
2.
Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1–7.CrossRefPubMed
3.
Duley L. Pre-eclampsia and the hypertensive disorders of pregnancy. Br Med Bull. 2003;67(1):161–76.CrossRefPubMed
4.
5.
Vata PK, Chauhan NM, Nallathambi A, Hussein F. Assessment of prevalence of preeclampsia from Dilla region of Ethiopia. BMC Res Notes. 2015;8(1):1–6.CrossRef
6.
Tsatsaris V, Fournier T, Winer N. Physiopathologie de la prééclampsie. J Gynecol Obstet Biol Reprod. 2008;37(1):16–23.CrossRef
7.
Kabuseba RK, Tugirimana PL, Moyene JPE, Kalume XK, Zambèze JBKS. Calcemia, Vitamin D and seasonal influences in preeclampsia in Goma. GSC Adv Res Rev. 2022;10(1):011–22.CrossRef
8.
9.
Laganà AS, Giordano D, Loddo S, Zoccali G, Vitale SG, Santamaria A, et al. Decreased Endothelial Progenitor Cells (EPCs) and increased Natural Killer (NK) cells in peripheral blood as possible early markers of preeclampsia: a case-control analysis. Arch Gynecol Obstet. 2017;295:867–72.CrossRefPubMed
10.
Petca A, Sinescu R, Sandru F, Petca RC, Dumitrascu M, Mehedintu C, et al. New approaches in predicting and diagnosing preeclampsia: Congo Red Dot Paper Test (Review). Exp Ther Med. 2022;23(4):270.CrossRefPubMedPubMedCentral
11.
Nema J, Sundrani D, Joshi S. Role of vitamin D in influencing angiogenesis in preeclampsia. Hypertens Pregnancy. 2019;38(4):201–7.CrossRefPubMed
12.
Benachi A, Baptiste A, Taieb J, Tsatsaris V, Guibourdenche J, Senat MV, et al. Relationship between vitamin D status in pregnancy and the risk for preeclampsia: A nested case-control study. Clin Nutr. 2020;39(2):440–6.CrossRefPubMed
13.
Richard KK, Marcelline BS, Jean-Pierre EM, Pierrot LT, Prosper KMK, Jean-Baptiste KSZ. Vitamin D Status and the Determinants of Preeclampsia in Pregnant Women in Goma (Democratic Republic of the Congo). Open J Obst Gynecol. 2020;10(06):820.CrossRef
14.
Naghshineh E, Sheikhaliyan S. Effect of vitamin D supplementation in the reduce risk of preeclampsia in nulliparous women. Advanced Biomedical Research. 2016;5.
15.
Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. Am J Obstet Gynecol. 2010;203(4):366-e1.CrossRefPubMedCentral
16.
Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014;111(1):23–45.CrossRefPubMed
17.
Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92(9):3517–22.CrossRefPubMed
18.
mondiale de la Santé O. Recommendations de l’OMS pour la prévention et le traitement de la prééclampsie et de l’éclampsie. 2014;
19.
Benachi A, Cordier AG, Courbebaisse M, Souberbielle JC. Vitamine D et grossesse. La Presse Médicale. 2013;42(10):1377–82.CrossRefPubMed
20.
Hollis BW, Wagner CL. Vitamin D and pregnancy: skeletal effects, nonskeletal effects, and birth outcomes. Calcif Tissue Int févr. 2013;92(2):128–39.CrossRef
21.
Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res. 2011;26(10):2341–57.CrossRefPubMed
22.
Hollis BW. Vitamin D status during pregnancy: The importance of getting it right. EBioMedicine. 2019;39:23–4.CrossRefPubMed
23.
Rostami M, Tehrani FR, Simbar M, BidhendiYarandi R, Minooee S, Hollis BW, et al. Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial. J Clin Endocrinol Metab. 2018;103(8):2936–48.CrossRefPubMed
24.
Haugen M, Brantsæter AL, Trogstad L, Alexander J, Roth C, Magnus P, et al. Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology. 2009;20:720–6.CrossRefPubMed
25.
De-Regil LM, Palacios C, Lombardo LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane database of systematic reviews. 2016;(1).
26.
Elongi JP, Tandu B, Spitz B, Verdonck F. Influence de la variation saisonnière sur la prévalence de la pré-éclampsie à Kinshasa. Gynécologie Obstétrique Fertilité. 2011;39(3):132–5.CrossRefPubMed
27.
Program NHBPE. Report of the national high blood pressure education program working group on high blood pressure in pregnancy Am J Obstet Gynecol 2000;183(1):s1‑22.
28.
Torchin H, Ancel PY. Epidemiology and risk factors of preterm birth. J Gynecol Obstet Biol Reprod. 2016;45(10):1213–30.CrossRef
29.
Behjat Sasan S, Zandvakili F, Soufizadeh N, Baybordi E. The effects of vitamin D supplement on prevention of recurrence of preeclampsia in pregnant women with a history of preeclampsia. Obstetrics and gynecology international. 2017;2017.
30.
Nausheen S, Habib A, Bhura M, Rizvi A, Shaheen F, Begum K, et al. Impact evaluation of the efficacy of different doses of vitamin D supplementation during pregnancy on pregnancy and birth outcomes: a randomised, controlled, dose comparison trial in Pakistan. BMJ Nutr Prev Health. 2021;4(2):425.CrossRefPubMedPubMedCentral
31.
Mirzakhani H, Litonjua AA, McElrath TF, O’Connor G, Lee-Parritz A, Iverson R, et al. Early pregnancy vitamin D status and risk of preeclampsia. J Clin Investig. 2016;126(12):4702–15.CrossRefPubMedPubMedCentral
32.
Karamali M, Beihaghi E, Mohammadi AA, Asemi Z. Effects of high-dose vitamin D supplementation on metabolic status and pregnancy outcomes in pregnant women at risk for pre-eclampsia. Horm Metab Res. 2015;47(12):867–72.CrossRefPubMed
33.
Parrish MR, Martin JN, Lamarca BB, Ellis B, Parrish SA, Owens MY, et al. Randomized, placebo controlled, double blind trial evaluating early pregnancy phytonutrient supplementation in the prevention of preeclampsia. J Perinatol. 2013;33(8):593–9.CrossRefPubMed
34.
Dominguez LJ, Farruggia M, Veronese N, Barbagallo M. Vitamin D sources, metabolism, and deficiency: available compounds and guidelines for its treatment. Metabolites. 2021;11(4):255.CrossRefPubMedPubMedCentral
35.
36.
Bouillon R, Verlinden L, Verstuyf A. Is vitamin D2 really bioequivalent to vitamin D3? Oxford University Press; 2016.
37.
Sablok A, Batra A, Thariani K, Batra A, Bharti R, Aggarwal AR, et al. Supplementation of vitamin D in pregnancy and its correlation with feto-maternal outcome. Clin Endocrinol. 2015;83(4):536–41.CrossRef
38.
Roth DE, Al Mahmud A, Raqib R, Akhtar E, Perumal N, Pezzack B, et al. Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial. Nutr J. 2013;12(1):1–16.CrossRef
39.
Singh J, Hariharan C, Bhaumik D. Role of vitamin D in reducing the risk of preterm labour. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):86–94.CrossRef
40.
Bilezikian JP, Formenti AM, Adler RA, Binkley N, Bouillon R, Lazaretti-Castro M, et al. Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all? Rev Endocr Metab Disord déc. 2021;22(4):1201–18.CrossRef
41.
Fogacci S, Fogacci F, Banach M, Michos ED, Hernandez AV, Lip GY, et al. Vitamin D supplementation and incident preeclampsia: a systematic review and meta-analysis of randomized clinical trials. Clin Nutr. 2020;39(6):1742–52.CrossRefPubMed
42.
Maugeri A, Barchitta M, Blanco I, Agodi A. Effects of vitamin D supplementation during pregnancy on birth size: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2019;11(2):442.CrossRefPubMedPubMedCentral
43.
Palacios C, Kostiuk LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2019;(7).
Metadata
Title
Effect of early vitamin D supplementation on the incidence of preeclampsia in primigravid women: a randomised clinical trial in Eastern Democratic Republic of the Congo
Authors
Richard Kabuseba Kabuyanga
Pierrot Lundimu Tugirimana
Balungwe Sifa
Mwanga Balezi
Michel Ekanga Dikete
Prudence Ndeba Mitangala
Jean Pierre Moyene Elongi
Xavier Kalume Kinenkinda
Jean-Baptiste Sakatolo Zambeze Kakoma
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Pre-Eclampsia
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-024-06277-6

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