SERUM 25 (OH) VITAMIN D AND CALCIUM LEVELS AND ADVERSE MATERNAL AND PERINATAL OUTCOMES IN PREGNANCY INDUCED HYPERTENSION

Abstract

Objectives: Incidence of hypertensive disorders in pregnancy is about 5–10% of all pregnancies [1]. Pre-eclampsia alone or superimposed on chronic hypertension is the most threatening. This study is done to evaluate the levels of serum 25 (OH) Vitamin D and Calcium in normal antenatal patients and patients with pregnancy-induced hypertension and their effects on perinatal and maternal outcome. Hence, that timely intervention can prevent adverse perinatal and maternal outcomes.

Methods: The present prospective observational study was done in the Department of Obstetrics and Gynecology, Government Medical College and Rajindra Hospital, Patiala, Punjab, India from May 2018 to April 2019. The study was conducted on 80 antenatal patients. Patients were divided into two groups with 40 patients in each group. Group I included patients with pregnancy-induced hypertension and Group II included normal antenatal patients. Serum levels of calcium and 25 (OH) Vitamin D were evaluated in both groups. Adverse perinatal and maternal outcomes were assessed in relation to the serum levels of calcium and 25 (OH) Vitamin D in patients with pregnancy-induced hypertension and normal antenatal patients. Categorical variables were analyzed by Chi-square test and Fisher’s exact test. The analysis of continuous variable was done by ANOVA. The data were analyzed using SPSS version 22 and Microsoft Excel. p≤0.05 is taken as statistically significant.

Results: The mean value of serum Vitamin D level in Group I was 22.30±6.11 ng/ml and 36.68±9.34 ng/ml in Group II giving p=0.016 which was highly significant. In Group I, mean calcium levels were 8.58±0.63 mg/dl and 9.27±0.40 mg/dl in Group II giving p=0.018 which was highly significant. The Pearson’s correlation coefficient was −0.753 for serum Vitamin D and systolic blood pressure (BP) and the same for serum Vitamin D and diastolic BP with p=0.001 which was highly significant. The Pearson correlation coefficient was −0.537, −0.514 for serum calcium and systolic BP and serum calcium and diastolic BP, respectively, giving p=0.001.

Conclusion: Serum levels of 25 (OH) Vitamin D and calcium have a significant relationship with pregnancy-induced hypertension. Low levels of calcium and 25 (OH) Vitamin D cause an increased risk of pregnancy-induced hypertension and supplementation of these reduces the incidence of pregnancy-induced hypertension. Hence, their supplementation can be used as a possible intervention strategy in preventing one of the most common causes of perinatal and maternal morbidity and mortality around the world.