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Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy

1
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork T12 Y337, Ireland
2
Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork T12 DFK4, Ireland
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(3), 294; https://doi.org/10.3390/nu10030294
Received: 21 December 2017 / Revised: 19 February 2018 / Accepted: 27 February 2018 / Published: 1 March 2018
This narrative systematic review evaluates growing evidence of an association between low maternal vitamin D status and increased risk of hypertensive disorders. The inclusion of interventional, observational, and dietary studies on vitamin D and all hypertensive disorders of pregnancy is a novel aspect of this review, providing a unique contribution to an intensively-researched area that still lacks a definitive conclusion. To date, trial evidence supports a protective effect of combined vitamin D and calcium supplementation against preeclampsia. Conflicting data for an association of vitamin D with gestational hypertensive disorders in observational studies arises from a number of sources, including large heterogeneity between study designs, lack of adherence to standardized perinatal outcome definitions, variable quality of analytical data for 25-hydroxyvitamin D (25(OH)D), and inconsistent data reporting of vitamin D status. While evidence does appear to lean towards an increased risk of gestational hypertensive disorders at 25(OH)D concentrations <50 nmol/L, caution should be exercised with dosing in trials, given the lack of data on long-term safety. The possibility that a fairly narrow target range for circulating 25(OH)D for achievement of clinically-relevant improvements requires further exploration. As hypertension alone, and not preeclampsia specifically, limits intrauterine growth, evaluation of the relationship between vitamin D status and all terms of hypertension in pregnancy is a clinically relevant area for research and should be prioritised in future randomised trials. View Full-Text
Keywords: 25-hydroxyvitamin D; gestational hypertension; preeclampsia; vitamin D 25-hydroxyvitamin D; gestational hypertension; preeclampsia; vitamin D
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O’Callaghan, K.M.; Kiely, M. Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy. Nutrients 2018, 10, 294.

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