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Am J Perinatol 2020; 37(14): 1446-1454
DOI: 10.1055/s-0039-1694007
Original Article

Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period

Kristi R. Van Winden
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
2   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Permanente Medical Group, Oakland, California
,
Allison Bearden
3   Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
,
Naoko Kono
4   Department of Preventive Medicine, University of Southern California, Los Angeles, California
,
Toni Frederick
3   Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
,
Eva Operskalski
3   Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
,
Alice Stek
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
5   Department of Obstetrics and Gynecology, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
,
Raj Pandian
6   Pan Laboratories, Irvine, California
,
Lorayne Barton
7   Division of Neonatal Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California
,
Andrea Kovacs
3   Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
› Author Affiliations Funding This study was supported by SC CTSI (NIH/NCRR/NCATS) through grant number UL1TR000130. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
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Abstract

Objective To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women.

Study Design This is a retrospective cohort study evaluating the impact of low maternal vitamin D levels on PIH and perinatal outcomes among HIV-infected pregnant women receiving care at an urban HIV center from 1991 to 2014.

Results A total of 366 pregnant women were included, of which 11% developed PIH. Lower levels of 25-hydroxyvitamin D (25(OH)D) and bioactive 1,25-dihydroxyvitamin D (1,25(OH)2D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)2D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79–0.95], p = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80–0.97], p = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)2D levels were associated with group B Streptococcus colonization (OR: 0.92 [95% CI: 0.86–0.99]) and low birth weight (LBW) (OR: 0.90 [95% CI: 0.83–0.98]) on multivariate analysis. Mean 1,25(OH)2D levels were significantly lower in women with preterm delivery and LBW infants.

Conclusion Lower bioactive vitamin D levels are related to PIH in HIV-infected women. This association may be related to the coexistence of abnormal placental vitamin D metabolism and abnormal placental implantation.

Keywords

pregnancy - hypertension - preeclampsia - pregnancy-induced hypertension - vitamin D - human immunodeficiency virus


Publication History

Received: 28 April 2019

Accepted: 25 June 2019

Article published online:
31 July 2019

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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