Effect of Vitamin D2 Calcium Supplementation for Prevention of Preeclampsia and its Severity

Abstract

Objective:  To evaluate the preventive and therapeutic efficacy of vitamin D₂ calcium supplementationin pregnant women with a predictor of hypertension or diagnosed with gestational hyperten- sion(GH) or preeclampsia(PE) to prevent preeclampsia and its severity. Methods: Pregnant women with a predictor of hypertension (130/80 to 135/85 mm Hg) or diagnosed with gestational hypertension(GH) or preeclampsia (non-severe, some severe) were selected. The study group was provided 3-5 capsules of vitaminD₂ calcium (600-1 500 mg daily in Ca content, 600-1500 IU in Vitamin D₂)  3 times a day at different time points in the 6-34 weeks of gestation, and to observe the clinical improvement including hypertension and proteinuria. The control group was selected from subjects who had received conventional management(home bed rest, antihypertensive, anticonvulsant use, etc.) and was subjected to retrospective analysis. Results:  Before the administration of vitaminD₂ calcium, the rate of the low levels of total serum Ca(<76μg/ml) was 53.4%(32 cases), significantly  higher(p<0.01) in the study group than the control one (16.7%, 9 cases), and the rate of high levels of that (>90μg /ml) was significan-tly lower in the study  group (23.3%, 14 cases) than the control one(55.5%, 30 cases). When the dose of vitamin D₂ calcium was more than 1 000 mg and the duration of use was more than 4 weeks, all pregnant women delivered more than 37 weeks (28 cases, 46.7%). At the dose of 600-900 mg with a duration of more than 4 weeks, there were 28.3% (17 cases) deliveries in the term and 13.3% (8 cases) preterm deliveries over 34 weeks. Two patients have been stopped(28^th, 31^th week respectively, severe) with the duration of use less than 3 weeks.

Total serum Ca showed significantly higher levels(>90μg/ml, 46.7%) after the admini-stration compared before the use(<76μg/ml: 53.4%, >90μg/ml: 23.3%) in the study group (p<0.05).

In the study group, the prenatal systolic blood pressure(S) after the administration of vitamin D₂ calcium was 139.50±15.93mmHg, significantly lower(10mmHg, p<0.05) compared to the onset period(S: 149.22±17.51mmHg), and diastolic blood pressure (D: 94.36±13.98 mmHg) tended to decrease(5mmHg, p=0.08) compared to onset period(D: 99.69±15.50 mmHg). Also BP before delivery in the study group was significantly lower(S: p<0.01, D: p<0.01, respectively) compared to the control one(S: 156.95±20.27mmHg; D: 106.05±18.17 mmHg). There was no significant difference between onset BP and prenatal BP in the control group.  The percentage of undetectable levels of urinary protein after the use of vitamin D₂ calcium (48.3%, 29 cases) was significantly higher(p<0.05) compared to the pre-use (36.7%, 22 cases), and the detection rate of >1 g/L was 28.4%(17patients), which was significantly lower (p <0.05) compared to the pre-use (53.3%, 32 patients). The neonatal birth weight after delivery was not significantly different between the two groups. Conclusions: It is believed that vitamin D₂ calcium (more than 1 000 mg of Ca element, Vitamin D₂ 1 000 IU, and longer than 4 weeks of use) can effectively prevent gestational hypertension and preeclampsia and its severity, as well as improving some critical parameters(BP, urinary prot-ein, etc.) and thus is of great value for its use in essential antenatal care to reduce maternal and perinatal mortality.