The Low Level of Serum 1,25-Dihydroxyvitamin D3 and Calcium in Preeclampsia Women and Its Impact on Maternal Outcomes

Abstract

Objective: To investigate the association of serum 1,25-dihydroxyvitamin D3 (1,25[OH]2D3) and calcium levels in pregnancy with the risk of preeclampsia and its impact on maternal outcomes. Methods: This cross-sectional observational study was conducted in the Obstetrics and Gynecology Department at Dr. M. Djamil Padang General Hospital from May 2021 to April 2022. Patients with normal pregnancy, diagnosed with preeclampsia, and willing to sign the informed consent were included in this study. Blood serum samples from patients were collected and examined with an ELISA kit. The collected data were then statistically analyzed with univariate and bivariate analysis. Results: The serum 1,25(OH)2D3 levels strongly correlate with maternal outcomes (systolic and diastolic blood pressure) among preeclampsia patients, with p-value = <0.0001. The serum 1,25(OH)2D3 levels in preeclampsia were significantly lower than in normal pregnancy (88,73 ± 42,22 vs. 111,11 ± 52,49 pg/ml), with p-value = 0,033. The serum calcium levels in preeclampsia patients were significantly lower compared to normal pregnant women's (8,67 ± 0,49 vs. 9,55 ± 0,93 mg/dL), with p-value = <0.0001. However, there was no association between serum 1,25(OH)2D3 and serum calcium levels in pregnancy. Conclusion: Serum levels of 1,25-dihydroxyvitamin D3 and calcium in preeclampsia were significantly lower than in normal pregnancy. Serum 1,25-dihydroxyvitamin D3 levels were also found to have a significant correlation with systolic and diastolic blood pressure in preeclamptic patients. These findings reinforce the suggestion of the importance of vitamin D and calcium supplementation during pregnancy to reduce the risk of preeclampsia and to achieve better maternal outcomes. Keywords: 1,25-Dihydroxyvitamin D3, calcium, hypertension, pregnancy, preeclampsia   Abstrak Tujuan: Mengetahui hubungan antara kadar serum 1,25-dihidroksivitamin D3 (1,25[OH]2D3) dan kalsium pada kehamilan dengan risiko preeklamsia dan pengaruhnya terhadap luaran maternal Metode: Studi observasional potong lintang ini dilakukan di Departemen Obstetri dan Ginekologi RSUP Dr. M. Djamil Padang dari Mei 2021 hingga April 2022. Pasien dengan kehamilan normal, terdiagnosis preeklampsia, dan bersedia menandatangani informed consent diinklusi dalam penelitian ini. Sampel serum darah dari pasien dikumpulkan dan diperiksa dengan ELISA-kit. Data yang terkumpul kemudian dianalisis secara statistik dengan analisis univariat dan bivariat. Hasil: Kadar serum 1,25(OH)2D3 memiliki hubungan yang kuat dengan luaran maternal (tekanan darah sistolik dan diastolik) pada pasien preeklamsia, dengan nilai p = <0,0001. Kadar serum 1,25(OH)2D3 pada preeklampsia lebih rendah secara signifikan dibandingkan kehamilan normal (88,73 ± 42,22 vs 111,11 ± 52,49 pg/ml), dengan p-value = 0,033. Kadar kalsium serum pada pasien preeklampsia juga secara signifikan lebih rendah dibandingkan ibu hamil normal (8,67 ± 0,49 vs 9,55 ± 0,93 mg/dL), dengan p-value = <0,0001. Namun, tidak ada hubungan antara kadar serum 1,25(OH)2D3 serum dengan kadar serum kalsium pada kehamilan. Kesimpulan: Kadar serum 1,25-dihidroksivitamin D3 dan kalsium pada preeklamsia lebih rendah secara signifikan dibandingkan kehamilan normal. Kadar serum 1,25-dihidroksivitamin D3 juga ditemukan memiliki korelasi yang signifikan dengan tekanan darah sistolik dan diastolik pada pasien preeklamsia. Temuan ini memperkuat saran akan pentingnya suplementasi vitamin D dan kalsium selama kehamilan untuk menurunkan risiko preeklampsia dan untuk mendapatkan luaran maternal yang lebih baik. Kata kunci: 1,25-Dihydroxyvitamin D3, kalsium, hipertensi, kehamilan, preeklamsia