تقييم مستوى فيتامين د لدى الحوامل المصابات بتسمم الحمل والحوامل الأصحاء
Assessment of Vitamin D Level in Preeclamptic and Healthy Pregnant Women
- الباحث
- علاء أكرم قاسم
- المشرف
- عفراء محمد الأمين
- الجامعة
- جامعة الموصل
- الكلية / القسم
- كلية الطب / الفسلجة الطبية
- الشهادة
- ماجستير
- السنة
- 2022
- لغة الرسالة
- انكليزي
- الكلمات المفتاحية
- Vitamin D ; Preeclampsia ; Pregnancy ; Medical Physiology
Abstract
Pre-eclampsia is a pregnancy-specific disorder that affects pregnant women after twenty weeks of gestation and may lead to multiple maternal and fetal complications. The pathophysiology of pre-eclampsia is multifactorial, with several genetic, environmental and immunological factor modification that related to the placental vascularization and angiogenesis that permits healthy placentation. Vitamin D is a fat-soluble vitamin. Maternal vitamin D deficiency has been associated with an increased risk of pre-eclampsia and has roles in pre-eclampsia through influences on immune modulation and vascular function. The study aims to assess vitamin D levels in preeclamptic and normotensive pregnant women in the second and third trimester, to find out the correlation between vitamin D deficiency and pre-eclampsia, and to evaluate the effect of pre-eclampsia on different organ systems of the mother This case-control study was performed in period from November 2020 till the end of April 2021 in the Obstetrics and Gynecology Department in Al-Batool and Al-Khansaa Teaching Hospitals and Primary Health Centers in Mosul city/Iraq The study includes two hundred six randomly selected pregnant women after twenty weeks of gestation in the age range of 16-40 years and without any chronic medical illnesses. The participants has been selected as cases and control groups. The cases group was one hundred six pregnant women with elevated blood pressure (V\VWROLFEORRGSUHVVXUH 6%3 •PP+JRUGLDVWROLFEORRG SUHVVXUH '%3 • PP+J) and presence of proteinuria, and the control group was one hundred normotensive pregnant women. The questionnaire was filled by each participant with basic information. Physical measurements has been done for all women included in this study were height, weight, body mass index (BMI) was calculated, and the laboratory parameters were included Vitamin D level, serum calcium, serum phosphate, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea, serum creatinine, platelet count, and presence of proteinuria. The result of the study revealed that the level of vitamin D of the participants was significantly lower in preeclamptic pregnant women with the mean (7.82±4.80ng/ml) in comparison to normotensive pregnant women with the mean (11.22±8.51ng/ml), the p-value was 0.001, (odds ratio = 5.1, 95% C.I. =1.94 -15.00) and about 51.9% of preeclamptic women group had vitamin D level between (5-9.9 ng/ml). There was a significant difference in liver biomarkers (ALT, AST) and kidney biomarker (blood urea, serum creatinine) with higher levels in the preeclamptic pregnant compared to the normotensive pregnant group with a p- value 0.001 and also was a significant difference of low level in platelet count in preeclamptic group comparing to control pregnant group with a p-value 0.001. On the other hand, there was no significant association between the level of serum calcium and serum phosphate between the two groups with the p-value (0.942, 0.588) respectively. The Pearson correlation in the preeclamptic pregnant group showed a weak positive significant correlation between the vitamin D and platelet count (r=0.270, p-value=0.007) and a positive non-significant correlation between vitamin D and serum phosphate (r=0.140, p-value=0.153). In contrast, a weak negative significant correlation between the vitamin D and serum creatinine and AST with (r= -0.294, p-value=0.012) (r= - 0.206, p-value=0.044) respectively. The study concluded that vitamin D level was lower in preeclamptic women compared to normotensive pregnant women and vitamin D deficiency increases the risk of pre-eclampsia in pregnant women by five times in addition to the effect of pre-eclampsia on many organ systems demonstrated by alteration in the biomarkers of the liver function, renal function, and platelet count.
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