Journal des soins de santé des femmes
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Vitamin D Supplemental Therapy can Explore the Interplay Circuit between Hypovitaminosis D, High Serum IL-6 and Pregnancy-Associated Morbidities

Khaled Fathy Helal and Ola A Harb

Objectives: To evaluate the relation between baseline Vitamin D (VD) serum levels and incidence and severity of Pregnancy-Associated Morbidities (PAM).

Patients and methods: The study included 386 pregnant women attended at the 6th gestational week and after full clinical and obstetric examination, gave fasting blood samples for estimation of fasting blood glucose (FBG) and ELISA estimation of serum VD, insulin and interleukin-6 (IL-6). Insulin resistance (IR) was determined according to homeostasis model assessment IR (HOMA-IR) score that was considered abnormal at score of ≥ 2. Enrolled women were categorized according to a booking VD level as sufficient (Group A), insufficient (Group B) and deficient (Group C). Women of group C received daily oral VD (1000 IU) supplemental therapy (VD-ST) till delivery. Study outcomes included incidence of PAM and its relation to serum VD levels, and the effect of VD-ST on incidence and severity of PAM.

Results: Groups A-C included 86, 130 and 170 women, respectively and 263 women developed 424 PAM. PAM incidence and serum IL-6 levels were significantly higher in group B than other groups. PAM incidence and serum IL-6 levels showed negative significant correlations with serum VD levels. Moreover, PAM incidence showed positive significant correlation with serum IL-6 level. ROC curve analysis defined at booking serum VD as significant specific and serum IL-6 as significant sensitive predictors for PAM development. VD-ST allowed significant reduction of PAM with significant reduction of serum IL-6 and FBG levels and IR. Incidence of PAM was negatively correlated with receiving VD-ST that was found to be significant predictor for decreased PAM incidence.

Conclusion: Hypovitaminosis D and high IL-6 serum levels may underlie PAM development. VD-ST improved pregnancy outcome in women with VD deficiency to a level better than in women with insufficient VD levels; thus it is recommended as empirical therapy for pregnant women.