Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Permanente Medical Group, Oakland, California.
Am J Perinatol. 2020 Dec;37(14):1446-1454. doi: 10.1055/s-0039-1694007. Epub 2019 Jul 31.
To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women.
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.
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)D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79-0.95], = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80-0.97], = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)D levels were associated with group B 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)D levels were significantly lower in women with preterm delivery and LBW infants.
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.
探讨人类免疫缺陷病毒（HIV）感染孕妇维生素 D 不足与妊娠高血压（PIH）风险的关系。
本研究是一项回顾性队列研究，评估了低母体维生素 D 水平对 HIV 感染孕妇 PIH 及围产期结局的影响，研究对象为 1991 年至 2014 年在城市 HIV 中心接受治疗的 HIV 感染孕妇。
共纳入 366 名孕妇，其中 11%发生 PIH。25-羟维生素 D（25（OH）D）和生物活性 1,25-二羟维生素 D（1,25（OH）D）水平较低与 HIV 疾病活动度增加有关。25（OH）D 水平与 PIH 的发生率无显著相关性。单因素分析（比值比，OR：0.87 [95%置信区间，CI：0.79-0.95]， = 0.004）和多因素分析（OR：0.88 [95% CI：0.80-0.97]， = 0.010）显示，1,25（OH）D 水平较高与 PIH 发生率降低相关。25（OH）D 水平与其他产科结局之间未发现相关性。较低的 1,25（OH）D 水平与 B 组定植（OR：0.92 [95% CI：0.86-0.99]）和低出生体重（LBW）（OR：0.90 [95% CI：0.83-0.98]）相关，多因素分析显示。早产和 LBW 婴儿的产妇 1,25（OH）D 平均水平显著降低。
HIV 感染妇女中生物活性维生素 D 水平较低与 PIH 相关。这种关联可能与胎盘维生素 D 代谢异常和胎盘植入异常并存有关。
