Maternal Vitamin D and its Association with Angiogenesis in Preeclampsia

Abstract

Vitamin D plays a key role in pregnancy and influences processes like implantation, newlineimmune functions, angiogenesis, inflammation and placental development. Deficiency of vitamin newlineD during pregnancy is a common global problem, in India the prevalence of vitamin D deficiency newlineduring pregnancy ranges from 34 to 96%. Studies by us and others have reported low maternal newlinevitamin D concentrations in women with preeclampsia at the time of delivery. However, limited newlinestudies have examined serial concentrations across gestation in preeclampsia and are inconsistent. newlinePreeclampsia is a hypertensive disorder of pregnancy associated with abnormal placentation. It is newlinea primary cause of maternal and fetal morbidity and has implications on fetal health. It affects 2- newline10% pregnancies worldwide and 8-10% of pregnancies in India. The etiology of preeclampsia newlineremains unclear. However, it is known that there is an imbalance in the levels of angiogenic newlinefactors in women with preeclampsia. Higher levels of anti-angiogenic factors like soluble fmslike newlinetyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) and low levels of pro-angiogenic newlinefactors like vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) have newlinebeen reported in women with preeclampsia. Cell culture studies suggest that vitamin D may play newlinea crucial role in the process of angiogenesis. An animal model has demonstrated that maternal newlinevitamin D supplementation increases VEGF levels, although its effect on other angiogencic newlinefactors has not been examined. Further, the possible pathway through which vitamin D may newlineinfluences preeclampsia has not been studied. In addition, the role of vitamin D in influencing newlineangiogenesis in women with preeclampsia has not been explored. In view of this, study was newlineundertaken to explore the association of vitamin D and angiogenesis in preeclampsia. We newlinehypothesize that Maternal vitamin D influences angiogenesis in preeclampsia . This hypothesis newlineis evaluated by undertaking an animal study as well as a human study.