On the relationship of vitamin D status and indicators of the uterine arteries pulsation index in pregnant women at risk of preeclampsia developing: cross-sectional study

Abstract

Preeclampsia (PE) of pregnant women continues to be one of the leading causes of maternal and perinatal morbidity and mortality, and the existing theories about the pathogenetic mechanisms of its development are not absolutely convincing. To take into account the data on the pleiotropic effects of vitamin D (VD) and its effect on reproductive function, we set a purpose to study the relationship between hemodynamic parameters in the uterine arteries and the level of VD in the blood of women at risk of PE developing. Materials and methods. From 2018 to 2021, 54 women with a risk of PE developing and VD insufficiency were under observation. A cross-sectional examination was carried out at the 1st trimester of pregnancy. Blood content of VD (25 (OH) D) was determined on an empty stomach by ELISA on a CobasIntegra 400 Plus analyzer (Roche Diagnostics, Switzerland). Measurement of the pulsation index in the uterine arteries (PI in UA) was done according to the recommendations of the Fetal Medicine Foundation (FMF) on an ultrasound apparatus "VOLUSON 730 EXPERT" (2008); volumetric convex intracavitary (RIC 5-9) and volumetric multifrequency convex probes (RAB 4-8P) were used. Results and discussion. The mean age of the women under examination was 28.4 ± 4.9 y.o.; there were 64.8% of primiparas; 62.9% of women were 25 y. o. and over; 92.6% of pregnant women were overweight or had obesity of various degrees; 72.5% of them had various extragenital pathologies. (25 (OH) D) mean level was 25.8 ± 7.3 ng / ml; the mean PI in UA was 1.98 ± 0.504. There were 19 pregnant women with PI in UA ranging > 50 and <95 percentile (35.19%), in every fifth woman (11 patients or - 20.4% ) resistance in MA exceeded 95 percentile. A significant negative statistical relationship was established between VD level in the blood and PI value in UA (rs = -0.734; P <0.01). Conclusions. Pregnant women with a high risk of PE development has pathologically increased resistance in the uterine vessels already in the first trimester of pregnancy. A strong inverse relationship was found between the level of vitamin D in the blood of high-risk pregnant women and indicator of impedance in the uterine arteries. Timely diagnosis and correction of vitamin D deficiency in women of reproductive age at the stage of preconception training can be a promising direction in the prediction and prevention of perinatal morbidity and mortality. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants.