• Shanga Abdulla Sleman Obstetrics and Gynecology Trainee, Sulaimani Maternity Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.
  • Ghada Saadallah Alsakkal Hawler Medical University, Erbil, Kurdistan Region, Iraq.
  • Shayan Jalal Khalaf Department of Gynecology and Obstetrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.



Preeclampsia, Vitamin D, Pregnancy, Sulaimani



Preeclampsia is new-onset hypertension and proteinuria after 20 gestational weeks. A low vitamin D level is thought to associate with a higher risk of preeclampsia.


We aimed to find the association of serum vitamin D levels with preeclampsia in our population, in which vitamin D deficiency is common. 

Patients and Methods

A prospective cohort study was performed on 80 pregnant women who were admitted to Sulaimani Maternity Teaching Hospital, Sulaimani, Kurdistan, Iraq. The women were collected from October 1, 2019, to March 13, 2020. The women were randomly selected and enrolled into three groups according to their clinical features of preeclampsia; no features of preeclampsia, a mild degree of preeclampsia, and severe form of preeclampsia. The inclusion criterion was pregnant women, and exclusion criteria were women with a history of hypertension, history of proteinuria before pregnancy, and refusal to participate. Demographic features and detailed clinical examination were recorded. Also, the serum vitamin D (ng/dL) was measured by Cobas ® 6000 analyzer machine (F. Hoffmann-La Roche Ltd).


The mean ± SD (standard deviation) of participants’ age was 31.33 ± 6.05 years, and there were no significant differences in demographic features among the three groups. Systolic and diastolic blood pressures among the three groups were significantly different. There was no significant association between pregnant women and serum vitamin D levels. However, all of the preeclamptic women had either deficient or insufficient serum vitamin D levels.


There was no significant association between serum vitamin D levels in pregnant women and the occurrence of preeclampsia.


- Sachan R, Patel ML, Dhiman S, Gupta P, Sachan P, Shyam R. Diagnostic and prognostic significance of serum soluble endoglin levels in preeclampsia and eclampsia. Adv Biomed Res. 2016; 5:119. DOI:

- Hutabarat M, Wibowo N, Obermayer-Pietsch B, Huppertz B. Impact of vitamin D and vitamin D receptor on the trophoblast survival capacity in preeclampsia. PLoS One. 2018; 13(11):e0206725.

- Mirzakhani H, Litonjua AA, McElrath TF, O'Connor G, Lee-Parritz A, Iverson R, et al. Early pregnancy vitamin D status and risk of preeclampsia. J Clin Invest. 2016; 126(12):4702-15. DOI:

- Wang Y, Chen Q, Zhao M, Walton K, Harrison C, Nie G. Multiple Soluble TGF-β Receptors in Addition to Soluble Endoglin Are Elevated in Preeclamptic Serum and They Synergistically Inhibit TGF-β Signaling. J Clin Endocrinol Metab. 2017; 102(8):3065–74. DOI:

- Bell MJ, Roberts JM, Founds SA, Jeyabalan A, Terhorst L, Conley YP. Variation in endoglin pathway genes is associated with preeclampsia: a case-control candidate gene association study. BMC Pregnancy Childbirth. 2013; 13:82. DOI:

- Tian H, Ketova T, Hardy D, Xu X, Gao X, Zijlstra A, et al. Endoglin Mediates Vascular Maturation by Promoting Vascular Smooth Muscle Cell Migration and Spreading [published correction appears in Arterioscler Thromb Vasc Biol. 2017 Jun;37(6):e67]. Arterioscler Thromb Vasc Biol. 2017; 37(6):1115–26. DOI:

- Portelli M, Baron B. Clinical Presentation of Preeclampsia and the Diagnostic Value of Proteins and Their Methylation Products as Biomarkers in Pregnant Women with Preeclampsia and Their Newborns. J Pregnancy. 2018;2018:2632637. DOI:

- Grauer GF. Proteinuria: measurement and interpretation. Top Companion Anim Med. 2011;26(3):121-7. DOI:

- Reda H, Soliman S, Girguis H, Nagy M, Mahmoud Y, Yasser N. A Comparison between Three Different Automated Total 25-hydroxyvitamin D Immunoassay Methods and Ultra Performance Liquid Chromatography. Asian Pac J Cancer Prev. 2020;21(4):1039-1044. DOI:

- Erdfelder E, Faul F, Buchner A. GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers. 1996;28:1–11. DOI:

- Mustafa AJ, Salih AF. Vitamin D intoxication in infants with vitamin D supplements. JSMC. 2020; 10(1): 67-71. DOI:

- Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, Del Valle HB. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011. Available from: DOI: 10.17226/13050. DOI:

- Goel P, Garg G, Kaur J, Mehra R, Tandon R, Huria A. Association of vitamin D deficiency during pregnancy with preeclampsia and eclampsia. IJRCOG. 2016; 5(9):3046-50. DOI:

Bodnar LM, Catov JM, Zmuda JM, Cooper ME, Parrott MS, Roberts JM, et al. Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational-age births in white women. J Nutr. 2010;140(5):999-1006. DOI:

- Weiss ST, Litonjua AA. The in utero effects of maternal vitamin D deficiency: how it results in asthma and other chronic diseases. Am J RespirCrit Care Med. 2011; 183(10):1286-7. DOI:

- Urrutia RP, Thorp JM. Vitamin D in pregnancy: current concepts. Curr Opin Obstet Gynecol. 2012; 24(2):57-64. DOI:

- Fogacci S, Fogacci F, Banach M, Michos ED, Hernandez AV, Lip GYH, et al. Vitamin D supplementation, and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials. Clin Nutr. 2020;39(6):1742-52. DOI:

- Hutabarat M, Wibowo N, Obermayer-Pietsch B, Huppertz B. Impact of vitamin D and vitamin D receptor on the trophoblast survival capacity in preeclampsia. PLoS ONE. 2018; 13(11):e0206725. DOI:

- Palacios C, Kostiuk LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019;7(7): CD008873. DOI:

- Akbari S, Khodadadi B, Ahmadi SAY, Abbaszadeh S, Shahsavar F. Association of vitamin D level and vitamin D deficiency with risk of preeclampsia: A systematic review and updated meta-analysis. Taiwan J Obstet Gynecol. 2018;57(2):241-7. DOI:

- Purswani JM, Gala P, Dwarkanath P, Larkin HM, Kurpad A, Mehta S. The role of vitamin D in preeclampsia: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):231. DOI:



How to Cite

Sleman S, Alsakkal G, Khalaf S. THE RISK OF LOW VITAMIN D IN THE DEVELOPMENT OF PREECLAMPSIA. JSMC [Internet]. 2021 Jun. 21 [cited 2024 Jul. 19];11(2):165-70. Available from:

Similar Articles

1-10 of 419

You may also start an advanced similarity search for this article.