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Efeitos dos níveis maternos de vitamina D na Pré-eclampsia
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Abstract(s)
Introdução: A pré-eclampsia (PE), uma doença hipertensiva da gravidez da qual a etiologia ainda não é totalmente compreendida, afeta 8-10% das gestantes no mundo, representando um dos maiores desafios da medicina materno-fetal. A deficiência de vitamina D, prevalente na gestação, tem sido associada a resultados adversos na gravidez, nomeadamente a PE. As evidências sobre o estado e a suplementação de vitamina D na etiologia e prevenção da PE são abordadas neste trabalho. Objetivos: Verificar se existe uma relação entre o défice de vitamina D e a pré-eclampsia bem como se a suplementação com vitamina D na gravidez tem um efeito protetor no desenvolvimento da doença. Materiais e Métodos: A pesquisa bibliográfica foi realizada na plataforma PubMed, Elsevier e Scopus, utilizando as seguintes palavras-chave: "Vitamin D", "Vitamin D Deficiency" e "Pre-Eclampsia". Após a aplicação dos critérios de inclusão e de exclusão, foram incluídos um total de 22 artigos. Resultados: Nos estudos analisados observou-se que baixos níveis de vitamina D aumentam significativamente o risco de PE, enquanto que a suplementação demonstrou efeitos protetores, embora com evidências limitadas. A qualidade metodológica dos estudos, segundo a tabela de evidencia de Furuya-Kanamori et al. 2021, foi maioritariamente baixa, com apenas um estudo de suplementação e dois sobre níveis séricos de vitamina D classificados como de alta qualidade. Conclusão: Embora a deficiência de vitamina D esteja associada a um maior risco de PE, a causalidade permanece inconclusiva. Dados sobre a suplementação são promissores, mas evidências limitadas impedem conclusões definitivas. Ensaios clínicos robustos, com maiores amostras e controlo rigoroso de variáveis, são essenciais para confirmar o papel da vitamina D na prevenção da PE.
Introduction: Preeclampsia (PE), a hypertensive disorder of pregnancy whose etiology is not yet fully understood, affects 8-10% of pregnant women worldwide, representing one of the greatest challenges in maternal-fetal medicine. Vitamin D deficiency, prevalent during pregnancy, has been associated with adverse pregnancy outcomes, namely PE. The evidence on vitamin D status and supplementation in the etiology and prevention of PE is addressed in this work. Objectives: To verify whether there is a relationship between vitamin D deficiency and pre-eclampsia, as well as whether vitamin D supplementation during pregnancy has a protective effect on the development of the disease. Materials and Methods: The bibliographic search was performed on the PubMed, Elsevier and Scopus platforms, using the following keywords: "Vitamin D", "Vitamin D Deficiency" and "Pre-Eclampsia". After applying the inclusion and exclusion criteria, a total of 22 articles were included. Results: In the studies analyzed, it was observed that low levels of vitamin D significantly increase the risk of PE, while supplementation demonstrated protective effects, although with limited evidence. The methodological quality of the studies, according to the evidence table by Furuya-Kanamori et al. 2021, was mostly low, with only one supplementation study and two on serum vitamin D levels classified as high quality. Conclusion: Although vitamin D deficiency is associated with an increased risk of PE, causality remains inconclusive. The data on supplementation is promising, but limited evidence prevents definitive conclusions. Robust clinical trials, with larger samples and rigorous control of variables, are essential to confirm the role of vitamin D in the prevention of PE.
Introduction: Preeclampsia (PE), a hypertensive disorder of pregnancy whose etiology is not yet fully understood, affects 8-10% of pregnant women worldwide, representing one of the greatest challenges in maternal-fetal medicine. Vitamin D deficiency, prevalent during pregnancy, has been associated with adverse pregnancy outcomes, namely PE. The evidence on vitamin D status and supplementation in the etiology and prevention of PE is addressed in this work. Objectives: To verify whether there is a relationship between vitamin D deficiency and pre-eclampsia, as well as whether vitamin D supplementation during pregnancy has a protective effect on the development of the disease. Materials and Methods: The bibliographic search was performed on the PubMed, Elsevier and Scopus platforms, using the following keywords: "Vitamin D", "Vitamin D Deficiency" and "Pre-Eclampsia". After applying the inclusion and exclusion criteria, a total of 22 articles were included. Results: In the studies analyzed, it was observed that low levels of vitamin D significantly increase the risk of PE, while supplementation demonstrated protective effects, although with limited evidence. The methodological quality of the studies, according to the evidence table by Furuya-Kanamori et al. 2021, was mostly low, with only one supplementation study and two on serum vitamin D levels classified as high quality. Conclusion: Although vitamin D deficiency is associated with an increased risk of PE, causality remains inconclusive. The data on supplementation is promising, but limited evidence prevents definitive conclusions. Robust clinical trials, with larger samples and rigorous control of variables, are essential to confirm the role of vitamin D in the prevention of PE.
Description
Keywords
Vitamina D Pré-eclampsia Suplementação Gravidez Saúde Materno-Fetal Preeclampsia Supplementation Pregnancy Maternal-Fetal Health