الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
Pregnancy induced hypertension is a pregnancy-specific disorder that affects 3–5% of pregnant women worldwide and is one of the most frequently encountered medical complication of pregnancy.
Hypertension is one of the most common medical complications of pregnancy. It remains one of the leading causes of maternal deaths all over the world. Early detection and appropriate management of the pregnancy may improve the outcome for both the mother and the fetus.
Despite growing knowledge of the pathophysiology of pregnancy induced hypertensive disorders, there is no preventive measures have been shown to be effective.
Recent research has pointed towards some role of vitamin D deficiency in pathogenesis of preeclampsia. Vitamin D deficiency in pregnant women and their children is a major health problem, with potential adverse consequences for overall health.
Vitamin D deficiency correlates with many other adverse effects such as infertility, gestational diabetes mellitus, bacterial vaginosis, preterm labour, low birth weight and an increased risk for cesarean delivery.
During pregnancy and lactation, significant changes in maternal vitamin D and calcium metabolism occur to provide the calcium that is needed for fetal bone mineral accretion.
Compared to normal pregnancies, vitamin D metabolism is markedly altered in pregnancy induced hypertension. This may be due to reduced placental 1α-hydroxylase activity resulting in lower circulating calcitriol concentrations compared to normotensive pregnant women.
Vitamin D inhibits the mRNA transcription of inflammatory cytokine genes (TNFα, IFNγ and IL-6) in trophoblast cell. Immune challenge by lipopolysaccharide induces the expression of VDR and CYP27B1 along with cytokines such as IL-6 in placenta.
The increase in the number of studies on this subject shows conflicting results on the association between 25(OH)D levels in pregnancy and adverse effects on maternal and fetal health, both skeletal and non-skeletal such as autoimmune diseases, cardiovascular diseases, diabetes and certain types of cancer.
The current study aimed to compare Serum 25 hydroxy vitamin D levels among patients with pregnancy induced hypertension and healthy normotensive pregnant women.
A case-control study was conducted at Minia University Maternity Hospital as 90 pregnant women, between 20-40 years, with Singleton pregnancy, between20-40 weeks of gestation without any other medical disorders. They were classified into 2 groups:
- group (1): 45 pregnancy induced hypertensive women.
- group (2): 45 normotensive women.
Pregnancy induced hypertension was defined as a systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mmHg and the presence of +1 or more of proteinuria or without proteinuria in gestational hypertension after 20 weeks of gestation.
Deficiency of vitamin D level in pregnant women was defined as serum level < 20 ng/ml, insufficiency as 21-30 ng/ml and optimum level as > 30 ng/ml.
All samples were screened by oRG570® 25-OH Vitamin D (total) ELISA (EIA-5396) as other methods of measurements arenot available in Egypt and it was found that mean 25 hydroxy vitamin D levels were lower in pregnancy induced hypertensive group than normotensive control group. Mean level of 25 hydroxy vitamin D between pregnancy induced hypertensive cases was11.7±3.4 ng/ml and between normotensive controls was 31.2±7.1 ng/ml
So, according to P value, the current study hypothesized that there is a significant deficiency in serum 25 hydroxy vitamin D levels in pregnancy induced hypertensive group than normotensive group.
In conclusion, from this study it can be concluded that vitamin D assay can be used for prediction of preeclampsia and vitamin D supplementation can be routinely recommended in prevention of pregnancy induced hypertension.
Conclusion
This study has shown an association between vitamin D level and pregnancy induced hypertension supporting definit role for vitamin D as a preventative agent against pregnancy induced hypertension.