Research Article
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What is the role of vitamin D deficiency in the pathogenesis of hyperemesis gravidarum?

Year 2018, Volume: 4 Issue: 2, 761 - 771, 15.08.2018
https://doi.org/10.30569/adiyamansaglik.408555

Abstract

Objectives:
Therefore
in this study, we investigated the relationship between hyperemesis gravidarum
and vitamin D deficiency.

Materials
and methods:
This is a retrospective case control
study which was held in the Medical Park Goztepe Hospital, Obstetrics and
Gyneacology Clinic between 1st of January and 31th of December 2017. The study
group consists of 50 women experience with newly- onset nausea and vomitting in
the first trimester of pregnancy  and the
control group consists of 50 healthy pregnant women at the same age group.

 
Therefore,
in the current study, we tested the hypothesis that suggests women with
hyperemesis gravidarum have lower 25-hydroxyvitamin D levels compared to
controls.

Results:
The  mean 25-hydroxy vitamin D levels was
significantly different between two groups (15,85ng/ml vs 19,64ng/ml; p<0.037).

Conclusion:
We
found that there was a correlation between vitamin  D deficiency and hyperemesis gravidarum.
Therefore , it might be speculated that,vitamin D level may play a critical
role in controlling inflammatory status associated with hyperemesis gravidarum.
We believe that vitamin D supplementation
and HG frequency can be reduced in pregnancies in which D vitamin deficiency is
detected in the first trimester or even in the pre-pregnancy 
period.  

References

  • 1. Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J. Hyperemesis gravidarum: a review. J Reprod Med 1994; 39: 605-12.
  • 2. Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry sudy. Eur J Obstet Gynecol Reprod Biol 1987; 26: 291-302.
  • 3. Bailit JL. Hyperemesis gravidarium: epidemiologic findings from a large cohort. Am J Obstet Gynecol.2005;193:811-4.
  • 4. Adams MM, Harlass FE, Sarno AP, Read JA, Rawlings JS. Antenatal hospitalization among enlisted servicewomen, Obstet Gynecol.1994;84:35-9.
  • 5. Gazmararian JA, Petersen R, Jamieson DJ, Schild L, Adams MM, Deshpande AD et al. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol.2002;100:94- 100.
  • 6. Einarson TR, Piwko C, Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J Popul Ther Clin Pharmacol 2013;20:171-83.
  • 7. Verberg MF, Gillott DJ, Al-Fardan N, et al. Hyperemesis gravidarum, a literature review. Hum Reprod . 2005; 11:527–39.
  • 8. Lacasse A, Rey E, Ferreira E, Morin C, Bérard A. Epidemiology of nausea and vomiting of pregnancy: prevalence, severity, determinants, and the importance of race/ethnicity. BMC Pregnancy Childbirth 2009;2;9:26.
  • 9. Klebanoff MA, Koslowe PA, Kaslow R, Rhoads GG. Epidemiology of vomiting in early pregnancy. Obstet Gynecol 1985;66:612-6.
  • 10. Heinrichs L. Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache. Am J Obstet Gynecol 2002;186:215-9.
  • 11. Koren G, Boskovic R, Hard M et al. Motherisk-PUQE [pregnancy-unique quantification of emesis and nausea] scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 2002;186: 228–31.
  • 12. Lacasse A, Rey E, Ferreira E et al. Validity of a modified Pregnancy-Unique Quantification of Emesis and Nausea [PUQE]scoring index to assess severity of nausea and vomiting of pregnancy. Am J Obstet Gynecol 2008; 198: 71–7.
  • 13. Ergur, A.T., Ergür AT, Berberoğlu M, Atasay B, Şıklar Z, Bilir P, Arsan S, Söylemez F, Öcal G. Vitamin D deficiency in Turkish mothers and their neonates and in women of reproductive age. J Clin Res Pediatr Endocrinol, 2009;1-6: 266-9.
  • 14. Gur, G. Abaci A, Köksoy AY, Anik A, Catli G, Kişlal FM, Akin KO, Andiran N. Incidence of maternal vitamin D deficiency in a region of Ankara, Turkey. Turk J Med Sci 2014;44:616-23.
  • 15. Practice, A.C.o.O.Vitamin D Screening and supplementation during pregnancy. Obstetrics & Gynecology 2011;118:197-8.
  • 16. Taylor CL, Yaktine AL, Del Valle HB.Dietary reference intakes for calcium and vitamin D. National Academy of Sciences 2011.
  • 17. Cantorna MT. Vitamin D, multiple sclerosis and inflammatory bowel disease. Arch Biochem Biophys 2012; 523:103–6.
  • 18. Zella JB, McCary LC, DeLuca HF. Oral administration of 1,25- dihydroxyvitaminD3 completely protects NOD mice from insulin- dependent diabetes mellitus. Arch Biochem Biophys 2003;417:77–80.
  • 19. Bruce D, Yu S, Ooi JH, Cantorna MT. Converging pathways lead to overproduction of IL-17 in the absence of vitamin D signaling. Int Immunol 2011;23:519–28.
  • 20. Michael F, Holick NC, Binkley HA, Bischoff-Ferrari M, Gordon DA, Hanley RP. Heaney M. Hassan Murad M. Evaluation, Treatment, and Prevention of Vitamin D Deficiency. The Journal of Clinical Endocrinology & Metabolism 2011;96:1911–30.
  • 21. JS Shin, MY Choi, MS Longtine, DM Nelson . Vitamin D effects on pregnancy and the placenta. Placenta 2010 ;1:15.
  • 22. Fernández-Alonso AM1, Valdera-Simbrón CJ, Fiol-Ruiz G, Rodríguez-Sánchez F, Chedraui P, Pérez-López FR. First trimester serum levels of 25-hydroxyvitamin D, free β-human chorionic gonadotropin, and pregnancy-associated plasma protein A in Spanish women. Gynecol Endocrinol. 2011;27:1061-4.
  • 23. Evans SK, Aiello DP, Green MR. Fluorescence resonance energy transfer as a method for dissecting in vivo mechanisms of transcriptional activation. Biochem Soc Symp 2006 ;1:217-24.

Hiperemezis gravidarum etiyopatogenezinde vitamin D eksikliğinin rolü var mı ?

Year 2018, Volume: 4 Issue: 2, 761 - 771, 15.08.2018
https://doi.org/10.30569/adiyamansaglik.408555

Abstract

Amaç:
Bu
retrospektif olgu-kontrol çalışmamızda D vitamini eksikliğinin, spesifik
olarak, gebeliğin bulantı-kusması ve hiperemezis gravidarum (HG) tablosu üzerindeki
etkilerini araştırdık.

Gereç
ve Yöntemler
: Bu retrospektif  olgu-kontrol
çalışmasına;   Medikal  Park Göztepe Hastane’si Kadın
Hastalıkları ve Doğum Kliniği’ne Ocak 2017–Aralık 2017  yılı
içerisinde, ilk trimesterde başvurmuş  HG’lu 50 gebe (olgu grubu)
ile  yaş ve  gebelik haftası ile eşleştirilmiş 50 sağlıklı
gebe (kontrol grubu ) dahil edildi. Bu çalışmada, HG tablosunun özelliklerini
taşıyan ilk trimester gebelerinin, ilk trimesterde  rutin olarak
baktırdıkları  D vitamini düzeyleri incelenmiş  ve olgu-kontrol
grupları arasında D vitamini
düzeyleri   arasında  istatistiksel
olarak  anlamlı bir ilişki olup olmadığı ortaya konmaya
çalışılmıştır.

Bulgular:  Olgu ve kontrol
grupları arasında D vitamini seviyeleri istatistiksel olarak anlamlı düzeyde farklı
bulundu (p<0,037).  Olgu grubunda
ortalama D vitamini düzeyi 15,85 ng/ml, kontrol grubunda ortalama vitamin D
düzeyi 19,64 ng/ml olarak saptandı. İstatistiksel olarak olgu- kontrol
gruplarında yaş ortalamaları açısından anlamlı farklılık bulunmadı (p>0,398).
Olgu- kontrol grupları arasında gebelik haftası açısından istatistiksel olarak
anlamlı bir farklılık bulunmadı (p>0,481).

Sonuç:
Çalışmamızda
25 hidroksi vitamin D seviyeleri olgu grubunda kontrol grubuna göre
istatistiksel olarak düşük saptandı. Düşük 25 hidroksi vitamin D düzeylerinin
HG patogenezinde etkin bir rol oynadığını düşünmekteyiz. İlk trimesterde hatta gebelik
öncesi dönemde D vitamini eksikliği saptanan gebelerde, D vitamini desteği ile
HG sıklığının azaltılabileceği kanaatindeyiz.









 

References

  • 1. Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J. Hyperemesis gravidarum: a review. J Reprod Med 1994; 39: 605-12.
  • 2. Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry sudy. Eur J Obstet Gynecol Reprod Biol 1987; 26: 291-302.
  • 3. Bailit JL. Hyperemesis gravidarium: epidemiologic findings from a large cohort. Am J Obstet Gynecol.2005;193:811-4.
  • 4. Adams MM, Harlass FE, Sarno AP, Read JA, Rawlings JS. Antenatal hospitalization among enlisted servicewomen, Obstet Gynecol.1994;84:35-9.
  • 5. Gazmararian JA, Petersen R, Jamieson DJ, Schild L, Adams MM, Deshpande AD et al. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol.2002;100:94- 100.
  • 6. Einarson TR, Piwko C, Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J Popul Ther Clin Pharmacol 2013;20:171-83.
  • 7. Verberg MF, Gillott DJ, Al-Fardan N, et al. Hyperemesis gravidarum, a literature review. Hum Reprod . 2005; 11:527–39.
  • 8. Lacasse A, Rey E, Ferreira E, Morin C, Bérard A. Epidemiology of nausea and vomiting of pregnancy: prevalence, severity, determinants, and the importance of race/ethnicity. BMC Pregnancy Childbirth 2009;2;9:26.
  • 9. Klebanoff MA, Koslowe PA, Kaslow R, Rhoads GG. Epidemiology of vomiting in early pregnancy. Obstet Gynecol 1985;66:612-6.
  • 10. Heinrichs L. Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache. Am J Obstet Gynecol 2002;186:215-9.
  • 11. Koren G, Boskovic R, Hard M et al. Motherisk-PUQE [pregnancy-unique quantification of emesis and nausea] scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 2002;186: 228–31.
  • 12. Lacasse A, Rey E, Ferreira E et al. Validity of a modified Pregnancy-Unique Quantification of Emesis and Nausea [PUQE]scoring index to assess severity of nausea and vomiting of pregnancy. Am J Obstet Gynecol 2008; 198: 71–7.
  • 13. Ergur, A.T., Ergür AT, Berberoğlu M, Atasay B, Şıklar Z, Bilir P, Arsan S, Söylemez F, Öcal G. Vitamin D deficiency in Turkish mothers and their neonates and in women of reproductive age. J Clin Res Pediatr Endocrinol, 2009;1-6: 266-9.
  • 14. Gur, G. Abaci A, Köksoy AY, Anik A, Catli G, Kişlal FM, Akin KO, Andiran N. Incidence of maternal vitamin D deficiency in a region of Ankara, Turkey. Turk J Med Sci 2014;44:616-23.
  • 15. Practice, A.C.o.O.Vitamin D Screening and supplementation during pregnancy. Obstetrics & Gynecology 2011;118:197-8.
  • 16. Taylor CL, Yaktine AL, Del Valle HB.Dietary reference intakes for calcium and vitamin D. National Academy of Sciences 2011.
  • 17. Cantorna MT. Vitamin D, multiple sclerosis and inflammatory bowel disease. Arch Biochem Biophys 2012; 523:103–6.
  • 18. Zella JB, McCary LC, DeLuca HF. Oral administration of 1,25- dihydroxyvitaminD3 completely protects NOD mice from insulin- dependent diabetes mellitus. Arch Biochem Biophys 2003;417:77–80.
  • 19. Bruce D, Yu S, Ooi JH, Cantorna MT. Converging pathways lead to overproduction of IL-17 in the absence of vitamin D signaling. Int Immunol 2011;23:519–28.
  • 20. Michael F, Holick NC, Binkley HA, Bischoff-Ferrari M, Gordon DA, Hanley RP. Heaney M. Hassan Murad M. Evaluation, Treatment, and Prevention of Vitamin D Deficiency. The Journal of Clinical Endocrinology & Metabolism 2011;96:1911–30.
  • 21. JS Shin, MY Choi, MS Longtine, DM Nelson . Vitamin D effects on pregnancy and the placenta. Placenta 2010 ;1:15.
  • 22. Fernández-Alonso AM1, Valdera-Simbrón CJ, Fiol-Ruiz G, Rodríguez-Sánchez F, Chedraui P, Pérez-López FR. First trimester serum levels of 25-hydroxyvitamin D, free β-human chorionic gonadotropin, and pregnancy-associated plasma protein A in Spanish women. Gynecol Endocrinol. 2011;27:1061-4.
  • 23. Evans SK, Aiello DP, Green MR. Fluorescence resonance energy transfer as a method for dissecting in vivo mechanisms of transcriptional activation. Biochem Soc Symp 2006 ;1:217-24.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Tuğba Gürbüz

Nur Dokuzeylül Güngör

Publication Date August 15, 2018
Submission Date March 21, 2018
Acceptance Date March 28, 2018
Published in Issue Year 2018 Volume: 4 Issue: 2

Cite

AMA Gürbüz T, Dokuzeylül Güngör N. Hiperemezis gravidarum etiyopatogenezinde vitamin D eksikliğinin rolü var mı ?. ADYÜ Sağlık Bilimleri Derg. August 2018;4(2):761-771. doi:10.30569/adiyamansaglik.408555