Preeclampsia at delivery is associated with lower serum vitamin D and higher antiangiogenic factors: a case control study

David B. Seifer, Geralyn Lambert-Messerlian, Glenn E. Palomaki, Robert M. Silver, Corette Parker, Carol J. Rowland Hogue, Barbara J. Stoll, George R. Saade, Robert L. Goldenberg, Donald J. Dudley, Radek Bukowski, Halit Pinar, Uma M. Reddy

Research output: Contribution to journalArticlepeer-review


Background: Preeclampsia is characterized by decreased trophoblastic angiogenesis leading to abnormal invasion of spiral arteries, shallow implantation and resulting in compromised placentation with poor uteroplacental perfusion. Vitamin D plays an important role in pregnancy influencing implantation, angiogenesis and placental development. The objective of this study was to determine whether there is an association between serum vitamin D levels, and anti-angiogenic factors at the time of delivery and the occurrence of preeclampsia. Methods: This nested case control study analyzed frozen serum samples at the time of delivery and related clinical data from women with singleton liveborn pregnancies who had participated in studies of the NICHD Stillbirth Collaborative Research Network. Women with a recorded finding of preeclampsia and who had received magnesium sulfate treatment prior to delivery were considered index cases (N = 56). Women without a finding of preeclampsia were controls (N = 341). Results: Women with preeclampsia had 14.5% lower serum vitamin D levels than women in the control group (16.5 ng/ml vs. 19 ng/ml, p = 0.014) with 64.5% higher sFlt-1 levels (11,600 pg/ml vs. 7050 pg/ml, p < 0.001) and greater than 2 times higher endoglin levels (18.6 ng/ml vs. 8.7 ng/ml, < 0.001). After controlling for gestational age at delivery and maternal BMI, vitamin D levels were 0.88 times lower (P = 0.051), while endoglin levels were 2.5 times higher and sFlt-1 levels were 2.1 times higher than in control pregnancies (P < 0.001). Conclusions: Women with preeclampsia at time of delivery have higher maternal antiangiogenetic factors and may have lower maternal serum vitamin D levels. These findings may lead to a better understanding of the underlying etiology of preeclampsia as well as possible modifiable treatment options which could include assuring adequate levels of maternal serum vitamin D prior to pregnancy.

Original languageEnglish (US)
Article number8
JournalReproductive Biology and Endocrinology
Issue number1
StatePublished - Dec 2022


  • Antiangiogenetic factors
  • Endoglin
  • Preeclampsia
  • Pregnancy
  • Vitamin D
  • sFlt-1

ASJC Scopus subject areas

  • Reproductive Medicine
  • Endocrinology
  • Obstetrics and Gynecology
  • Developmental Biology


Dive into the research topics of 'Preeclampsia at delivery is associated with lower serum vitamin D and higher antiangiogenic factors: a case control study'. Together they form a unique fingerprint.

Cite this