Vitamin-D deficiency as a potential indicator of defective placentation in preeclampsia

Objective: To determine the association of serum Vitamin-D levels and placental laminin expression in pre-eclamptic and normotensive women. Methods: This cross-sectional study was conducted from July 2018 to February 2021, in the Department of Anatomy, Basic Medical Sciences Institute (BMSI) in collaboration with the Department of Gynecology and Obstetrics after the approval from Institutional Review Board (IRB), Jinnah Postgraduate Medical Centre JPMC, Karachi. The placentae were collected from 120 women, segregated into two cohorts as normotensive (NT) (n=60) and pre-eclamptic (PE) (n=60) and serum Vitamin-D levels measured. All placentae were examined for histological changes by Hematoxylin & Eosin stain and the expression of Laminin (LN) was calculated by the optical density using ImageJ. Results: The serum Vitamin-D levels (ng/ml) in normotensive were significantly higher as compared to pre-ecclamptics (p-value = 0.001). The Syncytial knots, cytotrophoblast proliferation and basement membrane thickness were also significantly different among normotensive and pre-eclamptics (p-value= 0.001) When compared with normal placenta the optical density (expression) of LNs was significantly lower (p-value 0.001) in preeclampsia placentae. The association between serum Vitamin-D and laminin expression was highly positively significant. NT (r=0.811, p-value 0.001) and PE group (r=0.79, p-value 0.001) Conclusion: Our results show a strongly positive association between serum Vitamin-D levels, LN expression and severity of histopathological changes between normotensive and pre-eclamptic women.