Evidence map›Paper›PMID 41579684›Full record

Trial reportPregnancy hypertension2026

Preconception vitamin D status and subsequent risk of preeclampsia: A secondary cohort analysis from the EAGeR trial.

Zeina M Alkhalaf, Sunni L Mumford, Edmond D Shenassa, Enrique F Schisterman, Robert M Silver, Marie E Thoma

Abstract readMulticenter StudyRandomized Controlled Trial

In one paragraph

Trial report in Pregnancy hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it

0cells of the map it votes in

2citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Zeina M AlkhalafEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA; Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA. Electronic address: zalkhala@umd.edu.

Sunni L MumfordEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA; Department of Biostatistics, Epidemiology and Informatics and Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Edmond D ShenassaDepartment of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA.

Enrique F SchistermanEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA; Department of Biostatistics, Epidemiology and Informatics and Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Robert M SilverDepartment of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.

Marie E ThomaDepartment of Family Science, School of Public Health, University of Maryland, College Park, MD, USA.

Funding

EAGeR Trial - The Effects of Aspirin in Gestation and Reproduction TrialZ01HD008795 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI SCHISTERMAN, ENRIQUE · 2007 to 2008

$596k

Intramural NIH HHS Z01 HD008795

6 · The paper itself

Abstract

objectiveTo evaluate associations between maternal serum 25-hyroxyvitamin D [25(OH)D] measured at both preconception and 8 weeks gestation and the risk of preeclampsia. STUDY

designA secondary analysis of the EAGeR Trial (2006-2012), which was a multisite, prospective, double-blind, block-randomized, placebo-controlled clinical trial of women with regular menstrual cycles and 1-2 prior pregnancy losses. Analyses were restricted to participants who conceived and had a live birth (N = 552) and serum 25(OH)D measured at preconception and 8 weeks' gestation.

main outcome measuresLog-binomial regression with robust standard errors estimated risk ratios (RR) and 95% confidence intervals (CI) for preeclampsia across 25(OH)D categories. Inverse probability weighting accounted for selection bias from restricting analyses to live births.

resultsOverall, 55 (10.0%) women developed preeclampsia. In adjusted models excluding body mass index (BMI), deficient preconception 25(OH)D levels (≤20 ng/ml) were associated with an increased preeclampsia risk (RR: 2.32, 95% CI: 1.09, 4.95) compared with sufficient levels (≥30 ng/ml). These associations were attenuated after adjusting for BMI and other covariates (RR: 1.45, 95% CI: 0.64, 3.29). No significant associations were observed for insufficient 25(OH)D or for concentrations measured at 8 weeks' gestation.

conclusionDeficient preconception 25(OH)D levels may be associated with an increased risk of preeclampsia, although this relationship appears partly mediated by BMI. These findings highlight the preconception period as a potentially critical window for optimizing maternal vitamin D status and reducing future preeclampsia risk. Addressing maternal nutritional status before conception may offer a novel prevention strategy warranting confirmation in larger and more diverse populations.

Indexed as

Pre-EclampsiaVitamin DVitamin D DeficiencyAdultDouble-Blind MethodFemaleHumansPreconception CarePregnancyProspective StudiesRisk Factors25-hydroxyvitamin DVitamin D25(OH)DEarly pregnancyPreconceptionPreeclampsiaVitamin D

Identifiers

PMID41579684

DOI10.1016/j.preghy.2026.101417

PMCPMC13361926

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