Tehran University Medical Journal

Background: Gestational trophoblastic neoplasia (GTN) consists of a broad spectrum of benign and malignant tumors which are stem in human placental trophoblast. Vitamin D has several biologic rules. Among the effects of vitamin D on cells, we could mention induction of differentiation and apoptosis and also inhibition of proliferation, angiogenesis and metastatic potency. As nutrition plays a pivotal rule in GTN, in this study we compared serum 25-hydroxy-vitamin D [25(OH) vitamin D] in patients with GTN and normal pregnant women.

Methods: In this prospective case-control study, 30 GTN patients and 48 normal pregnant women were considered as control group who referred to Qaem University Hospital, Mashhad, Iran, from July 2013 to October 2015 were included. All included persons to the study had no history of chemotherapy or using vitamin D supplements. After filling informed consent forms and recording demographic data, 25(OH) vitamin D serum level were measured in both group by enzyme-linked immunosorbent assay (ELISA) method.

Results: Age in two groups was the same (P=0.565). There was no significant difference in gestational age between two groups (P=0.887). Pathologic diagnosis in 83.33% (25 patients) was complete hydatidiform mole and in 16.67% (5 patients) was partial hydatidiform mole. 25(OH) vitamin D serum level in 73.3% of GTN patients and 2.1% of normal pregnant women was lower than 10 ng/ml and among all participants, only 6.3% of pregnant patients had 25(OH) vitamin D serum level higher than 30 ng/ml. Mean serum level of 25(OH) vitamin D in GTN patients was significantly lower than pregnant women group (9.09±5.46 vs. 20.06±6.37, P=0.000). 25(OH) vitamin D serum level between complete and partial hydatidiform mole groups had no significant difference (P=0.384).

Conclusion: Altogether, it was observed that 25(OH) vitamin D serum level is significantly lower in women with GTN than normal pregnant women. Modifying serum levels of vitamin D in molar pregnancy with low level of vitamin D may prevent the development of GTN.