Vitamin E supplementation and increased risk of gestational hypertension and preeclampsia in women undergoing assisted reproductive technologies.

BACKGROUND

Existing literature regarding the influence of vitamin E (VE) supplementation on the risk of gestational hypertension (GH) and preeclampsia (PE) remains controversial. Our study aimed to assess the association between maternal VE supplementation during early pregnancy and the risk of developing GH/PE.

METHODS

The data included 3587 women from the Jiangsu Birth Cohort (JBC) who conceived through assisted reproductive technology (ART) and had gestational ages of at least 20 weeks. Data about the dietary intake and food supplements were collected using questionnaires. Additionally, blood samples were collected during the first trimester. GH/PE diagnoses were extracted from medical records. We independently assessed the associations of dietary VE intake and VE supplementation with the risk of GH/PE, respectively. We further analyzed the associations between VE-related metabolites and GH/PE development leveraging individual-level plasma untargeted metabolomics data.

RESULTS

Dietary VE intake was not associated with GH/PE risk. However, VE supplementation exceeding 100 mg/day in the early pregnancy was significantly associated with increased risk of GH/PE (odds ratio [OR], 1.68 [95% confidence interval [CI], 1.24-2.26]), particularly when VE supplementation intake of >2 months or >12,000 mg. Among women with low dietary VE intake, the significant adverse effect of VE supplementation was observed at doses exceeding 100 mg/day (OR, 1.61 [95% CI, 1.03-2.50]). Among high dietary VE intake, supplementation at both ≤100 mg/day (OR, 1.61 [95% CI, 1.07-2.44]) and >100 mg/day (OR, 1.74 [95% CI, 1.17-2.57]) were associated with a higher risk of GH/PE. Plasma metabolomics data further validated that elevated α-isomer metabolites were positively associated with GH/PE (OR, 1.55 [95% CI, 1.13-2.13]).

CONCLUSION

The findings underscore the importance of cautious use of VE supplements during pregnancy, particularly among women with adequate dietary VE intake, to avoid potential risks of GH/PE.