Risk factors, clinical aspects, and FOKI polymorphism of vitamin d receptor gene in preeclampsia cases attending combined military hospital, Muzaffarabad, Azad Kashmir

Preeclampsia (PE) is a pregnancy-related disorder. The current research was performed to study the epidemiology, clinical characteristics and predictive role of reproductive and demographic risk factors in the development of preeclampsia (PE). Furthermore, a FOKI sequence variant of VDR gene (rs2228570) was analyzed to see its association with pre-eclampsia phenotype. Current case-control study comprising of PE patients and age-matched controls recruited from the Gynecology department of Combined Military Hospital (CMH), Muzaffarabad, Azad Kashmir was conducted from August 2021 to January 2022 at Quaid-i-Azam University Islamabad, Pakistan. A predesigned questionnaire was used to collect socio-demographic information, clinical parameters, reproductive health, family history of hypertension, and various lifestyle factors from PE patients and controls. SPSS 20 was used to analyze the data. Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (RFLP-PCR) method was executed on extracted DNA samples of PE patients to examine the genotypes for VDR FOKI polymorphism. Out of 1933 pregnant women who delivered at CMH, Muzaffarabad during April to July, 2021, 3.10% were diagnosed with PE. A total of 300 pregnant females were recruited for this case control study out of which 60 were PE patients and 240 were age matched controls. SPSS analysis of data showed that family history of hypertension and previous miscarriage history were strongly associated with high risk of PE (p<0.05), whereas multiparity and proper supplements intake during pregnancy were strongly associated with decreased risk of PE in AJK women (p<0.05). Clinical characteristics i.e., Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT) and urinary proteins were found significantly elevated while blood haemoglobin was significantly lower in PE patients (p<0.0001). Frequency of minor allele of FOKI polymorphism was higher in PE patients but no significant association was detected. PE had a frequency of 3.10% among pregnant females presented at CMH, Muzaffarabad. Identification of positive association of family history of hypertension, previous miscarriage history with PE onset and high frequency of FOKI minor allele in PE patients reaffirms their involvement in PE etiology.