Background and aims: 25-hydroxyvitamin D (25(OH)D) affects glucose metabolism by increasing insulin secretion and insulin receptor expression. However, whether 25(OH)D deficiency will increase the risk of gestational diabetes mellitus (GDM) has not been clearly reported. The purpose of this study is to assess the relationship between vitamin D levels in the second trimester of pregnancy and the risk of GDM. Methods: According to the inclusion and exclusion criteria, 247 pregnant women came to the fourth hospital of Shijiazhuang (The affiliated obstetrics and gynecology hospital of Hebei Medical University) for obstetrics were investigated during the period of January 1, 2019 to December 31, 2020. The levels of 25(OH)D in the second trimester (16-20 weeks) and oral 75 g glucose tolerance test (OGTT) at 24-28 weeks of pregnancy were reviewed. The sociodemographic data were collected from questionnaire. Multivariate logistic regression was used to analyze the relationship between vitamin D levels and GDM. Results: The incidence of GDM in the observation group (25(OH)D ≤ 26 ng/ml) was higher than that in the control group (25(OH)D > 26 ng/ml) (p = 0.039). Compared with control group, the observation group had significantly higher level of fasting plasma glucose (FPG) (4.7 [4.5-5.0] mmol/L vs. 4.6 [4.4-4.8] mmol/L, p = 0.012). In the whole study, the level of 25(OH)D was negatively correlated with FPG (r = À 0.164， p = 0.010). After adjusting for age, pre-pregnancy BMI, parity and adverse pregnancy history, compared with the observation group (25 (OH) D ≤ 26 ng/ml), the risk of developing GDM decreased by 50.9% in control group (25(OH)D > 26 ng/ml) (odds ratio [OR] = 0.491, 95% confidence interval [CI] = 0.243-0.989, p = 0.047). Conclusion: Adequate vitamin D levels during the second trimester of pregnancy may reduce the risk of GDM.

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Aims To investigate the associations of serum trace elements (iron, zinc, and copper) between women with different pregnancy outcomes. Methods About 774 pregnant women who came to The Fourth Hospital of Shijiazhuang for prenatal examination were investigated. The concentrations of trace elements in the serum of pregnant women in the third trimester were collected. Multivariate logistic regression was used to analyze the relationship between serum trace element levels and the different pregnancy outcomes. Multiple linear regression was used to analyze the relationship between serum trace elements levels and hypersensitive‐C‐reactive‐protein. Results Results of the multiple logistic regression showed that zinc, copper and copper/zinc ratio were found to be associated with the risk of gestational diabetes mellitus, and zinc was a protective factor (p = 0.002) while copper and copper/zinc ratio as risk factors (p = 0.030 and p = 0.001, respectively) after adjusting for major confounders. It was found that iron and zinc were negatively associated with the risk of moderate or severe anemia (p = 0.022 and p = 0.001, respectively). In contrast, the copper/zinc ratio was positively related to the risk of moderate or severe anemia (p = 0.021). The adjusted relationships between copper and copper/zinc ratio with premature rupture of membranes were statistically significant (p = 0.007 and p = 0.037). Iron and zinc were negatively associated with the risk of chorioamnionitis, while copper and copper/zinc ratio were positively associated with the risk of chorioamnionitis (all p < 0.05). Conclusions Serum iron, zinc and copper levels are closely related to pregnancy outcomes.