Gestational diabetes mellitus (GDM) is a worldwide, growing complication during pregnancy (1). Many risk factors for GDM have been identified, including obesity prior to and during pregnancy, older maternal age, previous history of GDM, and family history of diabetes (1). However, these risk factors are not sufficient to predict GDM development in almost half of all cases (2). Hence, it is necessary to identify other risk factors, including potential nutritional factors.Vitamin D deficiency has recently been drawing the interest of medical researchers with its link to adverse outcomes of various diseases, other than bone diseases (3-6). Serum levels of 25-hydroxyvitamin D (25-OH-D), a good measure of vitamin D status in humans, are inversely related to hypertension, diabetes, carotid atherosclerosis, myocardial infarction, congestive heart failure, stroke, microalbuminuria, and kidney dysfunction (3-6). In a recent cross-sectional study on a Korean population, women less than 50 y old with more serum 25-OH-D (75 nmol/L) had a significantly lower prevalence of type 2 diabetes than those with less 25-OH-D (25 nmol/L) (7). In addition, serum 25-OH-D levels were significantly negatively associated with fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) values in all participants. As GDM has a similar pathophysiology to type 2 diabetes (1), serum 25-OH-D levels in the first trimester may be a risk factor for GDM in Korean women. In previous studies, there is still some controversy about the association of vitamin D deficiency in the first trimester with adverse pregnancy outcomes such as GDM development, pre-eclampsia, infections, caesarean section, and fetal growth restric- Summary The association between vitamin D deficiency in the first trimester and GDM development remains controversial in various ethnicities. We prospectively assessed whether pregnant women with vitamin D deficiency during early pregnancy had an increased likelihood of GDM development or poor fetal growth or pregnancy outcomes compared to those with sufficient vitamin D levels. Serum 25-OH-D measurements and fetal ultrasonograms were carried out at 12-14, 20-22, and 32-34 wk in 523 pregnant women. Each woman was screened for GDM at 24-28 wk. There were no differences in serum 25-OH-D levels at 12-14 wk or 22-24 wk of pregnancy between GDM and non-GDM women after adjusting for maternal age, BMI at prepregnancy, BMI at first visit, BMI at GDM screening, gestational age at sampling, previous history of GDM, vitamin D intake, and seasonal variation in sampling. The risk of GDM, insulin resistance, and impaired b-cell function had no association with serum 25-OH-D levels in crude or adjusted logistic regression analysis. GDM was not associated with maternal serum 25-OH-D deficiency during the first trimester or fetal growth during the first and second trimesters. Pregnancy outcomes such as miscarriage, Apgar 1, Apgar 5 and birth weight were independent of maternal serum 25-OH-D levels during the first, second and third ...

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Ultrasonographic findings suggesting adenomyosis in early pregnancy were associated with increased risks of preterm delivery and low birth weight in women who conceived with the use of assisted reproductive technologies but not in women who conceived spontaneously.