A validated screening tool correctly identifies the majority of pregnant women at high risk of vitamin D deficiency

Bärebring, Linnea; Amberntsson, Anna; Augustin, Hanna

doi:10.1016/j.clnesp.2022.03.034

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…In an external validation study by Lamain-de Ruiter et al of twelve published models for predicting GDM, the ROC statistic of included studies ranged from 0.67 to 0.78 [ 46 ], which is comparable to our results. Previous screening tools during pregnancy intended to predict either a high risk for maternal vitamin D deficiency [ 47 ] or for caesarean delivery among women with GDM [ 48 ]. With respect to excessive GWG, only one study to date has examined nine psychological, physical, and social factors as risk factors for excessive GWG within a cross-validated prediction model in 970 women (AUC 0.62) [ 49 ], but without validating the results against an external study population or implementing them as part of a screening tool.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain

Geyer

Raab

Hoffmann

et al. 2023

BMC Pregnancy Childbirth

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Background Excessive weight gain during pregnancy is associated with adverse health outcomes for mother and child. Intervention strategies to prevent excessive gestational weight gain (GWG) should consider women’s individual risk profile, however, no tool exists for identifying women at risk at an early stage. The aim of the present study was to develop and validate a screening questionnaire based on early risk factors for excessive GWG. Methods The cohort from the German “Gesund leben in der Schwangerschaft”/ “healthy living in pregnancy” (GeliS) trial was used to derive a risk score predicting excessive GWG. Sociodemographics, anthropometrics, smoking behaviour and mental health status were collected before week 12th of gestation. GWG was calculated using the last and the first weight measured during routine antenatal care. The data were randomly split into development and validation datasets with an 80:20 ratio. Using the development dataset, a multivariate logistic regression model with stepwise backward elimination was performed to identify salient risk factors associated with excessive GWG. The β coefficients of the variables were translated into a score. The risk score was validated by an internal cross-validation and externally with data from the FeLIPO study (GeliS pilot study). The area under the receiver operating characteristic curve (AUC ROC) was used to estimate the predictive power of the score. Results 1790 women were included in the analysis, of whom 45.6% showed excessive GWG. High pre-pregnancy body mass index, intermediate educational level, being born in a foreign country, primiparity, smoking, and signs of depressive disorder were associated with the risk of excessive GWG and included in the screening questionnaire. The developed score varied from 0–15 and divided the women´s risk for excessive GWG into low (0–5), moderate (6–10) and high (11–15). The cross-validation and the external validation yielded a moderate predictive power with an AUC of 0.709 and 0.738, respectively. Conclusions Our screening questionnaire is a simple and valid tool to identify pregnant women at risk for excessive GWG at an early stage. It could be used in routine care to provide targeted primary prevention measures to women at particular risk to gain excessive gestational weight. Trial registration NCT01958307, ClinicalTrials.gov, retrospectively registered 9 October 2013.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain

Geyer

Raab

Hoffmann

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…This finding led to the ratio of VE to lipid being used to clinically determine VE status [27][28][29][30][31][32][36][37][38] and also encouraged us to assess whether or not 25(OH)VD to total TG ratio is a better method in assessing vitamin D deficiency. Currently, vitamin D status is determined by quantifying circulating levels of 25(OH) vitamin D (25(OH)VD) per ml of serum or plasma [39][40][41][42]. To the authors' best knowledge, no previous study has examined if the ratio of serum 25(OH)VD to serum lipids is more efficient in determining vitamin D status compared to the current method and if the inverse relationship among vitamin D deficiency and high BMD in AA retires when measuring vitamin D levels as this ratio described.…”

Section: Rationale Behind the Use Of 25(oh)vd To Total Serum Tg Ratiomentioning

confidence: 99%

“…Our First Novel Hypothesis: Could the Paradoxical Relationships Be Linked to Each Other? Currently, vitamin D status is determined by assessing circulating levels of [25(OH)D] per milliliter of serum or plasma [39][40][41][42]. To the best of our knowledge, no studies have examined whether measuring the ratio of serum vitamin D to serum lipids is more efficient in determining vitamin D status than the current method and whether the inverse relationship between vitamin D deficiency and high BMD in AA disappears when measuring vitamin D levels as this ratio described.…”

Section: Our First Novel Hypothesis: Could the Paradoxical Relationsh...mentioning

confidence: 99%

Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature

Stevens,

Jain

2024

IJMS

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Vitamin D is known to have a positive effect on bone health. Despite the greater frequency of vitamin D deficiency in African Americans (AA), they have a higher bone mineral density (BMD) compared to whites, demonstrating a disconnect between BMD and vitamin D levels in AA. Another intriguing relationship seen in AA is the triglyceride (TG) paradox, an unusual phenomenon in which a normal TG status is observed even when patients house conditions known to be characterized by high TG levels, such as Type II diabetes. To the best of our knowledge, no study has examined whether these two paradoxical relationships exist simultaneously in AA subjects with Type II diabetes. In this study, we compared levels of blood markers, including HbA1c, TG, and vitamin D, measured as serum 25-hydroxyvitamin D [25(OH)VD] µM/mL, [25(OH)VD]/TG, calcium, and BMD in AA (n = 56) and white (n = 26) subjects with Type II diabetes to see whether these relationships exist concurrently. We found that AA subjects had significantly lower TG and [25(OH)VD] levels and a significantly higher BMD status compared to white subjects, even when the ages, BMI, duration of diabetes, HbA1c, and calcium levels were similar between the two groups. This demonstrates that these two paradoxical relationships exist simultaneously in Type II diabetic AA subjects. In addition to these findings, we discuss the current hypotheses in the literature that attempt to explain why these two intriguing relationships exist. This review also discusses four novel hypotheses, such as altered circulating levels and the potential role of estrogen and hydrogen sulfide on BMD and HMG-CoA reductase as a possible contributor to the TG paradox in AA subjects. This manuscript demonstrates that there are still many unanswered questions regarding these two paradoxical relationships and further research is needed to determine why they exist and how they can be implemented to improve healthcare.

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A validated screening tool correctly identifies the majority of pregnant women at high risk of vitamin D deficiency

Cited by 2 publications

References 23 publications

Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain

Development and validation of a screening questionnaire for early identification of pregnant women at risk for excessive gestational weight gain

Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature

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