Association of Maternal Vitamin D Status with Glucose Tolerance and Caesarean Section in a Multi-Ethnic Asian Cohort: The Growing Up in Singapore Towards Healthy Outcomes Study

Abstract

ObjectiveEpidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.MethodsPlasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26–28 weeks’ gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section.ResultsIn total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73).Conclusions25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.

Serum 25(OH) Vitamin D Levels in Polish Women during Pregnancies Complicated by Hypertensive Disorders and Gestational Diabetes

“…Also, Loy et al did not observe a relationship between 25(OH)D inefficiency/deficiency and GDM [47]. In the B.A.B.Y.…”

Risk factors for gestational diabetes: is prevention possible?

“…Studies of the association between dietary factors and the risk of GDM have just emerged over the last decade. There is evidence suggests that plasma vitamin D and vitamin C concentrations in early pregnancy and dietary fat intake during pregnancy may be implicated in the aetiology of GDM [6,14]. However, it is worth noting that the number of GDM cases in the majority of these studies is rather low in general and extremely limited among the non-Caucasian population.…”

Insulin resistance, obesity and hypovitaminosis D adversely affect pregnancy utcome: Can Supplemental vitamin D cut this risk?

“…The reported figure of Hypo-VD goes in hand with Loy et al [33] who reported VD inadequacy rate of 41.3%, and Al-Shaikh et al [34] who reported VD deficiency in 86.4% of pregnant females in Riyadh and GDM was the commonest complication detected in 11.1%. Moreover, Karras et al [35] out of literature systemic review found the prevalence of VD insufficiency among pregnant Greece women ranged from 9.3 to 41.4%, whereas that of VD deficiency from 22.7 to 90.3%.…”