Association of Vitamin D in Different Trimester with Hemoglobin during Pregnancy

Abstract

The association between vitamin D and hemoglobin has been suggested. Vitamin D can affect erythropoiesis by the induction of erythroid progenitor cell proliferation and enhance iron absorption by regulating the iron-hepcidin-ferroportin axis in monocytes. However, this relationship in pregnant women is scarce. The purpose of this study was to investigate the association between plasma vitamin D levels with hemoglobin concentration in pregnant women considering each trimester and iron supplementation. The data were obtained from Zhoushan Pregnant Women Cohort, collected from 2011 to 2018. Plasma 25(OH)D was measured in each trimester using liquid chromatography–tandem mass spectrometry. Generalized estimating equations and multiple linear regressions were performed. Finally, 2962 pregnant women and 4419 observations in the first trimester were included in this study. Plasma 25(OH)D in first trimester (T1) (β = 0.06, p = 0.0177), second trimester (T2) (β = 0.15, p < 0.0001), and third trimester (T3) (β = 0.12, p = 0.0006) were positively associated with Hb. Association between plasma 25(OH)D levels in T1 and Hb concentration was positively associated with gestational age (β = 0.005, p = 0.0421). Pregnant women with VD deficiency in T1 (OR = 1.42, 95% CI: 1.07–1.88) or T2 (OR = 1.94, 95% CI: 1.30–2.89) presented an increased risk of anemia, compared with women without VD deficiency. Moreover, the significant relationship between VD and Hb was only observed among women with iron supplementation during pregnancy. Plasma 25(OH)D levels in each trimester were positively associated with Hb concentration. Iron supplementation might be an important factor affecting the relationship between VD and Hb.

A Cross-Sectional Study of the Associations between Biomarkers of Vitamin D, Iron Status, and Hemoglobin in South African Women of Reproductive Age: the Healthy Life Trajectories Initiative, South Africa

“…One explanation for the discrepancy between these findings and the current study is that characteristics specific to the population group under study (such as pregnant women, children, or older individuals), may impact the significance of the relationship. For example, one study even found variations in the association between vitamin D deficiency and anemia according to pregnancy trimester [ 66 ]. Interestingly, that study also found that the positive association between vitamin D and Hb was only significant in pregnant women who were taking iron supplements, potentially due to the role of vitamin D on the absorption of available iron, through hepcidin.…”

Nutritional Modulation of Hepcidin in the Treatment of Various Anemic States

“…Multiple observational studies report the association between vitamin D deficiency, high hepcidin levels and anemia in conditions characterized by inflammatory processes such as inflammatory bowel disease, acute infectious disease, severe traumatic injury and healthy preterm infants [127][128][129][130], while in other cases, vitamin D and iron deficiencies did not correlate with high hepcidin levels, even in the presence of inflammation [131]. Furthermore, in a study of pregnant women, vitamin D supplementation had no effect on hepcidin, ferritin and inflammatory status [106], however, the adequate intake of vitamin D during pregnancy correlated with better hemoglobin levels [132]. High-dose vitamin D supplementation improved iron status but did not affect hepcidin levels in athletes [107] nor in patients affected by chronic kidney disease [108].…”

Associations of Dietary Patterns and Vitamin D Levels with Iron Status in Pregnant Women: A Cross-Sectional Study in Taiwan

“…However, the role of vitamin D in anemia prevention and iron absorption remains controversial [22]. In animal-and population-based pregnancy studies, Qiu et al [23] and Si et al [24] both reported a positive association between blood vitamin D levels and iron status. A cross-sectional study conducted by Mayasari et al revealed an association between dietary intake and serum hepcidin levels during pregnancy [25].…”