Maternal Serum 25-Hydroxyvitamin D Concentrations Are Associated with Small-for-Gestational Age Births in White Women

Bodnar, Lisa M.; Catov, Janet M.; Zmuda, Joseph M.; Cooper, Margaret E.; Parrott, Meredith Snook; Roberts, James M.; Marazita, Mary L.; Simhan, Hyagriv N.

doi:10.3945/jn.109.119636

Cited by 258 publications

(255 citation statements)

References 62 publications

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“…This study reported a decrease in the inflammatory response with vitamin D treatment by measurement of IL-8 [24]. Also of note, vitamin D has been associated with increased risk of preeclampsia [25], infants that are small for gestational age (SGA) [26][27][28][29], cesarean section [30], and gestational diabetes (GDM) [31].…”

Section: Pregnancy Lossmentioning

confidence: 72%

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Pacis

Fortin

Zarek

et al. 2014

J Assist Reprod Genet

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Purpose To review the current literature regarding the role of vitamin D status in pregnancy outcomes in women undergoing assisted reproductive technology (ART) and to assess cost-effectiveness of routine vitamin D deficiency screening and repletion prior to initiation of ART.Methods A systematic literature review was conducted using PubMed. Relevant study outcomes were compared among the selected studies. A cost-benefit analysis was performed using a decision tree mathematical model with sensitivity analyses from the perspective of direct societal cost. Published data were used to estimate probabilities and costs in 2014 US dollars. Results Thirty-four articles were retrieved, of which eight met inclusion criteria. One study demonstrated a negative relationship between vitamin D status and ART outcomes, while two studies showed no association. The remaining five studies concluded that ART outcomes improved after vitamin D repletion. Conclusion The majority of reviewed studies reported a decrement in ART outcomes in patients with vitamin D deficiency. Cost-benefit analyses suggested that screening and supplementing vitamin D prior to ART might be cost effective, but further evidence is needed. Given the absence of Level I evidence regarding vitamin D status and ART outcomes, full endorsement of routine vitamin D screening and supplementation prior to ART is premature.

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Section: Pregnancy Lossmentioning

confidence: 72%

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Pacis

Fortin

Zarek

et al. 2014

J Assist Reprod Genet

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“…A nested case-control study of seventy seven mothers who had their serum 25-OHD concentrations determined at 22 weeks gestation reported a significant association with both low (< 37 . 5 nmol/l) and high (> 75 nmol/l) maternal 25-OHD concentrations and the incidence of SGA (21) (Fig. 2).…”

Section: Effects Of Maternal Vitamin D Deficiency On Fetal Growth Andmentioning

confidence: 92%

Does vitamin D during pregnancy impact offspring growth and bone?

Specker

2011

Proc. Nutr. Soc.

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During pregnancy, maternal and fetal Ca demands are met through increased intestinal Ca absorption. Increased Ca absorption may be more dependent on oestrogen's up-regulation of Ca transport genes than on vitamin D status. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to abnormal Ca homoeostasis in the neonate. Some, but not all, studies of maternal vitamin D supplementation during pregnancy find a greater birth weight among infants of mothers with adequate vitamin D status. Observational studies find a higher incidence of small-for-gestational age (SGA) infants among mothers who are vitamin D deficient, but this effect may be modified by genetics. In addition, the effect of vitamin D status on SGA may not be linear, with increased occurrence of SGA at high maternal 25-hydroxyvitamin D (25-OHD) concentrations. Some studies, but not all, also have found that maternal vitamin D status is associated with growth trajectory during the first year of life, although the findings are contradictory. There are recent studies that suggest maternal 25-OHD, or surrogates of vitamin D status, are associated with growth and bone mass later in childhood. These results are not consistent, and blinded randomised trials of vitamin D supplementation during pregnancy with long-term follow-up are needed to determine the benefits, and possible risks, of maternal vitamin D status on offspring growth and bone development. The possibility of adverse outcomes with higher maternal 25-OHD concentrations should be considered and investigated in all ongoing and future studies. (2) . The increase in 1,25-(OH) 2 D concentrations is accompanied by an increase in intestinal Ca absorption, and fractional Ca absorption is approximately 50-60 % greater than pre-pregnant levels during the second and third trimesters (3,4) . The increased Ca absorption is thought to be the reason for the hypercalciuria that is observed during pregnancy. Some investigators have suggested that Ca absorption during pregnancy is not dependent on vitamin D, since intestinal Ca transport genes are up regulated by oestrogens, which are increased SGA, small-for-gestational age; UVB, ultraviolet B.

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“…This does not exclude a potential contribution of vitamin D to GDM risk, but also raises the possibility of other pertinent seasonal factors. (26) Schneuer et al (27) Bodnar et al (28) Flood-Nichols et al (20) Akcakus et al * ng/ml has been converted to nmol/l for the purpose of comparison.…”

Section: Discussionmentioning

confidence: 99%

“…For example, because vitamin D increases intestinal absorption of Ca, in a population where dietary calcium is particularly low, vitamin D status maybe an important predictor for developing pre-eclampsia but not when dietary Ca is adequate (30) . Genetic polymorphisms of the vitamin D nuclear receptor and vitamin D binding protein have been associated with a wide variety of conditions (33,34) , and may explain why a study in the USA found that vitamin D deficiency (<37·5 nmol/l) was a risk factor for SGA in white women (adjusted OR 7·5; 95 % CI 1·8, 31·9) but not in black women (adjusted OR 1·5; 95 % CI 0·6, 3·5) (28) . This study found a non-linear association between 25-hydroxyvitamin D concentration and SGA, with an increased risk of SGA with concentrations >75 nmol/l (OR 2·2; 95 % CI 1·2, 3·8).…”

mentioning

confidence: 99%

The relationship between 25-hydroxyvitamin D concentration in early pregnancy and pregnancy outcomes in a large, prospective cohort

et al. 2016

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Type of publicationArticle (peer-reviewed)Link to publisher's version http://dx.doi.org/10.1017/S0007114516003202Access to the full text of the published version may require a subscription. Rights © The Authors 2016Embargo information Access to this article is restricted until 12 months after publication by the request of the publisher Abstract Vitamin D insufficiency and deficiency have been associated with an increased risk of adverse pregnancy outcomes. Controversy remains as findings have been inconsistent between disparate populations. The aim of this study was to investigate the relationship between vitamin D status and pregnancy outcomes in a large, prospective pregnancy cohort. 25-Hydroxyvitamin D concentration was analysed in serum samples collected at 15 weeks of gestation from 1710 New Zealand women participating in a large, observational study. Associations between vitamin D status and pre-eclampsia, preterm birth, small for gestational age (SGA) and gestational diabetes were investigated. The mean 25-hydroxyvitamin D concentration was 72·9 nmol/l. In all, 23 % had 25-hydroxyvitamin D concentrations <50 nmol/l, and 5 % of participants had concentrations <25 nmol/l. Women with 25-hydroxyvitamin D concentrations <75 nmol/l at 15 weeks of gestation were more likely to develop gestational diabetes mellitus than those with concentrations >75 nmol/l (OR 2·3; 95 % CI 1·1, 5·1). However, this effect was not significant when adjustments were made for BMI and ethnicity (OR 1·8; 95 % CI 0·8, 4·2). 25-Hydroxyvitamin D concentration at 15 weeks was not associated with development of pre-eclampsia, spontaneous preterm birth or SGA infants. Pregnancy complications were low in this largely vitamin D-replete population.Key words: Vitamin D: Gestational diabetes mellitus: Pre-eclampsia Much progress has been made in the screening, diagnosis and management of important pregnancy disorders, but little progress has been made in the prevention of such disorders. Preeclampsia remains the second most common cause of maternal death worldwide (1) . Prematurity, mostly due to spontaneous preterm birth, is the leading cause of death among infants worldwide (2) . This is followed by growth restriction in term infants (3) . Furthermore, infants born preterm or with low birth weight have an increased risk of CVD and metabolic diseases later in life, the leading cause of death in adulthood (4) . The incidence of gestational diabetes mellitus (GDM) is increasing rapidly worldwide (5) and is associated with lifelong risks of metabolic disease in both mother and baby (6,7) . An association between low vitamin D and adverse pregnancy outcomes was first identified in the early 2000s (8) ; consequently, vitamin D has been postulated as a possible intervention strategy to reduce pregnancy complications. A recent meta-analysis found that low vitamin D, defined variably by the authors of included studies, was associated with an increased likelihood of pre-eclampsia (OR 1·79; 95 % CI 1·25, 2·58), small-for-gestational age (SGA) babies (OR 1·...

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Maternal Serum 25-Hydroxyvitamin D Concentrations Are Associated with Small-for-Gestational Age Births in White Women

Cited by 258 publications

References 62 publications

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

Does vitamin D during pregnancy impact offspring growth and bone?

The relationship between 25-hydroxyvitamin D concentration in early pregnancy and pregnancy outcomes in a large, prospective cohort

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