Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size

Abstract

Background/Objectives: Vitamin D is required for bone growth and normal insulin secretion. Maternal hypovitaminosis D may impair fetal growth and increase the risk of gestational diabetes. We have related maternal vitamin D status in pregnancy to maternal and newborn glucose and insulin concentrations, and newborn size, in a South Indian population. Subjects/Methods: Serum 25 hydroxy vitamin D (25(OH)D) concentrations, glucose tolerance, and plasma insulin, proinsulin and 32-33 split proinsulin concentrations were measured at 30 weeks gestation in 559 women who delivered at the Holdsworth Memorial Hospital, Mysore. The babies' anthropometry and cord plasma glucose, insulin and insulin precursor concentrations were measured. Results: In total 66% of women had hypovitaminosis D (25(OH)D concentrations o50 nmol l À1 ) and 31% were below 28 nmol l À1 . There was seasonal variation in 25(OH)D concentrations (Po0.0001). There was no association between maternal 25(OH)D and gestational diabetes (incidence 7% in women with and without hypovitaminosis D). Maternal 25(OH)D concentrations were unrelated to newborn anthropometry or cord plasma variables. In mothers with hypovitaminosis D, higher 25(OH)D concentrations were associated with lower 30-min glucose concentrations (P ¼ 0.03) and higher fasting proinsulin concentrations (P ¼ 0.04). Conclusions: Hypovitaminosis D at 30 weeks gestation is common in Mysore mothers. It is not associated with an increased risk of gestational diabetes, impaired fetal growth or altered neonatal cord plasma insulin secretory profile.

A Cross-Sectional Study of Postpartum Changes in Bone Status in Indian Mothers

“…Low bone status [28] along with high prevalence of hypo-vitaminosis D among lactating mothers as was seen in our subjects has also been reported by others. Our study also reports higher prevalence of vitamin D deficiency in Indian postpartum women in line with other studies [31][32][33][34]. In a Danish study, Møller et al also reported higher prevalence of vitamin D deficiency along with secondary hyperparathyroidism around 1 year postpartum, although the incidence was lower than that in our study population [35].…”

Hypovitaminosis D in pregnancy and its correlation with preeclampsia and gestational diabetes mellitus

“…In our study, Vitamin D deficiency was significantly higher in pregnant women with GDM (96.9%) than those without GDM (68.7%), which is in line with findings from the cross sectional study of Maghbooli et al 34 This was in contrast to Ferrant et al, who studied 559 pregnant women in India and found no association between second trimester 25(OH)D levels and GDM. 35 We noted a negative correlation between fasting blood glucose and vitamin D levels in our study. This is in corroboration with Tsur et al 36 Present results also highlight that neonates are at particularly high risk of vitamin D deficiency.…”

Vitamin D and Human Pregnancy

“…Preeclampsia 198,199,201 Bacterial vaginosis 157,195 Gestational diabetes 190,214,215 Fetal/Neonatal Small for gestational age 216,217 Fetal skeleton/bone 218 Neonatal bone mass 219,220 Childhood bone mass 197 [190][191][192][193] , and Australia 187,194 . In several of these studies it was observed that pregnant women with darker skin pigmentation were at even greater risk of low vitamin D status when compared to pregnant women with lighter pigmented skin 11,187,189,195 .…”