Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case–Control Study

Abstract

Several meta-analyses found an association between low maternal serum 25-hydroxyvitamin D (25(OH)D) level and gestational diabetes mellitus (GDM). However, some of them reported significant heterogeneity. We examined the association of serum 25(OH)D concentration measured in the first and in the second halves of pregnancy with the development of GDM in Russian women surveyed in the periods of 2012–2014 and 2018–2021. We conducted a case–control study (including 318 pregnant women) nested on two previous studies. In 2012–2014, a total of 214 women (83 GDM and 131 controls) were enrolled before 15 weeks of gestation and maternal serum 25(OH)D concentrations were measured twice: at 8th–14th week of gestation and simultaneously with two-hour 75 g oral glucose tolerance test (OGTT) at 24th–32nd week of gestation. In the period of 2018–2021, 104 women (56 GDM and 48 controls) were included after OGTT and 25(OH)D concentrations were measured at 24th–32nd week of gestation. Median 25(OH)D levels were 20.0 [15.1–25.7] vs. 20.5 [14.5–27.5] ng/mL (p = 0.565) in GDM and control group in the first half of pregnancy and 25.3 [19.8–33.0] vs. 26.7 [20.8–36.8] ng/mL (p = 0.471) in the second half of pregnancy, respectively. The prevalence rates for vitamin D deficiency (25(OH)D levels <20 ng/mL) were 49.4% and 45.8% (p = 0.608) in the first half of pregnancy and 26.2% vs. 22.1% (p = 0.516) in the second half of pregnancy in women who developed GDM and in women without GDM, respectively. The frequency of vitamin D supplements intake during pregnancy increased in 2018–2021 compared to 2012–2014 (p = 0.001). However, the third trimester 25(OH)D levels and prevalence of vitamin D deficiency (25.5 vs. 23.1, p = 0.744) did not differ in women examined in the periods of 2012–2014 and 2018–2021. To conclude, there was no association between gestational diabetes risk and maternal 25(OH)D measured both in the first and in the second halves of pregnancy. The increased prevalence of vitamin D supplements intake during pregnancy by 2018–2021 did not lead to higher levels of 25(OH)D.

Dietary management of gestational diabetes: A review

“…[70] However, some studies suggest that vitamin D deficiency in early pregnancy does not lead to GDM. [71][72][73][74] A randomized controlled trial noted that vitamin D supplementation during pregnancy in vitamin D-deficient patients did not prevent the development of PIH and GDM. [75] Vitamin D deficiency not associated with GDM in women undergoing assisted reproductive technology.…”

Review: Influence of Vitamin D Blood Concentration and Supplementation during Pregnancy on Preeclampsia Development and Neonatal Outcomes

“…Several studies support an association between low blood 25(OH)D levels and an increased risk of GDM and preeclampsia [68][69]. In contrast, a recent case-control study found no evidence of an association between 25(OH)D levels in either the former or and in the second half of pregnancy and further development of GDM [75].…”

Review: Influence of 25(OH)D Blood Concentration and Supplementation during Pregnancy on Preeclampsia Development and Neonatal Outcomes

“…Several studies support an association between low blood 25(OH)D levels and an increased risk of GDM and preeclampsia [ 69 , 70 ]. In contrast, a recent case–control study found no evidence of an association between the 25(OH)D levels in either the former or in the second half of pregnancy and the further development of GDM [ 76 ].…”