Abstract
BackgroundPrevious evidence has suggested that lower gestational vitamin D levels might increase the risks of adverse pregnancy and birth outcomes. The results remain inconsistent and require further exploration.MethodsA total of 2814 Chinese mother-infant pairs were included in this retrospective cohort study. Serum concentrations of 25(OH)D were reviewed in early pregnancy (16.3 ± 2.3 weeks). Outcomes of maternal gestational diabetes mellitus (GDM), cesarean section, fetal distress, preterm birth, low birth weight (LBW), and macrosomia were extracted from the medical records. Cox regression analysis was used to explore these associations.ResultsIn total, 19.3% of mothers were pregnant at an advanced age (≥35 years), and 40.3% of pregnant women had vitamin D deficiency (< 50 nmol/L). After adjusting for potential covariates, the hazard ratio (HR) (95% CI) per standard deviation (SD) increase of serum 25(OH)D concentrations was 0.86 (0.779, 0.951) for GDM, 0.844 (0.730, 0.976) for preterm birth, and 0.849 (0.726, 0.993) for LBW. Similar protective associations were found for GDM, cesarean section, and preterm birth for a better vitamin D status when compared with vitamin D deficiency.ConclusionHigher early pregnancy vitamin D was associated with a lower risk of GDM, cesarean section, preterm birth, and LBW.
Highlights
Previous evidence has suggested that lower gestational vitamin D levels might increase the risks of adverse pregnancy and birth outcomes
Significant protective associations were found between the vitamin D levels and gestational diabetes mellitus (GDM) and preterm birth
After adjusting for potential covariates (Table 3), higher 25(OH)D concentrations were associated with a 13.9% (HR: 0.861, 95% CI: 0.779, 0.951) decrease in the GDM risk, a 15.6% (HR: 0.844, 95% CI: 0.730, 0.976) decrease in the preterm birth risk, and a 15.1% (HR: 0.849, 95% CI: 0.726, 0.993) decrease in the low birth weight (LBW) risk
Summary
Previous evidence has suggested that lower gestational vitamin D levels might increase the risks of adverse pregnancy and birth outcomes. It has been suggested that the risk of adverse complications or birth outcomes increases as maternal age increases [15,16,17]. With the change of population policy in China, the percentage of women pregnant at an advanced age (> 35 years) has increased, and proper strategies are urgently needed for the prevention of adverse complications [18]. Whether the influence of vitamin D on maternal and infant outcomes remained the same for women pregnant at young (< 35 years) and advanced ages remains unclear, and more studies are needed to better illustrate the problem
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