Abstract
BackgroundVitamin A and D deficiency is prevalent in pregnant women worldwide. Both vitamins are involved in fetal skeletal development. A positive association between maternal vitamin D levels and offspring bone mineral density (BMD) at adulthood has been observed. The impact of maternal vitamin A status in pregnancy on offspring peak bone mass remains unclear.Method and findingsForty-one mother-child pairs were recruited from a population-based prospective cohort study in Trondheim, Norway, where pregnant women were followed from gestational week 17. Their term-born infants were followed from birth (1986–88). Regression analyses were performed for vitamin A (retinol), 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] in maternal serum (gestational weeks 17, 33, 37) and cord blood. Offspring BMD and spine trabecular bone score (TBS), a measure of bone quality, were analyzed by dual x-ray absorptiometry at 26 years. Average levels during pregnancy of retinol, 25(OH)D and 1,25(OH)2D were 1.66 (0.32) μmol/L, 59.0 (20.6) nmol/L, and 251.3 (62.4) pmol/L, respectively. 1,25(OH)2D levels were similar in those with 25(OH)D levels <30 and >75 nmol/L. After adjustment for maternal age, BMI, smoking, and education, and offspring birth weight, maternal serum retinol was positively associated with offspring spine BMD [mean change 30.8 (CI 7.6, 54.0) mg/cm2 per 0.2 μmol/L retinol], and with offspring TBS, although non-significant (p = 0.08). No associations were found between maternal 25(OH)D and 1,25(OH)2D levels and offspring bone parameters. Vitamin levels in cord blood were not associated with offspring BMD or TBS.ConclusionsThis is the first study to show an association between maternal vitamin A status and offspring peak bone mass. Our findings may imply increase future risk for osteoporotic fracture in offspring of mothers with suboptimal vitamin A level. No associations were observed between 25(OH)D and 1,25(OH)2D and offspring BMD.
Highlights
Increasing evidence suggests that the in-utero environment plays an important role in the development of future osteoporosis [1, 2]
Vitamin levels in cord blood were not associated with offspring bone mineral density (BMD) or trabecular bone score (TBS). This is the first study to show an association between maternal vitamin A status and offspring peak bone mass
All-trans retinoic acid, the biologically active form, binds to retinoic acid receptors (RARs) which heterodimerize with retinoid X receptors (RXRs) [8, 10, 11]
Summary
Increasing evidence suggests that the in-utero environment plays an important role in the development of future osteoporosis [1, 2]. Maternal vitamin D deficiency during pregnancy is a worldwide epidemic with a reported prevalence from 18–84% [5,6,7]. An inverse association between maternal serum retinol in late pregnancy and offspring total bone mineral content (BMC) was reported in neonates within 2 weeks after birth, whereas β-carotene was positively associated [13]. The association between maternal serum retinol during pregnancy and offspring bone health in adulthood has not been addressed. Vitamin A and D deficiency is prevalent in pregnant women worldwide. Both vitamins are involved in fetal skeletal development. A positive association between maternal vitamin D levels and offspring bone mineral density (BMD) at adulthood has been observed. The impact of maternal vitamin A status in pregnancy on offspring peak bone mass remains unclear
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