Maternal Vitamin D Status and Adverse Pregnancy and Neonatal Outcomes in India

Abstract

ObjectiveTo examine the prevalence of vitamin D deficiency and its association with risk of adverse pregnancy and neonatal outcomes in Southern India.MethodsA total of 366 women participating in a vitamin B12 supplementation trial in India were monitored to assess plasma 25‐hydroxyvitamin D (25OHD) concentrations in each trimester during pregnancy. All women received daily iron and folic acid supplementation during pregnancy. Binomial and linear regression models were used to evaluate the associations of maternal vitamin D status and pregnancy and neonatal outcomes.ResultsVitamin D insufficiency was common in pregnancy: 85% of mothers were vitamin D deficient (25OHD <20.0 ng/mL), and 40% had vitamin D concentrations less than 10.0 ng/mL at their first prenatal visit. Maternal vitamin D concentrations increased significantly during pregnancy (p<0.05). However, 75% of mothers were vitamin D deficient (25OHD <20.0 ng/mL) and 31% had vitamin D concentrations less than 10.0 ng/mL in the third trimester. Maternal vitamin D status was not significantly associated with risk of adverse pregnancy outcomes, including infant birth weight, low birth weight (<2,500 g), intrauterine growth restriction, gestational age at delivery, or preterm delivery (<37 weeks). However, maternal vitamin D concentrations at baseline were associated with increased neonatal head circumference (p=0.02) in multivariate analyses, after adjusting for gestational age at sample collection, vitamin B12 intervention, maternal body mass index (BMI), socioeconomic status, and C‐reactive protein concentrations. Maternal vitamin D deficiency at enrollment was associated with significantly lower neonatal mid‐upper arm circumference (p=0.02) and biceps skinfold thickness (p=0.04) in multivariate analyses, after adjusting for gestational age at sample collection, vitamin B12 intervention, maternal BMI, socioeconomic status, and C‐reactive protein concentrations.ConclusionsVitamin D deficiency is common in pregnant Indian women, and is associated with lower neonatal arm anthropometric and fat measures.Support or Funding InformationNational Institutes of Health, Indian Council of Medical Research, Harvard University