Deficiency In Early Pregnancy Research Articles

Prevalence and Determinants of Vitamin D Deficiency during the First Trimester: Evidence from a Major Metropolitan City in Bangladesh

Introduction: Vitamin D deficiency in early trimesters can have detrimental effect on feto-maternal outcomes. This research aimed to determine the prevalence and possible associated factors with vitamin D deficiency during first trimester in Chattogram city, Bangladesh. Methods: This was a cross-sectional study conducted from July to September, 2023 in Chattogram metropolitan city with purposive sampling. After obtaining consent a questionnaire was provided and blood was drawn for biochemical analysis. Statistical inference was done through SPSS V25. Results: Total 398 women participated in this study with mean age of 27 years. More than half (51.8%) were suffering subpar vitamin D level, with 15.1% being deficient and 36.7% having insufficient vitamin D level. Most participants were housewives (78.6%) with over half (57.5%) completing their undergraduate degree. Private service (40.5%) was the most prevalent spouse’s profession. Most of the women were primigravid (41.2%). 34.4% and 34.4% of participants had one instance of cesarean section and abortion respectively. High prevalence of anemia was present (49.2%) and was statistically significant with subpar vitamin D level (p<0.05). Husband’s occupation and covered clothing style was also found to be statistically significant. Conclusion: There is significant prevalence of vitamin D deficiency in early pregnancy in Chattogram metropolitan region. Further research and early intervention should be implemented to prevent and mitigate this deficiency and prevent associated adversities. J Shaheed Suhrawardy Med Coll 2023; 15(1): 39-44

Vitamin D supplementation during pregnancy and the role of maternal prenatal depression

BackgroundThe current study sought to investigate the correlation between vitamin D supplementation in pregnant women with vitamin D deficiency in early pregnancy and the incidence of prenatal depression prior to delivery.MethodsThis is a retrospective, single-center study that was conducted at a tertiary hospital in Chengdu, China. We conducted an analysis on pregnant women who were initially diagnosed with vitamin D deficiency at 12–14 weeks of gestation. After starting vitamin D supplementation at a dose of 800 IU daily from 14 weeks onwards, we measured both their vitamin D concentration and depression scores again during median gestational week 39 prior to delivery.ResultsThe study cohort comprised 1365 women who had been diagnosed with vitamin D deficiency at 12–14 weeks of gestation between November 1st, 2021 to November 1st, 2022. 537 pairs were matched based on a propensity score to control for other confounding factors. After propensity score matching, the baseline vitamin D levels were made consistent between the groups (P = 0.512). The incidence of depression in patients in vitamin D deficiency group following vitamin D supplementation was significantly higher than insufficiency group and reached statistical significance (P < 0.001). Additionally, we observed that serum 25-(OH) D concentration achieving insufficiency status after supplementation was 59.12%.ConclusionOur study indicates that daily supplementation of 800IU of vitamin D can improve the depressive symptoms of individuals who are vitamin D deficiency during early pregnancy but achieve vitamin D insufficiency after supplementation during prenatal period.

Association between early spontaneous abortion and homocysteine metabolism.

The purpose of this study is to explore the effects of homocysteine (HCY) metabolism and related factors on early spontaneous abortion. We conducted a hospital-based case-control study and included a total of 500 cases and 1,000 controls in Shaanxi China. Pregnant women waiting for delivery in the hospital were interviewed to report their characteristics and other relevant information during pregnancy. The unconditional Logisitic regression model was applied to assess the association between early spontaneous abortion and HCY metabolism and related factors. The multiplicative model was applied to assess the effects of interaction of HCY metabolism and related factors on early spontaneous abortion. The logit test method of generalized structural equation model (GSEM) was used to construct the pathway diagram of HCY metabolism and related factors affecting early spontaneous abortion. Folic acid supplementation and adequate folic acid supplementation during periconception were the protective factors of early spontaneous abortion (OR = 0.50, 95% CI: 0.38-0.65; OR = 0.44, 95% CI: 0.35-0.54). The serum folate deficiency, higher plasma HCY in early pregnancy, the women who carried the MTHFR 677TT genotype were the risk factors of early spontaneous abortion (OR = 5.87, 95% CI: 1.53-22.50; OR = 2.94, 95% CI: 1.14-7.57; OR = 2.32, 95% CI: 1.20-4.50). The women's educational level and maternal and child health care utilization affected the occurrence of early spontaneous abortion by influencing the folic acid supplementation during periconception. The folic acid supplementation during periconception affected the occurrence of early spontaneous abortion by influencing the level of serum folate or plasma HCY in early pregnancy. The maternal MTHFR 677 gene polymorphism affected the occurrence of early spontaneous abortion by influencing the level of serum folate in early pregnancy. In terms of the risks for early spontaneous abortion, there was multiplicative interaction between higher plasma HCY in early pregnancy, serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 1.76, 95% CI: 1.17-4.03), and there was multiplicative interaction between higher plasma HCY and serum folate deficiency in early pregnancy (OR = 3.46, 95% CI: 2.49-4.81), and there was multiplicative interaction between serum folate deficiency in early pregnancy and maternal MTHFR 677TT genotype (OR = 3.50, 95% CI: 2.78-5.18). The above interactions are all synergistic. The occurrence risk of early spontaneous abortion was significantly increased if multiple factors existed at the same time. Our study is the first time to construct the pathway of HCY metabolism and related factors affecting early spontaneous abortion, and provides a comprehensively new idea to prevent and reduce the occurrence of spontaneous abortion.

The Association Between the Imbalance of Single-Carbon Nutrients in Early Pregnancy and Gestational Diabetes Mellitus Risk is Influenced by Serum Selenium Status: A Cohort Study.

The role of imbalanced one-carbon nutrients in gestational diabetes mellitus (GDM) risk has garnered significant interest, yet existing studies yield inconsistent results. Our objective was to assess whether the association between an unbalanced ratio of folate to vitamin B12 and GDM risk is influenced by the status of other micronutrients. This cohort study included 366 singleton-pregnancy Han women enrolled at the Shunyi District Maternal and Child Health Hospital in Beijing, China. During the first trimester of pregnancy, we measured red blood cell (RBC) folate, serum levels of vitamin B12, vitamin D, and selenium. We examined the association between the imbalanced status of RBC folate and vitamin B12 and GDM risk using logistic regression, stratified by serum selenium or vitamin D status. Among the 366 women, 67 (18.3%) were diagnosed with GDM, 201 (54.9%) had vitamin D deficiency, and 245 (66.9%) had selenium deficiency. Overall, women with higher RBC folate/vitamin B12 ratios did not exhibit a significantly higher risk of GDM compared to those in reference tertile (all P > 0.05). Subsequently, we divided women into deficient and non-deficient groups based on serum selenium or vitamin D levels. In women with selenium deficiency, those in the highest tertile of the RBC folate/vitamin B12 ratio had the highest odds of GDM [OR: 3.40 (1.16-9.97), P=0.026] after adjusting for covariates. However, similar findings were not observed in pregnancies with normal selenium status. Irrespective of vitamin D status, women with higher RBC folate/vitamin B12 ratios did not exhibit a significantly increased risk of GDM. Micronutrient deficiencies are common in early pregnancy. Women with a higher folate/vitamin B12 ratio coupled with selenium deficiency in early pregnancy have a higher GDM risk. These findings underscore the importance of micronutrient assessment in early pregnancy and subsequent interventions for micronutrient deficiencies.

Maternal vitamin D deficiency in early pregnancy and perinatal and long-term outcomes

BackgroundVitamin D deficiency is common in pregnant women. Some studies have linked vitamin D deficiency to obstetric complications such as gestational hypertension, gestational diabetes, and preterm birth. Therefore, the objective of this study is to investigate the potential impact of vitamin D deficiency during pregnancy on both perinatal and long-term outcomes. MethodsIn this retrospective study, conducted between 2017 and 2021, we analyzed the data of 1079 singleton pregnant women with no medical or surgical complications prior to pregnancy. We evaluated obstetric and perinatal outcomes, as well as neurodevelopmental outcomes using Bayley-III tests, Gross Motor Function Measure, or chart review. ResultsThe maternal serum vitamin D level in the first trimester was 18.2 ± 9.0 ng/mL. Vitamin D deficiency (<20 ng/mL) was found in 308 (62.0%) women in the first trimester, of which 288 women (26.7%) were in the very deficient group (<10 ng/mL). There were no differences in maternal age, body mass index, and previous preterm birth between the group with vitamin D < 10 ng/mL and ≥10 ng/mL group. There were also no differences in the rates of gestational hypertension, gestational diabetes, and preterm birth between the two groups, except for the rate of preterm birth before 37 weeks of gestation, which was significantly higher in the very deficient group (adjusted odds ratios [aOR] = 7.78, 95%CI [2.23–27.12], p = 0.001). In the very deficient group, the risk of developmental delay was also higher (aOR = 4.28, 95%CI [1.40–13.05], p = 0.011). ConclusionsThis is the first study to analyze the effects of maternal vitamin D deficiency during pregnancy on both long-term developmental outcomes and perinatal prognosis. Vitamin D deficiency, defined as a level lower than 10 ng/mL in the first trimester, may increase the risk of preterm birth and developmental delay in children.

The synergistic effects of short inter-pregnancy interval and micronutrients deficiency on third-trimester depression.

ObjectiveTo explore the effect of inter-pregnancy interval (IPI) and micronutrients on depression in the third trimester of pregnancy.Materials and methodsA total of 5,951 eligible pregnant women were included in this single-center retrospective cohort study. Variables with potential effects on third-trimester depression were collected. These variables included: maternal factors [age, pregnancy interval, body mass index (BMI), BMI change, gravidity, native place, education, smoking, and alcohol consumption], previous delivery outcomes [preterm birth, preeclampsia, intrahepatic cholestasis of pregnancy (ICP), gestational diabetes mellitus (GDM), fetal growth restriction (FGR), and delivery mode], and micronutrients in early pregnancy (folic acid, 25-hydroxy vitamin D, vitamin B12, calcium, and ferritin). Univariate and multivariate analyses were used to screen the factors affecting the occurrence of depression. Based on these factors, the nomogram model was established. At the same time, the interaction between IPI and micronutrients was verified.ResultsThe incidence of depression in the third trimester of pregnancy was 4.3%. Univariate and multivariate analysis showed that there were five independent risk factors for third-trimester depression: gravidity, previous cesarean section delivery, folic acid, and vitamin D levels in early pregnancy and IPI. According to the multivariate logistic regression analysis, the prediction model and nomogram were established. The prediction cut-offs of the corresponding factors were calculated according to the Youden index. Finally, the synergistic effect of short IPI and micronutrient deficiency was verified.ConclusionThere is a synergistic effect between short IPI and micronutrient deficiency in early pregnancy, which can aggravate the occurrence of depression in late pregnancy.

Association between non-anemic iron deficiency in early pregnancy and perinatal mental health: A retrospective pilot study.

Postpartum anemia and iron deficiency are reportedly involved in postpartum depression, but the association between perinatal depression and iron deficiency with or without anemia is poorly documented. This pilot study retrospectively investigated the relationship between non-anemic iron deficiency (NAID) in early pregnancy and perinatal depressive symptoms. This study included 31 non-anemic women among patients who received perinatal care with preserved residual serum from routine antenatal checkups in Kyoto University Hospital. All participants gave informed consent for research. The ferritin concentration in their preserved serum was measured. The hemoglobin (Hb) and ferritin in early pregnancy, as well as the Edinburgh Postpartum Depression Scale (EPDS) at mid-pregnancy and 1 month after childbirth were analyzed. Iron deficiency was defined as a serum ferritin concentration < 30 ng/mL. Based on the ferritin level in early pregnancy, 13 women (41.9%) had NAID, whereas 18 were normal. The mean Hb and ferritin were 12.7 ± 0.6g/dL and 18.5 ± 5.8ng/mL in the NAID group and 12.8 ± 0.9g/dL and 74.7 ± 39.2ng/mL in the normal group, respectively. The median EPDS scores at mid-pregnancy and 1 month postpartum, respectively, were 2.0 (2.0-3.3) and 5.0 (4.0-6.6) in the NAID group and 4.5 (2.3-7.3) and 4.5 (2.3-5.7) in the normal group. EPDS scores increased significantly from mid-pregnancy to 1month postpartum in the NAID group only. NAID in early pregnancy was highly prevalent and was suggested to reduce resilience to depression during the perinatal period.

The prevalence of perioperative iron deficiency anaemia in women undergoing caesarean section—a retrospective cohort study

BackgroundCaesarean section is a common surgery, with almost 23 million procedures performed globally each year. Postpartum haemorrhage, in association with caesarean section surgery, is a leading global cause of maternal morbidity and mortality. Perioperative iron deficiency anaemia is a risk factor for intraoperative bleeding. Therefore, anaemia is an important and modifiable risk factor for bleeding during caesarean section surgery. Recent recommendations advise that all preoperative patients with anaemia (defined as haemoglobin concentration (Hb) < 130 g/L), regardless of sex, be assessed and treated to normalise haemoglobin levels. It is unclear how this recommendation translates to pregnant women where the World Health Organization (WHO) defines anaemia at a much lower threshold (Hb < 110 g/L). We aimed to determine the prevalence, and characterization, of Hb levels < 130 g/L perioperatively in women undergoing caesarean section.MethodWe conducted a retrospective cohort study of 489 consecutive women who underwent caesarean section over a 12-week period, in a single-centre tertiary referral maternity unit in Australia. We calculated the proportion of women who were anaemic (Hb < 130 g/L) at four time points—first hospital appointment, third trimester, preoperatively and on discharge from hospital. The proportion of women who were iron deficient (ferritin level < 30 μg/L) at their first hospital appointment was determined.ResultsHaemoglobin was measured in 479 women. Ferritin was measured in 437 of these women. The mean (SD) Hb at the first hospital appointment, third trimester, preoperatively, and postoperatively on discharge was 126.7 (11.4) g/L, 114.6 (10.6) g/L, 124.1 (12.4) g/L, and 108.0 (13.6) g/L respectively. Iron deficiency was present in 148 (33.9%) women at their first hospital appointment; 107 of 248 (43.1%) women with anaemia and 41 of 189 (21.7%) with no anaemia. 29 women were found to have moderate anaemia (Hb 80−109 g/L) with 18 of these 29 (62.1%) women having iron deficiency. Only 68 (45.9%) women with iron deficiency at their first hospital appointment received treatment. The prevalence of anaemia classified as Hb < 130 g/L versus the WHO classification of Hb < 110 g/L from all causes was 57.4% versus 6.1% at first hospital appointment, 94% versus 26.1% in third trimester, and 66.0% versus 12.2% preoperatively. Postoperatively at least 40% of women had Hb < 130 g/L on hospital discharge versus at least 23% of women using WHO definition of Hb < 110 g/L. Of the 112 women with hospital discharge Hb < 110 g/L, 35 (31.3%) women were iron deficient at their first hospital appointment.ConclusionOver one in three women were iron deficient at their first hospital appointment. 62% of women with moderate anaemia (Hb 80–109 g/L) also had iron deficiency. At least four in 10 women were anaemic (Hb < 130 g/L) on hospital discharge. Less than half of the women with anaemia were treated. Our data suggests that 30% of postoperative anaemia may be prevented with intensive treatment of iron deficiency in early pregnancy. Large prospective studies, are needed to determine outcomes after caesarean section in women, stratified by preoperative Hb and ferritin levels. The prevalence of anaemia in our data suggests it is a moderate public health problem.

Effect of Moderate-to-Severe Iodine Deficiency in Early Pregnancy on Subclinical Hypothyroidism: A Longitudinal Study in an Iodine-Sufficient Region in China.

ObjectiveTo investigate iodine status among pregnant women in an iodine-sufficient region in China after the implementation of revised universal salt iodization (USI) standards in 2012 and assess the association between urinary iodine concentrations (UIC) in early pregnancy and the incidence of subclinical hypothyroidism (SCH) in euthyroid women negative for antithyroid Ab during different trimesters.MethodsWe measured the iodine status of 1,264 pregnant women, and performed follow-up assessment of thyroid function at 20 and 30 weeks of gestation among a cohort of 250 euthyroid women. We assessed the association of UIC in the 1st trimester with the incidence of SCH in subsequent trimesters. UIC and serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured.ResultsThe median UIC was 135.95 μg/L among 1,264 women. Serum FT4 level was significantly higher in the group of UIC 150 to 249 μg/L compared with other UIC groups (P < 0.001). TSH was significantly higher in the UIC more than or equal to 250 μg/L group than the UIC 150 to 249 g/L group (P = 0.043). Of the 250 euthyroid women negative for antithyroid Ab (TSH value of 2.5–3.55 mU/L) in the 1st trimester, pregnant women with UIC lower than 100 μg/L in the 1st trimester exhibited a significantly increased risk of SCH (odds ratio [OR] = 2.47; 95% confidence interval [CI] = 1.22–5.71; P = 0.012, according to the Chinese Medical Association criteria; OR = 5.22, 95% CI = 1.73–6.09, P = 0.004, according to ATA criteria) during the latter half of pregnancy compared with the UIC 150 to 249 μg/L group.ConclusionModerate-to-severe iodine deficiency (UIC lower than 100 μg/L) in the 1st trimester was associated with a significantly higher risk of SCH during the 2nd or 3rd trimesters among euthyroid pregnant women who had negative for antithyroid Ab. Women with SCH during pregnancy require regular UIC tests to maintain appropriate iodine status.

Prothrombotic state and calcium deficiency in early pregnancy are risk factors for gestational diabetes mellitus: a retrospective cohort study

Objectives To investigate whether the prothrombotic state (PTS), calcium deficiency and iron deficiency anemia (IDA) in early pregnancy is associated with the risk of gestational diabetes mellitus (GDM). Methods We conducted a retrospective cohort study, including consecutive pregnant women tested for PTS, calcium deficiency and IDA before 20 weeks' gestation between September 1, 2017 and March 21, 2021. For routine prenatal care, pregnant women underwent a 75-g oral glucose tolerance test (OGTT) to make a GDM diagnosis during 24–28 weeks of gestation. Testing data and relevant clinical information were obtained from Shenzhen Baoan Women's and Children's Hospital. To estimate GDM risk of exposures (PTS, calcium deficiency and IDA) in early pregnancy, we used logistic regression to obtain odds ratio (OR) adjusted for maternal age, parity, family history of diabetes and pre-pregnancy body mass index. Results The cohort included 8396 pregnant women with complete data of exposures and GDM outcomes. Baseline characteristics were not comparable between exposure and control groups. PTS (adjusted OR 2.38, 95% CI 1.61–3.52) or calcium deficiency (adjusted OR 1.23, 95% CI 1.02–1.49) in early pregnancy was independently associated with increased GDM risk after adjusting covariates. There was no significant association between IDA status and GDM risk (adjusted OR 0.86, 95% CI 0.63–1.18). Conclusions PTS and calcium deficiency in early pregnancy may be independent risk factors of GDM. These findings need further validation in well-designed prospective cohorts.

Is 1,25 Dihydroxy vitamin D Measurement Useful for the Diagnosis of Vitamin D Deficiency in Early Pregnancy?

Is 1,25 Dihydroxy vitamin D Measurement Useful for the Diagnosis of Vitamin D Deficiency in Early Pregnancy?

Reference intervals for reticulocyte parameters (reticulocyte haemoglobin equivalent and immature reticulocyte fraction) in first-trimester pregnancy

Reticulocyte parameters including reticulocyte haemoglobin equivalent (Ret-He) and immature reticulocyte fraction (IRF) are newly recognised hematological parameters that are being used for diagnosis and follow-up of anaemic patients. Reference intervals of these parameters have been established in different populations, however, the data relating to pregnancy are still lacking. One hundred and fifty-five first-trimester pregnant females were screened and the reference interval was calculated after selecting the patient with fixed criteria. R statistical software was used for statistical calculations. We tried to establish a reference interval of Ret-He content and IRF in first-trimester pregnancy in our study. IMPACT STATEMENT What is already known on this subject? Ret-He and IRF have been established as the marker of iron deficiency and iron-deficiency anaemia in different age groups and as a marker of response to iron therapy. However, literature is scarce regarding the reference intervals of these parameters, especially in pregnancy. What do the results of this study add? This study establishes the reference interval of newer reticulocyte parameters in first-trimester pregnancy which is not yet established in the literature. Establishing a reference interval is required for any laboratory parameters to be used in the clinical context. What are the implications of these findings for clinical practice and further research? The results of this study may help in making a clinical decision regarding iron deficiency in early pregnancy which is one of the common clinical problems in pregnancy. This study also serves as a baseline study for further studies of reference intervals for newer reticulocyte parameters in pregnancy. A similar study with a larger study population and follow-up with iron therapy may establish these parameters as one of the important markers of iron deficiency in pregnancy and help institute iron therapy on case-to-case basis.

Journal Digest: Electrical Brain Stimulation and OC; Postpartum Depression Scale; Antidepressants and Sciatica Pain; Vitamin D and ADHD Risk in Children; Cannabidiol and Cocaine Relapse; Gender Differences and Suicide Attempt

Journal Digest: Electrical Brain Stimulation and OC; Postpartum Depression Scale; Antidepressants and Sciatica Pain; Vitamin D and ADHD Risk in Children; Cannabidiol and Cocaine Relapse; Gender Differences and Suicide Attempt

Diagnosis and treatment of iron deficiency anemia in early pregnancy

This article is dedicated to explore iron deficiency during the pregnancy in an early stage. Moreover, the research presents a great deal of data concern about diagnosis and treatment of iron deficiency in early pregnancy. On the top of that main causes and effects of anemia at this rate, as well as prevention forms dealing with iron deficiency. The research outcomes are implemented in terms of facts, affairs and humans’ affections.

Distribution of TNF-α Among Antenatal Women with Varying Levels of Vitamin D

Background and objective: Vitamin D deficiency in antenatal mothers adversely affects not only the health of pregnant mother but also her child. Vitamin D is crucial for proper immune system functioning and management of cytokine environment. Relationship between vitamin D deficiency and TNF-α may prove useful in early detection of inflammatory conditions in pregnant mothers. Therefore, this study assessed serum vitamin D and TNF-α levels in antenatal mothers. Materials & Methods: 78 serum samples of healthy pregnant mothers were included. Serum 25-OH Vitamin D and TNF-α levels were estimated using commercially available ELISA kits. Results:25-OH Vitamin D levels were inadequate (<32ng/ml) in 94.9% of antenatal cases. Majority (74.4%)had an insufficient (11-32 ng/ml)25-OH Vitamin D level. Mean and median vitamin D levels were 16 ± 7.5 SD and 14.5 ng/ml (3.5-39.5) respectively in antenatal mothers. None or a very weak positive linear relationship was observed between serum 25-OH Vitamin D and TNF-α levels (r: 0.13). No correlation was seen between 25-OH Vitamin D & age and TNF-α & age (r: 0.04; r: 0.06 respectively). Conclusions: In settings where subnormal vitamin D levels are prevalent in antenatal mothers, screening for vitamin D deficiency in early pregnancy with subsequent supplementation if needed is recommended. No correlation was observed between serum vitamin D and pro-inflammatory marker TNF-α levels. Further elaborate studies are required to investigate the effects of vitamin D on cytokine environment especially in pregnant mothers.

Association between Vitamin D Deficiency and Bacterial Vaginosis among First Trimester Pregnant Women in Erbil Maternity Hospital

Background: Bacterial vaginosis (BV) is a polymicrobial clinical syndrome characterized by changes in vaginal flora, with replacement of normally abundant Lactobacillus species by high concentrations of anaerobic bacteria among reproductive age women. Studies have different aspects on the effect of vitamin D on BV. Objective: To find out the prevalence of BV, vitamin D deficiency in early pregnancy and to examine association between BV and vitamin D deficiency. Patients and Methods: A cross-sectional study was carried out during July 2017 till October 2018 among 100 pregnant women at first trimester pregnancy, aged 18-35 years old at Erbil Maternity Hospital. Results: At enrollment the prevalence of BV was (53%), about (73%) of our clients suffering from homogenous white greyish vaginal discharge, (57%) were with elevated vaginal PH and fishy odor, clue cells was found among (53%) of them. Vitamin D deficiency, defined as 25 (OH) D concentration below 20 ng/ml, was found in (67%) of women. Insufficiency of the vitamin D 25(OH) D concentration between 20-30ng/ml was present in (29%) of the women. Sufficient level of 25 (OH) over (30 ng/ml) was found in (4%). The incidence of Vitamin D pattern among women with BV were (49.3%), (62.1%) and (50%) respectively for each vitamin D deficiency, Insufficiency and sufficient vitamin D. No significant association was found between Vitamin D deficiency and BV. Conclusion: High occurrence of BV and vitamin D deficiency were found. Vitamin D was not associated significantly with increased BV incidence. We suggested that pregnant women should check and manage their level of vitamin D and BV additionally they must not depend only on vitamin D for curing BV.

Association between vitamin D status in early pregnancy and atopy in offspring in a vitamin D deplete cohort.

Vitamin D status may play a role in the development of atopic diseases due to its action on lung development and immune system development and function. Our objective was to assess whether 25-hydroxyvitamin D (25OHD) levels in maternal blood in pregnancy were associated with atopy in children. We analysed 279 mother-child pairs from the ROLO study conducted in Dublin, Ireland. Serum 25OHD was measured at 13 and 28weeks of pregnancy. Development of childhood atopy was self-reported by mothers at follow-up appointments at 6months, 2years or 5years. Logistic regression analysis was used to evaluate associations between maternal 25OHD status and development of atopy. The mean (SD) 25OHD levels in early and late pregnancy were 41.9 (19.2) nmol/L and 40.2 (21.6) nmol/L, respectively. Maternal 25OHD status in early pregnancy, but not in late pregnancy, was associated with a reduced risk of atopy at 2years (OR 0.972, CI 0.946-0.999). In early pregnancy, those with serum 25OHD levels < 30nmol/L compared with those with 25OHD > 50nmol/L had significantly greater risk of developing atopy at 2years (OR 4.76, CI 1.38-16.47). The development of childhood atopy may be associated with maternal vitamin D deficiency in early pregnancy among a cohort of women at risk of vitamin D deficiency. Further research is required to explore the relationship between vitamin D and atopy, particularly among women with poor vitamin D status, and whether supplementation should be prioritised in early pregnancy to reduce childhood atopy.

Association of Bacterial Vaginosis with Vitamin D in Pregnancy: Secondary Analysis from the Kellogg Pregnancy Study.

Objective Bacterial vaginosis (BV) is associated with vitamin D deficiency and poor pregnancy outcomes. We studied a nested cohort from a randomized controlled trial to investigate the association between BV and vitamin D concentration in pregnancy. Study Design Subjects with randomly assigned 400 versus 4,400 IU of daily cholecalciferol (vitamin D 3 ) had vaginal swabs collected for Gram staining and Nugent score calculation, as well as plasma 25-hydroxyvitamin D (25(OH)D) measurement at three pregnancy time points. Results Fifty-two (21.2%) of the 245 women included in the analysis were diagnosed with BV at study entry. Women with BV were also more likely to be African American ( p < 0.0001) and have lower 25(OH)D concentrations at 22 to 24 weeks' gestation ( p = 0.03). There were no differences in pregnancy outcomes of interest within this group compared with the remaining study subjects. In mixed regression modeling, while race ( p = 0.001) and age ( p = 0.03) were significant predictors of BV prevalence independently, 25(OH)D concentration ( p = 0.81), gestational age ( p = 0.06), and body mass index ( p = 0.87) were not. Conclusion Neither vitamin D deficiency in early pregnancy nor supplementation decreased BV incidence during pregnancy. Pregnancy outcomes (preterm birth and hypertensive disorders of pregnancy) were similar among women with and without BV.

Association of maternal vitamin D deficiency and infants' neurodevelopmental status: A cohort study on vitamin D and its impact during pregnancy and childhood in Indonesia.

Vitamin D deficiency in early pregnancy may cause the disruption of fetal brain development and neurodevelopmental function. This study aimed to explore the extent of neurodevelopment disruption could be associated with maternal vitamin D deficiency. A cohort study was conducted in Sukabumi and Waled, West Java, Indonesia, beginning in July 2016. Maternal serum 25(OH)-vitamin D was measured between 10 and 14 weeks of gestational age. Child development was measured using the Ages and Stages Questionnaire-3 (ASQ-3) at age 3, 6 and 12 months. A total of 141 mother-infant pairs participated. One pair was excluded due to anencephaly of the infant. Vitamin D deficiency was found in 27 (19%) mothers, but delays occurred in gross motor function among 104 (76.1%) infants and in problem-solving functions among 61 (43.7%) infants at 3 months old. In general, the mean ASQ score at ages 3 and 6 months were lower among infants whose mothers had a vitamin D deficiency. The mean ASQ score for gross motor function at age 3 months was found to be significantly lower among these infants (31.5 vs. 37.9; P = 0.02), with increased risk for delayed motor function at age 3 months (relative risk (95% confidence interval) = 1.22 (1.09-1.49); P = 0.03). Neurodevelopmental function disruptions among infants whose mothers had vitamin D deficiency during pregnancy were reflected in lower ASQ scores, in which gross motor function was significantly impaired at 3 months of age.

Mild-to-Moderate Iodine Deficiency in Early Pregnancy Is Associated with Lower Verbal IQ in Children

Mild-to-Moderate Iodine Deficiency in Early Pregnancy Is Associated with Lower Verbal IQ in Children