Low Maternal Vitamin Research Articles

Low Maternal Vitamin D and Calcium Food Intake during Pregnancy Associated with Place of Residence: A Cross-Sectional Study in West Sumatran Women, Indonesia.

BACKGROUND:There is a high prevalence of vitamin D deficiency in pregnancy worldwide, and variable availability of vitamin D-rich foods may affect the adequacy of vitamin D food intake in different regions.AIM:We analysed the relationship between place of residence and maternal food intake of vitamin D and calcium in West Sumatra, Indonesia.METHODS:This cross-sectional study was conducted in 203 pregnant women. Data collection was carried out in four districts in West Sumatra – two in coastal locations and two in mountainous locations – with subjects divided into groups based on their place of residence. The dietary intakes of pregnant women were assessed through a semi-quantitative food-frequency questionnaire (SQ-FFQ).RESULTS:The means of maternal vitamin D and calcium food intake were 7.92 ± 5.26 µg/day and 784.88 ± 409.77 mg/day, respectively. There were no reports of vitamin D supplement intake during pregnancy. A total of 86.7% and 89.7% of the study subjects had low vitamin D and calcium food intake status, respectively. There was a significant association between maternal vitamin D intake and place of residence (p = 0.02) and significant different mean levels of vitamin D food intake with the place of residence (9.04 vs 6.55 µg/day; p = 0.01). Mothers who had higher education levels had adequate calcium food intake (p = 0.015; OR: 0.295; 0.116–0.751).CONCLUSION:Low maternal vitamin D and calcium food intake were found to be common in West Sumatra, Indonesia and their differed between those residents in mountainous and in coastal areas.

Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period.

To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women. This is a retrospective cohort study evaluating the impact of low maternal vitamin D levels on PIH and perinatal outcomes among HIV-infected pregnant women receiving care at an urban HIV center from 1991 to 2014. A total of 366 pregnant women were included, of which 11% developed PIH. Lower levels of 25-hydroxyvitamin D (25(OH)D) and bioactive 1,25-dihydroxyvitamin D (1,25(OH)2D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)2D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79-0.95], p = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80-0.97], p = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)2D levels were associated with group B Streptococcus colonization (OR: 0.92 [95% CI: 0.86-0.99]) and low birth weight (LBW) (OR: 0.90 [95% CI: 0.83-0.98]) on multivariate analysis. Mean 1,25(OH)2D levels were significantly lower in women with preterm delivery and LBW infants. Lower bioactive vitamin D levels are related to PIH in HIV-infected women. This association may be related to the coexistence of abnormal placental vitamin D metabolism and abnormal placental implantation.

Vitamin D concentration and psychotic disorder: associations with disease status, clinical variables and urbanicity.

The association between schizophrenia and decreased vitamin D levels is well documented. Low maternal and postnatal vitamin D levels suggest a possible etiological mechanism. Alternatively, vitamin D deficiency in patients with schizophrenia is presumably (also) the result of disease-related factors or demographic risk factors such as urbanicity. In a study population of 347 patients with psychotic disorder and 282 controls, group differences in vitamin D concentration were examined. Within the patient group, associations between vitamin D, symptom levels and clinical variables were analyzed. Group × urbanicity interactions in the model of vitamin D concentration were examined. Both current urbanicity and urbanicity at birth were assessed. Vitamin D concentrations were significantly lower in patients (B = -8.05; 95% confidence interval (CI) -13.68 to -2.42; p = 0.005). In patients, higher vitamin D concentration was associated with lower positive (B = -0.02; 95% CI -0.04 to 0.00; p = 0.049) and negative symptom levels (B = -0.03; 95% CI -0.05 to -0.01; p = 0.008). Group differences were moderated by urbanicity at birth (χ2 = 6.76 and p = 0.001), but not by current urbanicity (χ2 = 1.50 and p = 0.224). Urbanicity at birth was negatively associated with vitamin D concentration in patients (B = -5.11; 95% CI -9.41 to -0.81; p = 0.020), but not in controls (B = 0.72; 95% CI -4.02 to 5.46; p = 0.765). Lower vitamin D levels in patients with psychotic disorder may in part reflect the effect of psychosis risk mediated by early environmental adversity. The data also suggest that lower vitamin D and psychopathology may be related through direct or indirect mechanisms.

Maternal 25-hydroxycholecalciferol during lactation improves intestinal calcium absorption and bone properties in sow-suckling piglet pairs.

Lower maternal vitamin D status during lactation is a common health problem. The objectives of this study were to investigate the effects of maternal 25-hydroxycholecalciferol (25-OH-D3) supplementation during lactation on maternal and neonatal bone health in a sow model. 32 Large White × Landrace sows were assigned randomly to one of two diets supplemented with 2000IU/kg vitamin D3 (ND) or 50μg/kg 25-OH-D3 (25-D). The experiment began on day 107 of gestation and continued until weaning on day 21 of lactation. Maternal 25-OH-D3 supplementation significantly decreased milk n-6:n-3 PUFA ratio, which supported bone formation of piglets. Supplementation with 25-OH-D3 altered bone turnover rate of sows and piglets, as evidenced by higher bone-specific alkaline phosphatase (BALP) concentration in serum. 25-D sows had significantly higher bone density and mechanical properties of tibias and femurs than ND sows. Calcium (Ca) absorption rate was higher in 25-D sows than ND sows, which was caused partially by the increased mRNA expressions of renal 1α-hydroxylase (CYP27B1) and duodenal vitamin D receptor (VDR), transient receptor potential vanilloid 6 (TRPV6), and calcium-binding protein D9k (CaBP-D9k). Maternal 25-OH-D3 supplementation increased tibial and femoral Ca content by up-regulating Ca-related gene expression in kidney (CYP27B1), ileum (VDR and claudin-2), and colon (VDR and CaBP-D9k), thus, activating 1,25-dihydroxyvitamin D3 [1,25-(OH)2-D3]-dependent Ca transport in piglets. In conclusion, improved milk fatty acids and higher mRNA expressions of calcitropic genes triggered by maternal 25-OH-D3 supplementation would be the potential mechanism underlying the positive effects of 25-OH-D3 on maternal and neonatal bone health.

Placental expression of ENG, VEGF, and FLT: Gender-specific associations with maternal vitamin B12 status.

Adequate vitamin B12 is a requisite during pregnancy and its deficiency is linked with increased risk for adverse outcomes, likely mediated by impaired placental angiogenesis. Thus, we aimed to test associations of maternal vitamin B12 status with the placental expression of angiogenesis-associated genes ENG, VEGF, and FLT. In this retrospective case-control study, placental and maternal trimester 1 blood samples (n = 104) were collected from small for gestational age (SGA) and appropriate for gestational age (AGA) full-term singleton pregnancies. Maternal trimester 1 vitamin B12 status was measured. Placentae and neonates were weighed at birth. Realtime quantitative PCR was performed to assess placental transcript abundance of ENG, VEGF, and FLT normalized to a panel of reference genes. Associations of placental transcript abundance of the genes with maternal trimester 1 vitamin B12 status were evaluated. Placental ENG transcript abundance associated negatively with maternal trimester 1 vitamin B12 status (β = -0.461, P = 0.017, n = 104). This association was specific to the female births (β = -0.590, P = 0.014, n = 60). Placental VEGF transcript levels were negatively associated with maternal trimester 1 vitamin B12 status only in the female births (β = -1.995, P = 0.029). Placental FLT transcript levels were not associated with maternal trimester 1 vitamin B12 status. Maternal trimester 1 vitamin B12 status was associated negatively with placental ENG and VEGF expression predominantly in the female births. Therefore, we hypothesize that the placenta adapts to low maternal vitamin B12 status by up-regulating angiogenic pathways in a gender-specific manner.

Effects of maternal B12 supplementation on neurophysiological outcomes in children: a study protocol for an extended follow-up from a placebo randomised control trial in Bangalore, India

IntroductionVitamin B12 deficiency is highly prevalent in pregnant Indian women. Neuropsychological tests have shown an association between low maternal vitamin B12 status and poorer cognitive performances in the offspring, although...

Relationship between low maternal vitamin D status and the risk of severe preeclampsia: A case control study.

Low maternal vitamin D status has been associated with several adverse outcomes during pregnancy. The aim of the study was to evaluate the vitamin D levels in preeclamptic and healthy pregnant women and the role of vitamin D deficiency in the etiology of preeclampsia. In this case-control study, 80 preeclamptic women and 80 healthy pregnant women were selected from Motahari hospital in Urmia, Iran. 2 ml of venous blood sample was collected from each pregnant woman and the serum 25-OH-D level was measured by Enzyme-Linked Immunosorbent Assay (ELISA) and reported in nanograms per milliliter. levels of 25-OH-D less than 10 ng mL-1, between 10 ng mL-1 and 29 ng mL-1 and more than 30 ng mL-1, were considered as deficient, insufficient and normal 25-OH-D concentrations, respectively. Results were analyzed by independent t-test, Mann-Whitney U test, and logistic regression. Preeclamptic women (n = 80) were noted to have decreased total 25-OH-D levels relative to healthy control women (n = 80; P = 0.01). This difference in total 25-OH-D remained significant after control for potential confounders [odds ratio (OR) = 4.79, confidence interval (CI) = 1.45-9.87, P = 0.01]. These results showed that vitamin D deficiency has a statistically significant relationship with preeclampsia and support the hypothesis that vitamin D deficiency may be a risk factor for preeclampsia.

Maternal serum vitamin D levels and preterm delivery among low-risk parturients in Lagos, Nigeria.

To determine the association between low maternal vitamin D levels and preterm delivery among parturients in Lagos, Nigeria. The present study was an analytical cross-sectional study of women with preterm deliveries (defined as <37weeks) and women with term deliveries (defined as ≥37weeks) at the labor unit of Lagos University Teaching Hospital between December 1, 2015, and October 31, 2016. Relevant information was obtained via a proforma, and maternal venous samples were collected immediately after delivery. Serum 25-hydroxy vitamin D was determined by a vitamin D enzyme-linked immunoassay kit. The study enrolled 103 women in each group. The overall prevalence of vitamin D deficiency was 14.1% (29/206). 24 (23.3%) women with preterm delivery had low serum vitamin D (<30ng/mL) as compared with only 5 (4.9%) women with term delivery (P<0.001). Compared with normal serum vitamin D levels, low maternal vitamin D had an approximately nine-fold higher likelihood of preterm delivery (adjusted odds ratio 9.41, 95% confidence interval 2.42-36.54; P<0.001). The prevalence of serum vitamin D deficiency was higher among women with preterm delivery than among those with term delivery. The potential role of prenatal vitamin D supplementation in the prevention of preterm delivery should be further investigated.

Maternal vitamin D and E intakes in pregnancy and asthma to age 15 years: A cohort study.

This study investigated whether the previously reported associations in this birth cohort between maternal vitamin D and E intakes during pregnancy and childhood wheeze/asthma outcomes at age 5 and 10 years are still evident at age 15 years. In a prospective study of 1924 children recruited in utero, maternal vitamin D and E intakes during pregnancy were assessed by food frequency questionnaire and the children completed raespiratory questionnaire at age 15 years. Treatment for asthma at age 15 was also ascertained using healthcare data. Maternal vitamin D and E intakes were also related to combined childhood asthma data collected at 1, 2, 5, 10, and 15 years of age. Symptom data were available for 747 (39%) 15-year olds and healthcare data for 1689 (88%). There were no associations between maternal vitamin D and E intakes and childhood wheeze and asthma at age 15. Analysis of combined data collected between 1 and 15 years of age demonstrated that higher maternal vitamin D and E intakes during pregnancy were associated with a reduced likelihood of being diagnosed with asthma in the first 15 years: hazard ratio (95%CI) per quartile increase in vitamin intake of 0.87 (0.78,0.98) and 0.88 (0.78,0.98), respectively. Lower maternal vitamin D and E intakes during pregnancy are associated with increased risk of children wheezing and being diagnosed with asthma in the first 10 years but not after puberty, suggesting that post-natal exposures predominate in the etiology of incident asthma as children transition through puberty into adulthood.

Dermatologic findings of vitamin B12 deficiency in infants.

Vitamin B12 deficiency in infants is uncommonly reported from developed countries and generally lacks dermatologic manifestations. On the contrary, infantile vitamin B12 deficiency is common in India and cutaneous manifestations are a constant feature, although often overshadowed by neurologic and hematological manifestations. The aim of this study was to describe the skin changes of vitamin B12 deficiency in infants. A retrospective chart review of vitamin B12 deficient infants for clinical and laboratory parameters was performed and data analyzed. Forty-three infants, 30 boys and 13 girls, aged 4 to 27months, with vitamin B12 deficiency were identified. Skin hyperpigmentation was present in 41 infants; it was localized to the dorsa of hands and feet in 26. Fifteen infants had generalized hyperpigmentation; 10 had a reticulate pattern, and 5 had a homogeneous pattern. Brown and sparse scalp hair were present in all. Glossitis was seen in 5 infants and cheilitis in 3. Of the 32 infants who underwent laboratory investigations, 28 had anemia and 21 macrocytosis. Serum vitamin B12 was measured in 30 infants; it was low in 19. Of the 11 with normal serum vitamin B12 , 9 had received vitamin B12 before referral but had macrocytosis and low maternal serum vitamin B12 . The infants were treated with vitamin B12 . Skin pigmentation and mucosal changes resolved completely by 3-4weeks, but hair changes were slower to reverse. Cutaneous findings are a common feature of vitamin B12 deficiency in Indian infants and resolve with treatment.

Prevalence of vitamin D deficiency in cord blood of newborns and the association with maternal vitamin D status

There is a high prevalence of vitamin D deficiency among Thai neonates. Adequate prenatal vitamin D supplementation should be implemented as routine antenatal care. What is Known: • Vitamin D deficiency is prevalent in Southeast Asia. • There are widespread vitamin D deficiency among Thai populations including pregnant women. What is New: • There is a high prevalence of vitamin D deficiency among Thai neonates. • The factors associated with cord blood vitamin D deficiency are low maternal vitamin D level and no vitamin D supplement during pregnancy.

Ratio between Low Serum Maternal 25-Hydroxy vitamin D Concentration and the Risk of Preeclampsia

Background: Vitamin D may play a role in the etiology of preeclampsia by regulating the transcription and function of genes associated with placental function, including placental invasion, normal implantation, and angiogenesis. Vitamin D also, modulates immune function and inflammatory response. Maternal vitamin D concentration may be influenced by several factors, including diet, supplementation, sun exposure, skin pigmentation, and genetics. Therefore, vitamin D deficiency is a potentially modifiable risk factor for preeclampsia. Objective: To find out if lower levels of vitamin D is more prevalent in preeclamptic women. Patients and Methods: This study carried out on 50 pregnant women recruited at pre labour room. They divided into preeclamptic group and non-preeclamptic group, 25 cases in each group. Current study was conducted as a case-control study to compare vitamin D level between preeclamptic and non-preeclamptic women at Al-Hussein University Hospital as current study recruited 50 primigravida. Women after 36 weeks of gestation without any other medical disorders. They were classified into preeclamptic case group and normotensive control group. Results: The current study found that vitamin D levels were lower in preeclamptic group than normotensive control group but these differences were not statistically significant.

Ratio between Low Serum Maternal 25-Hydroxy vitamin D Concentration and the Risk of Preeclampsia

Background: Vitamin D may play a role in the etiology of preeclampsia by regulating the transcription and function of genes associated with placental function, including placental invasion, normal implantation, and angiogenesis. Vitamin D also, modulates immune function and inflammatory response. Maternal vitamin D concentration may be influenced by several factors, including diet, supplementation, sun exposure, skin pigmentation, and genetics. Therefore, vitamin D deficiency is a potentially modifiable risk factor for preeclampsia. Objective: To find out if lower levels of vitamin D is more prevalent in preeclamptic women. Patients and Methods: This study carried out on 50 pregnant women recruited at pre labour room. They divided into preeclamptic group and non-preeclamptic group, 25 cases in each group. Current study was conducted as a case-control study to compare vitamin D level between preeclamptic and non-preeclamptic women at Al-Hussein University Hospital as current study recruited 50 primigravida. Women after 36 weeks of gestation without any other medical disorders. They were classified into preeclamptic case group and normotensive control group. Results: The current study found that vitamin D levels were lower in preeclamptic group than normotensive control group but these differences were not statistically significant.

Maternal Vitamin D Level and Rate of Primary Cesarean Section

Background: Vitamin D deficiency has been a worldwide health problem, and pregnant women are considered as a high risk group among whom the prevalence of vitamin D deficiency is increasing to be around 5-40% and to reach a rate of 10-56% in breast fed infants. Recent studies revealed the importance of vitamin D during pregnancy and correlated its level to several pregnancy and neonatal outcomes. We aimed to assess the effect of low level of maternal vitamin D on the progress of labor affecting primary cesarean section (C-section) rate, pregnancy outcomes (such as risk of uterine atony and postpartum hemorrhage, pregnancy-induced hypertension, preeclampsia and gestational diabetes) and neonatal outcomes (such as low birth weight and preterm birth). Methods: A prospective cohort study was conducted in two university hospitals in Lebanon between September 2016 and January 2017. A questionnaire was used for collecting date after taking informed consent to participate in the study. Demographic data, calcium intake, vitamin D intake including the dose, obstetric history complicating the current or previous pregnancy, mode of delivery and finally maternal and neonatal outcomes were recorded. Blood samples were collected from all patients participating in the study for vitamin D level measurement. Patients were divided into two groups: the control group (vitamin D level > 30 ng/mL) and the deficient group (≤ 30 ng/mL). Results: A total of 381 patients were included in this study. In total, 40.9% of the deficient group delivered by C-section for failure of induction, failure to progress or failure to descend, compared to 12.8% only of the control group (P value < 0.0001). There was also a significant association between vitamin D deficiency and risk of uterine atony and postpartum hemorrhage (4.7% and 5.6%, respectively in the study group with low level of vitamin D compared to 0.7% and 1.3% in the control group with significant P value of 0.033 and 0.040, respectively). Conclusion: Low maternal vitamin D level was associated with increased risk of primary C-section, uterine atony and postpartum hemorrhage. J Clin Gynecol Obstet. 2018;7(2):43-51 doi: https://doi.org/10.14740/jcgo473w

T12. VITAMIN D STATUS AND PSYCHOTIC DISORDER: ASSOCIATIONS WITH CLINICAL VARIABLES AND RISK FACTORS

BackgroundThe association between schizophrenia and decreased vitamin D levels is well documented. Low maternal and postnatal vitamin D levels suggest a possible etiological mechanism. Vitamin D deficiency in patients diagnosed with schizophrenia is presumably (also) the result of disease-related factors.Furthermore, certain demographic risk factors such as urbanicity may be associated with vitamin D.MethodsIn a large study population of 347 patients with psychotic disorder and 282 controls, associations between vitamin D levels in blood and clinical variables and risk factors were investigated.Regression analyses were conducted correcting for gender, age, ethnicity, body mass index (BMI), smoking and sampling season. Group × symptomatology and group × urbanicity interactions were investigated. Both current urbanicity and urbanicity at birth were assessed.ResultsVitamin D concentrations were significantly lower in patients (B= -8.05; 95% confidence interval (CI) -13.68 to -2.42; p=0.005). There were (trend) significant interactions between group and vitamin D for symptomatology (positive symptoms: χ2=2.81 and p=0.094; negative symptoms: χ2=5.63 and p=0.018). A small but significant effect was detected: higher vitamin D concentration was associated with lower positive (B= -0.02; 95% CI -0.04 to 0.00; p=0.049) and negative symptom levels (B= -0.03; 95% CI -0.05 to -0.01; p=0.008) in patients. The group × current urbanicity interaction was not significant. However, the group × urbanicity at birth was significant when corrected for current urbanicity (χ2=11.26 and p=0.001).DiscussionVitamin D levels in patients with psychotic disorder were lower than in controls, with an interaction between group and urbanicity at birth. In the patient group, symptom levels were lower when vitamin D concentration was higher.

The impact of vitamin D: From a fetus to an infant

The focus of this paper is to review the data on the classic and nonclassic role of VD with regards to pregnancy and the newborn period. Over the past decade, new evidence has shown that vitamin D (VD) deficiency, in addition to its classical role in calcium metabolism and bone homeostasis, may contribute to the risk of developing a wide range of chronic diseases. VD may produce a wide array of favourable biological effects via genomic, non-genomic or intracrine mechanisms, and therefore contributes to the improvement of human health. Some of these effects may be even more important during pregnancy. Data from animal and human studies implicate maternal VD deficiency as a significant risk factor for several adverse outcomes affecting maternal, foetal and child health. In the newborn period, these comprise bone health, growth and immune response. Conclusion − Recent evidence supports the fact that low maternal vitamin D status is associated with an increased risk of adverse pregnancy outcomes. This paper investigates the effects of vitamin D on the placento-foetal unit and the mother, in terms of calcium metabolism and non-calcium effects.

Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy

This narrative systematic review evaluates growing evidence of an association between low maternal vitamin D status and increased risk of hypertensive disorders. The inclusion of interventional, observational, and dietary studies on vitamin D and all hypertensive disorders of pregnancy is a novel aspect of this review, providing a unique contribution to an intensively-researched area that still lacks a definitive conclusion. To date, trial evidence supports a protective effect of combined vitamin D and calcium supplementation against preeclampsia. Conflicting data for an association of vitamin D with gestational hypertensive disorders in observational studies arises from a number of sources, including large heterogeneity between study designs, lack of adherence to standardized perinatal outcome definitions, variable quality of analytical data for 25-hydroxyvitamin D (25(OH)D), and inconsistent data reporting of vitamin D status. While evidence does appear to lean towards an increased risk of gestational hypertensive disorders at 25(OH)D concentrations <50 nmol/L, caution should be exercised with dosing in trials, given the lack of data on long-term safety. The possibility that a fairly narrow target range for circulating 25(OH)D for achievement of clinically-relevant improvements requires further exploration. As hypertension alone, and not preeclampsia specifically, limits intrauterine growth, evaluation of the relationship between vitamin D status and all terms of hypertension in pregnancy is a clinically relevant area for research and should be prioritised in future randomised trials.

Low Vitamin D is Associated With Infections and Proinflammatory Cytokines During Pregnancy.

Vitamin D is known to regulate innate and adaptive immune processes at the cellular level, but the role of vitamin D status on associated inflammatory processes across pregnancy is unclear. Our primary objective was to evaluate the relationships between serum biomarkers of inflammation (interleukin [IL]-6, IL-10, tumor necrosis factor [TNF]-α), acute-phase proteins (C-reactive protein and hepcidin) and vitamin D status, 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D), measured across pregnancy and in the neonate at birth. A second objective was to identify associations between vitamin D status and clinically diagnosed infections. In this study, 158 racially and ethnically diverse pregnant adolescents were recruited from the Rochester Adolescent Maternity Program (RAMP) in Rochester, NY. Serum 1,25(OH)2D was significantly lower in adolescents and neonates with IL-6 concentrations above the 75th percentile at delivery ( P = .04) and at birth ( P = .004), respectively. After adjusting for other potential covariates of inflammation, maternal serum 1,25(OH)2D was significantly positively associated with TNF-α during pregnancy ( P = .02), but at delivery 1,25(OH)2D and TNF-α were inversely associated with one another ( P = .02). Teens with 25(OH)D concentrations <30 ng/mL were more likely to test positive for candida ( P = .002) and bacterial vaginosis ( P = .02) during pregnancy. African Americans exhibited significantly lower TNF-α concentrations at both mid-gestation ( P = .009) and delivery ( P = .001) compared to the Caucasian adolescents. These results suggest that lower maternal vitamin D status may increase risk of infection across gestation.

Low maternal vitamin D status in pregnancy increases the risk of childhood obesity.

Vitamin D may modulate adipogenesis. However, limited studies have investigated the effect of maternal vitamin D during pregnancy on offspring adiposity or cardiometabolic parameters with inconclusive results. The objective of this study is to examine the association of maternal 25(OH)-vitamin D [25(OH)D] status with offspring obesity and cardiometabolic characteristics in 532 mother-child pairs from the prospective pregnancy cohort Rhea in Crete, Greece. Maternal 25(OH)D concentrations were measured at the first prenatal visit (mean: 14weeks, SD: 4). Child outcomes included body mass index standard deviation score, waist circumference, skin-fold thickness, blood pressure and serum lipids at ages 4 and 6years. Body fat percentage was also measured at 6years. Body mass index growth trajectories from birth to 6years were estimated by mixed effects models with fractional polynomials of age. Adjusted associations were obtained via multivariable linear regression analyses. About two-thirds of participating mothers had 25(OH)D concentrations <50nmol L-1 . Offspring of women in the low 25(OH)D tertile (<37.7nmol L-1 ) had higher body mass index standard deviation score (β 0.20, 95% CI: 0.03, 0.37), and waist circumference (β 0.87 95% CI: 0.12, 1.63) at preschool age, compared with the offspring of women with higher 25(OH)D measurements (≥37.7nmol L-1 ), on covariate-adjusted analyses. The observed relationships persisted at age 6years. We found no association between maternal 25(OH)D concentrations and offspring blood pressure or serum lipids at both time points. Exposure to very low 25(OH)D concentrations in utero may increase childhood adiposity indices. Given that vitamin D is a modifiable risk factor, our findings may have important public health implications.

Vitamin D status in pregnant women with asthma and its association with adverse respiratory outcomes during infancy

Background Vitamin D may influence pregnancy and infant outcomes, especially infant respiratory health. This study aimed to examine vitamin D status in pregnant women with asthma, and whether higher vitamin D levels are associated with fewer adverse respiratory outcomes in their infants. Methods Pregnant women with asthma, recruited from John Hunter Hospital Newcastle Australia (latitude 33°S), had serum total 25-hydroxyvitamin-D (25(OH)D) measured at 16 and 35 weeks gestation. Infant respiratory outcomes were collected at 12 months by parent-report questionnaire. Mother–infant dyads were grouped by serum 25(OH)D during pregnancy: 25(OH)D < 75 nmol/L (at both time-points) versus 25(OH)D ≥ 75 nmol/L (at one or both time-points). Results In 52 pregnant women with asthma, mean serum 25(OH)D levels were 61 (range 26–110) nmol/L at 16 weeks, and 65 (range 32–116) nmol/L at 35 weeks, gestation. Thirty-one (60%) women had 25(OH)D < 75 nmol/L at both time-points; 21 (40%) had 25(OH)D ≥ 75 nmol/L at one or both time-points. Maternal 25(OH)D < 75 nmol/L during pregnancy was associated with a higher proportion of infants with “wheeze ever” at 12 months, compared with 25(OH)D ≥ 75 nmol/L (71 versus 43%, p = .04). Infant acute-care presentations (45 versus 13%, p = .02) and oral corticosteroid use (26 versus 4%, p = .03) due to “asthma/wheezing” were higher in the maternal group with 25(OH)D < 75 nmol/L, versus ≥75 nmol/L. Conclusions Most pregnant women with asthma had low vitamin D status, which persisted across gestation. Low maternal vitamin D status was associated with greater risk of adverse respiratory outcomes in their infants, a group at high risk of developing childhood asthma.