Association of maternal vitamin D status during pregnancy with bone-mineral content in offspring: a prospective cohort study

Abstract

Background: Maternal vitamin D status in pregnancy is a suggested determinant of bone-mineral content (BMC) in offspring, but has been assessed in small studies. We investigated this association in a large prospective study.

Methods: Eligible participants were mother-and-singleton-offspring pairs who had participated in the Avon Longitudinal Study of Parents and Children, and in which the mother had recorded measurements of 25(OH)D concentration in pregnancy and the offspring had undergone dual-energy x-ray absorptiometry at age 9-10 years. 25(OH)D concentrations in pregnancy were assessed per 10·0 nmol/L and classified as sufficient (more than 50·00 nmol/L), insufficient (49·99-27·50 nmol/L), or deficient (lower than 27·50 nmol/L). Associations between maternal serum 25(OH)D concentrations and offspring total body less head (TBLH) and spinal BMC were assessed by trimester.

Results: 3960 mother-and-offspring pairs, mainly of white European origin, were assessed (TBLH BMC n=3960, spinal BMC n=3196). Mean offspring age was 9·9 years. 2644 (67%) mothers had sufficient, 1096 (28%) insufficient, and 220 (6%) deficient 25(OH)D concentrations in pregnancy, but TBLH and spinal BMC did not differ between offspring of mothers in the lower two groups versus sufficient 25(OH)D concentration. No associations with offspring BMC were found for any trimester, including the third trimester, which is thought to be most relevant (TBLH BMC confounder-adjusted mean difference -0·03 g per 10·0 nmol/L, 95% CI -1·71 to 1·65; spinal BMC 0·04 g per 10·0 nmol/L, 95% CI -0·12 to 0·21).

Conclusions: We found no relevant association between maternal vitamin D status in pregnancy and offspring BMC in late childhood.

Funding: UK Medical Research Council, Wellcome Trust, and University of Bristol.

Figure 1

Trial profile ALSPAC= Avon Longitudinal Study of Parents and Children. 25(OH)D=25-hydroxyvitamin D. DXA=dual-energy x-ray absorptiometry.

Figure 2

Mean differences in offspring bone-mineral content in relation to maternal 25(OH)D concentrations in pregnancy, by trimester (A) Offspring total body bone-mineral content (total body less head measured; n=3960). (B) Offspring spine bone-mineral content (n=3196). The p values test whether the association between maternal 25(OH)D concentration and offspring BMC differs by trimester of measurement. Model A adjusted for maternal age and offspring age and sex. Model B, the main confounder-adjusted model, was model A plus adjustment for maternal education, ethnic origin, parity, smoking in pregnancy, and body-mass index before pregnancy. Model C was model B plus adjustment for potential mediation by birthweight, gestational age, and offspring height, lean mass, and fat mass. Model D was model B plus adjustment for potential mediation by offspring 25(OH)D concentrations. Values missing for covariables were calculated by multivariate multiple imputation. 25(OH)D=25-hydroxyvitamin D. Predicted 3rd=all women with 25(OH)D concentrations adjusted to 34 weeks' gestation.

Figure 3

Mean differences in offspring bone-mineral content in relation to maternal 25(OH)D concentrations in pregnancy, by trimester and sex of offspring (A) Offspring total body bone-mineral content (total body less head measured; n=3960). (B) Offspring spine bone-mineral content (n=3196). Model A adjusted for maternal age and offspring age and sex. Model B, the main confounder-adjusted model was model A plus adjustment for maternal education, ethnic origin, parity, smoking in pregnancy, and body-mass index before pregnancy. Model C was model B plus adjustment for potential mediation by birthweight, gestational age, and offspring height, lean mass, and fat mass. Model D was model B plus adjustment for potential mediation by offspring 25(OH)D. Values missing for covariables were calculated by multivariate multiple imputation. 25(OH)D=25-hydroxyvitamin D. Predicted 3rd=all women with 25(OH)D concentrations adjusted to 34 weeks' gestation.