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. 2018 Feb 13;18(1):51.
doi: 10.1186/s12884-018-1683-7.

Trajectory of vitamin D status during pregnancy in relation to neonatal birth size and fetal survival: a prospective cohort study

Linnea Bärebring  1 , Maria Bullarbo  2   3 , Anna Glantz  4 , Lena Hulthén  5 , Joy Ellis  6 , Åse Jagner  4 , Inez Schoenmakers  7   8 , Anna Winkvist  5 , Hanna Augustin  5
Affiliations

Trajectory of vitamin D status during pregnancy in relation to neonatal birth size and fetal survival: a prospective cohort study

Linnea Bärebring et al. BMC Pregnancy Childbirth. .

Abstract

Background: We investigated the associations between vitamin D status in early and late pregnancy with neonatal small for gestational age (SGA), low birth weight (LBW) and preterm delivery. Furthermore, associations between vitamin D status and pregnancy loss were studied.

Methods: Serum 25-hydroxyvitamin D (25OHD) was sampled in gestational week ≤ 16 (trimester 1 (T1), N = 2046) and > 31 (trimester 3 (T3), N = 1816) and analysed using liquid chromatography tandem mass spectrometry. Pregnant women were recruited at antenatal clinics in south-west Sweden at latitude 57-58°N. Gestational and neonatal data were retrieved from medical records. Multiple gestations and terminated pregnancies were excluded from the analyses. SGA was defined as weight and/or length at birth < 2 SD of the population mean and LBW as < 2500 g. Preterm delivery was defined as delivery < 37 + 0 gestational weeks and pregnancy loss as spontaneous abortion or intrauterine fetal death. Associations between neonatal outcomes and 25OHD at T1, T3 and change in 25OHD (T3-T1) were studied using logistic regression.

Results: T1 25OHD was negatively associated with pregnancy loss and 1 nmol/L increase in 25OHD was associated with 1% lower odds of pregnancy loss (OR 0.99, p = 0.046). T3 25OHD ≥ 100 nmol/L (equal to 40 ng/ml) was associated with lower odds of SGA (OR 0.3, p = 0.031) and LBW (OR 0.2, p = 0.046), compared to vitamin D deficiency (25OHD < 30 nmol/L, or 12 ng/ml). Women with a ≥ 30 nmol/L increment in 25OHD from T1 to T3 had the lowest odds of SGA, LBW and preterm delivery.

Conclusions: Vitamin D deficiency in late pregnancy was associated with higher odds of SGA and LBW. Lower 25OHD in early pregnancy was only associated with pregnancy loss. Vitamin D status trajectory from early to late pregnancy was inversely associated with SGA, LBW and preterm delivery with the lowest odds among women with the highest increment in 25OHD. Thus, both higher vitamin D status in late pregnancy and gestational vitamin D status trajectory can be suspected to play a role in healthy pregnancy.

Keywords: 25-hydroxyvitamin D; Intrauterine fetal death; Low birth weight; Miscarriage; Preterm delivery; Small for gestational age; Vitamin D.

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Conflict of interest statement

Ethics approval and consent to participate

All participants provided written informed consent and all procedures were approved by the Regional Ethics Committee in Gothenburg (Dnr 897–11 and T439–13).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the study inclusion
See this image and copyright information in PMC

References

    1. Hacker NF, Gambone JC, Hobel CJ. Hacker and Moore's essentials of obstetrics and gynecology. 5. Philadelphia: Saunders Elsevier; 2010.
    1. Kiely ME, Zhang JY, Kinsella M, Khashan AS, Kenny LC. Vitamin D status is associated with uteroplacental dysfunction indicated by pre-eclampsia and small-for-gestational-age birth in a large prospective pregnancy cohort in Ireland with low vitamin D status. Am J Clin Nutr. 2016;104(2):354–361. doi: 10.3945/ajcn.116.130419. - DOI - PubMed
    1. Bärebring L, Bullarbo M, Glantz A, Leu Agelii M, Jagner A, Ellis J, et al. Preeclampsia and blood pressure trajectory during pregnancy in relation to vitamin D status. PLoS One. 2016;11(3):e0152198. doi: 10.1371/journal.pone.0152198. - DOI - PMC - PubMed
    1. Chen YH, Fu L, Hao JH, Yu Z, Zhu P, Wang H, et al. Maternal vitamin D deficiency during pregnancy elevates the risks of small for gestational age and low birth weight infants in Chinese population. J Clin Endocrinol Metab. 2015;100(5):1912–1919. doi: 10.1210/jc.2014-4407. - DOI - PubMed
    1. Schneuer FJ, Roberts CL, Guilbert C, Simpson JM, Algert CS, Khambalia AZ, et al. Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population1-3. Am J Clin Nutr. 2014;99(2):287–295. doi: 10.3945/ajcn.113.065672. - DOI - PubMed

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