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. 2022 Jan 29;22(1):83.
doi: 10.1186/s12884-022-04403-w.

Maternal excess adiposity and serum 25-hydroxyvitamin D < 50 nmol/L are associated with elevated whole body fat mass in healthy breastfed neonates

Maryam Razaghi  1 , Nathalie Gharibeh  1 , Catherine A Vanstone  1 , Olusola F Sotunde  1 , Shu Qin Wei  2 , Dayre McNally  3 , Frank Rauch  4 , Glenville Jones  5 , Hope A Weiler  6   7
Affiliations

Maternal excess adiposity and serum 25-hydroxyvitamin D < 50 nmol/L are associated with elevated whole body fat mass in healthy breastfed neonates

Maryam Razaghi et al. BMC Pregnancy Childbirth. .

Abstract

Background: Vitamin D status of pregnant women is associated with body composition of the offspring. The objective of this study was to assess whether the association between maternal vitamin D status and neonatal adiposity is modified by maternal adiposity preconception.

Methods: Healthy mothers and their term appropriate weight for gestational age (AGA) infants (n = 142; 59% male, Greater Montreal, March 2016-2019) were studied at birth and 1 month postpartum (2-6 weeks). Newborn (24-36 h) serum was collected to measure total 25-hydroxyvitamin D [25(OH)D] (immunoassay); maternal pre-pregnancy BMI was obtained from the medical record. Anthropometry, body composition (dual-energy X-ray absorptiometry) and serum 25(OH)D were measured at 2-6 weeks postpartum in mothers and infants. Mothers were grouped into 4 categories based on their vitamin D status (sufficient 25(OH)D ≥ 50 nmol/L vs. at risk of being insufficient < 50 nmol/L) and pre-pregnancy BMI (< 25 vs. ≥25 kg/m2): insufficient-recommended weight (I-RW, n = 24); insufficient-overweight/obese (I-OW/O, n = 21); sufficient-recommended weight (S-RW, n = 69); and sufficient-overweight/obese (S-OW/O, n = 28). Partial correlation and linear fixed effects model were used while adjusting for covariates.

Results: At birth, infant serum 25(OH)D mean concentrations were below 50 nmol/L, the cut-point for sufficiency, for both maternal pre-pregnancy BMI categories; 47.8 [95%CI: 43.8, 51.9] nmol/L if BMI < 25 kg/m2 and 38.1 [95%CI: 33.5, 42.7] nmol/L if BMI ≥25 kg/m2. Infant serum 25(OH)D concentrations at birth (r = 0.77; P < 0.0001) and 1 month (r = 0.59, P < 0.0001) were positively correlated with maternal postpartum serum 25(OH)D concentrations. Maternal serum 25(OH)D concentration was weakly correlated with maternal percent whole body fat mass (r = - 0.26, P = 0.002). Infants of mothers in I-OW/O had higher fat mass versus those of mothers in S-OW/O (914.0 [95%CI: 766.4, 1061.6] vs. 780.7 [95%CI: 659.3, 902.0] g; effect size [Hedges' g: 0.42]; P = 0.04 adjusting for covariates) with magnitude of difference of 220.4 g or ~ 28% difference.

Conclusions: Maternal and neonatal vitamin D status are positively correlated. In this study, maternal adiposity and serum 25(OH)D < 50 nmol/L are dual exposures for neonatal adiposity. These findings reinforce the importance of vitamin D supplementation early in infancy irrespective of vitamin D stores acquired in utero and maternal weight status.

Keywords: Body composition; Mother-infant dyads; Vitamin D status.

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Conflict of interest statement

The authors state no conflicts of interest.

Figures

Fig. 1
Fig. 1
Maternal and neonatal serum 25(OH)D according to maternal BMI and FMI categories. Serum 25(OH)D concentrations of A mothers according to pre-pregnancy BMI categories (healthy: BMI < 25 or overweight/obese: BMI ≥25 kg/m2), B serum 25(OH)D concentrations of mothers according to postpartum BMI categories (healthy: BMI < 25, overweight: BMI 25-29.9, obese: BMI ≥30 kg/m2, C mothers according to their postpartum fat mass index (FMI) categories (low to normal: 4-9, excess fat: > 9-13, and obese: > 13 kg/m2). Serum 25(OH)D concentrations of infants at birth according to mothers, D pre-pregnancy BMI categories, E postnatal BMI categories and, F FMI categories. Data were compared using a linear fixed effects model, maternal pre-pregnancy, postpartum BMI and FMI as categorical fixed effects followed by post hoc Tukey’s tests with Tukey-Kramer adjustment for multiple comparisons. Data are mean ± SD
Fig. 2
Fig. 2
The interaction effect of maternal pre-pregnancy BMI and maternal 25(OH)D status with neonatal body composition. A Whole-body fat mass, B whole-body fat percentage, C fat mass index (FMI), D whole-body lean mass, E whole-body lean percentage, and F lean mass index (LMI). Data were compared using a linear fixed effects model, maternal pre-pregnancy BMI and 25(OH)D interaction as a categorical fixed effect followed by post hoc Tukey’s tests with Tukey-Kramer adjustment for multiple comparisons. Data are mean ± SD
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