Tags

Type your tag names separated by a space and hit enter

Vitamin D, pregnancy, breastfeeding, and postpartum multiple sclerosis relapses.
Arch Neurol 2011; 68(3):310-3AN

Abstract

OBJECTIVE

To determine whether low levels of 25-hydroxyvitamin D (25[OH]D) contribute to the increased risk of postpartum multiple sclerosis (MS) relapses.

DESIGN

Prospective cohort study.

SETTING

Outpatients identified through membership records of Kaiser Permanente Northern California or Stanford University outpatient neurology clinics.

PATIENTS

Twenty-eight pregnant women with MS.

INTERVENTIONS

We prospectively followed up patients through the postpartum year and assessed exposures and symptoms through structured interviews. Total serum 25(OH)D levels were measured using the DiaSorin Liaison Assay during the third trimester and 2, 4, and 6 months after giving birth. The data were analyzed using longitudinal multivariable methods.

MAIN OUTCOME MEASURES

Levels of 25(OH)D and relapse rate.

RESULTS

Fourteen (50%) women breastfed exclusively, and 12 women (43%) relapsed within 6 months after giving birth. During pregnancy, the average 25(OH)D levels were 25.4 ng/mL (range, 13.7-42.6) and were affected only by season (P=.009). In contrast, in the postpartum period, 25(OH)D levels were significantly affected by breastfeeding and relapse status. Levels of 25(OH)D remained low in the exclusive breastfeeding group, yet rose significantly in the nonexclusive breastfeeding group regardless of season (P=.007, unadjusted; P=.02, adjusted for season). By 4 and 6 months after childbirth, 25(OH)D levels were, on average, 5 ng/mL lower in the women who breastfed exclusively compared with the nonbreastfeeding group (P=.001).

CONCLUSIONS

Pregnancy and exclusive breastfeeding are strongly associated with low 25(OH)D levels in women with MS. However, these lower vitamin D levels were not associated with an increased risk of postpartum MS relapses. These data suggest that low vitamin D in isolation is not an important risk factor for postpartum MS relapses.

Authors+Show Affiliations

Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA. annette.m.langer-gould@kp.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21059988

Citation

Langer-Gould, Annette, et al. "Vitamin D, Pregnancy, Breastfeeding, and Postpartum Multiple Sclerosis Relapses." Archives of Neurology, vol. 68, no. 3, 2011, pp. 310-3.
Langer-Gould A, Huang S, Van Den Eeden SK, et al. Vitamin D, pregnancy, breastfeeding, and postpartum multiple sclerosis relapses. Arch Neurol. 2011;68(3):310-3.
Langer-Gould, A., Huang, S., Van Den Eeden, S. K., Gupta, R., Leimpeter, A. D., Albers, K. B., ... Nelson, L. M. (2011). Vitamin D, pregnancy, breastfeeding, and postpartum multiple sclerosis relapses. Archives of Neurology, 68(3), pp. 310-3. doi:10.1001/archneurol.2010.291.
Langer-Gould A, et al. Vitamin D, Pregnancy, Breastfeeding, and Postpartum Multiple Sclerosis Relapses. Arch Neurol. 2011;68(3):310-3. PubMed PMID: 21059988.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D, pregnancy, breastfeeding, and postpartum multiple sclerosis relapses. AU - Langer-Gould,Annette, AU - Huang,Stella, AU - Van Den Eeden,Stephen K, AU - Gupta,Rohit, AU - Leimpeter,Amethyst D, AU - Albers,Kathleen B, AU - Horst,Ron, AU - Hollis,Bruce, AU - Steinman,Lawrence, AU - Nelson,Lorene M, Y1 - 2010/11/08/ PY - 2010/11/10/entrez PY - 2010/11/10/pubmed PY - 2011/5/20/medline SP - 310 EP - 3 JF - Archives of neurology JO - Arch. Neurol. VL - 68 IS - 3 N2 - OBJECTIVE: To determine whether low levels of 25-hydroxyvitamin D (25[OH]D) contribute to the increased risk of postpartum multiple sclerosis (MS) relapses. DESIGN: Prospective cohort study. SETTING: Outpatients identified through membership records of Kaiser Permanente Northern California or Stanford University outpatient neurology clinics. PATIENTS: Twenty-eight pregnant women with MS. INTERVENTIONS: We prospectively followed up patients through the postpartum year and assessed exposures and symptoms through structured interviews. Total serum 25(OH)D levels were measured using the DiaSorin Liaison Assay during the third trimester and 2, 4, and 6 months after giving birth. The data were analyzed using longitudinal multivariable methods. MAIN OUTCOME MEASURES: Levels of 25(OH)D and relapse rate. RESULTS: Fourteen (50%) women breastfed exclusively, and 12 women (43%) relapsed within 6 months after giving birth. During pregnancy, the average 25(OH)D levels were 25.4 ng/mL (range, 13.7-42.6) and were affected only by season (P=.009). In contrast, in the postpartum period, 25(OH)D levels were significantly affected by breastfeeding and relapse status. Levels of 25(OH)D remained low in the exclusive breastfeeding group, yet rose significantly in the nonexclusive breastfeeding group regardless of season (P=.007, unadjusted; P=.02, adjusted for season). By 4 and 6 months after childbirth, 25(OH)D levels were, on average, 5 ng/mL lower in the women who breastfed exclusively compared with the nonbreastfeeding group (P=.001). CONCLUSIONS: Pregnancy and exclusive breastfeeding are strongly associated with low 25(OH)D levels in women with MS. However, these lower vitamin D levels were not associated with an increased risk of postpartum MS relapses. These data suggest that low vitamin D in isolation is not an important risk factor for postpartum MS relapses. SN - 1538-3687 UR - https://www.unboundmedicine.com/medline/citation/21059988/Vitamin_D_pregnancy_breastfeeding_and_postpartum_multiple_sclerosis_relapses_ DB - PRIME DP - Unbound Medicine ER -