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Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population.
Am J Clin Nutr. 2014 Feb; 99(2):287-95.AJ

Abstract

BACKGROUND

Low serum 25-hydroxyvitamin D [25(OH)D] concentrations during pregnancy have been associated with adverse pregnancy outcomes in a few studies but not in other studies.

OBJECTIVES

We assessed the serum 25(OH)D concentration at 10-14 wk of pregnancy and its association with adverse pregnancy outcomes and examined the predictive accuracy.

DESIGN

In this nested case-control study, we measured serum 25(OH)D in 5109 women with singleton pregnancies who were attending first-trimester screening in New South Wales, Australia. Multivariate logistic regression was conducted to examine the association between low 25(OH)D concentrations and adverse pregnancy outcomes (small for gestational age, preterm birth, preeclampsia, gestational diabetes, miscarriage, and stillbirth). The predictive accuracy of models was assessed.

RESULTS

The median (IQR) 25(OH)D concentration for the total population was 56.4 nmol/L (43.3-69.8 nmol/L). Serum 25(OH)D concentrations showed significant variation by parity, smoking, weight, season of sampling, country of birth, and socioeconomic status. After adjustment for maternal and clinical risk factors, low 25(OH)D concentrations were not associated with most adverse pregnancy outcomes. The area under the receiver operating characteristic curve (AUC) and likelihood ratio for a composite of severe adverse pregnancy outcomes of 25(OH)D concentrations <25 nmol/L were 0.51 and 1.44, respectively, and, for risk factors alone, were 0.64 and 2.87, respectively. The addition of 25(OH)D information to maternal and clinical risk factors did not improve the ability to predict severe adverse pregnancy outcomes (AUC: 0.64; likelihood ratio: 2.32; P = 0.39).

CONCLUSION

Low 25(OH)D serum concentrations in the first trimester of pregnancy are not associated with adverse pregnancy outcomes and do not predict complications any better than routinely assessed clinical and maternal risk-factor information.

Authors+Show Affiliations

Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research (FJS, CLR, CG, CSA, AZK, AWA, JMM, and NN); the Sydney School of Public Health (JMS), University of Sydney, Sydney, Australia; and Fetal Maternal Medicine, Royal North Shore Hospital, St Leonards, Australia (VT).No 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, Non-U.S. Gov't

Language

eng

PubMed ID

24257720

Citation

Schneuer, Francisco J., et al. "Effects of Maternal Serum 25-hydroxyvitamin D Concentrations in the First Trimester On Subsequent Pregnancy Outcomes in an Australian Population." The American Journal of Clinical Nutrition, vol. 99, no. 2, 2014, pp. 287-95.
Schneuer FJ, Roberts CL, Guilbert C, et al. Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population. Am J Clin Nutr. 2014;99(2):287-95.
Schneuer, F. J., Roberts, C. L., Guilbert, C., Simpson, J. M., Algert, C. S., Khambalia, A. Z., Tasevski, V., Ashton, A. W., Morris, J. M., & Nassar, N. (2014). Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population. The American Journal of Clinical Nutrition, 99(2), 287-95. https://doi.org/10.3945/ajcn.113.065672
Schneuer FJ, et al. Effects of Maternal Serum 25-hydroxyvitamin D Concentrations in the First Trimester On Subsequent Pregnancy Outcomes in an Australian Population. Am J Clin Nutr. 2014;99(2):287-95. PubMed PMID: 24257720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population. AU - Schneuer,Francisco J, AU - Roberts,Christine L, AU - Guilbert,Cyrille, AU - Simpson,Judy M, AU - Algert,Charles S, AU - Khambalia,Amina Z, AU - Tasevski,Vitomir, AU - Ashton,Anthony W, AU - Morris,Jonathan M, AU - Nassar,Natasha, Y1 - 2013/11/20/ PY - 2013/11/22/entrez PY - 2013/11/22/pubmed PY - 2014/4/15/medline SP - 287 EP - 95 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 99 IS - 2 N2 - BACKGROUND: Low serum 25-hydroxyvitamin D [25(OH)D] concentrations during pregnancy have been associated with adverse pregnancy outcomes in a few studies but not in other studies. OBJECTIVES: We assessed the serum 25(OH)D concentration at 10-14 wk of pregnancy and its association with adverse pregnancy outcomes and examined the predictive accuracy. DESIGN: In this nested case-control study, we measured serum 25(OH)D in 5109 women with singleton pregnancies who were attending first-trimester screening in New South Wales, Australia. Multivariate logistic regression was conducted to examine the association between low 25(OH)D concentrations and adverse pregnancy outcomes (small for gestational age, preterm birth, preeclampsia, gestational diabetes, miscarriage, and stillbirth). The predictive accuracy of models was assessed. RESULTS: The median (IQR) 25(OH)D concentration for the total population was 56.4 nmol/L (43.3-69.8 nmol/L). Serum 25(OH)D concentrations showed significant variation by parity, smoking, weight, season of sampling, country of birth, and socioeconomic status. After adjustment for maternal and clinical risk factors, low 25(OH)D concentrations were not associated with most adverse pregnancy outcomes. The area under the receiver operating characteristic curve (AUC) and likelihood ratio for a composite of severe adverse pregnancy outcomes of 25(OH)D concentrations <25 nmol/L were 0.51 and 1.44, respectively, and, for risk factors alone, were 0.64 and 2.87, respectively. The addition of 25(OH)D information to maternal and clinical risk factors did not improve the ability to predict severe adverse pregnancy outcomes (AUC: 0.64; likelihood ratio: 2.32; P = 0.39). CONCLUSION: Low 25(OH)D serum concentrations in the first trimester of pregnancy are not associated with adverse pregnancy outcomes and do not predict complications any better than routinely assessed clinical and maternal risk-factor information. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/24257720/Effects_of_maternal_serum_25_hydroxyvitamin_D_concentrations_in_the_first_trimester_on_subsequent_pregnancy_outcomes_in_an_Australian_population_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.113.065672 DB - PRIME DP - Unbound Medicine ER -