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Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes.
BJOG. 2015 Nov; 122(12):1695-704.BJOG

Abstract

OBJECTIVE

To investigate the association of maternal circulating 25-hydroxyvitamin D3 [25(OH)D3] concentration with pregnancy and birth outcomes.

DESIGN

Prospective cohort study.

SETTING

Four geographical areas of Spain, 2003-2008.

POPULATION

Of 2382 mother-child pairs participating in the INfancia y Medio Ambiente (INMA) Project.

METHODS

Maternal circulating 25(OH)D3 concentration was measured in pregnancy (mean [SD] 13.5 [2.2] weeks of gestation). We tested associations of maternal 25(OH)D3 concentration with pregnancy and birth outcomes.

MAIN OUTCOME MEASURES

Gestational diabetes mellitus (GDM), preterm delivery, caesarean section, fetal growth restriction (FGR) and small-for-gestational age (SGA), anthropometric birth outcomes including weight, length and head circumference (HC).

RESULTS

Overall, 31.8% and 19.7% of women had vitamin D insufficiency [25(OH)D3 20-29.99 ng/ml] and deficiency [25(OH)D3 < 20 ng/ml], respectively. After adjustment, there was no association between maternal 25(OH)D3 concentration and risk of GDM or preterm delivery. Women with sufficient vitamin D [25(OH)D3 ≥ 30 ng/ml] had a decreased risk of caesarean section by obstructed labour compared with women with vitamin D deficiency [relative risk (RR) = 0.60, 95% CI 0.37, 0.97). Offspring of mothers with higher circulating 25(OH)D3 concentration tended to have smaller HC [coefficient (SE) per doubling concentration of 25(OH)D3, -0.10 (0.05), P = 0.038]. No significant associations were found for other birth outcomes.

CONCLUSION

This study did not find any evidence of an association between vitamin D status in pregnancy and GDM, preterm delivery, FGR, SGA and anthropometric birth outcomes. Results suggest that sufficient circulating vitamin D concentration [25(OH)D3 ≥ 30 ng/ml] in pregnancy may reduce the risk of caesarean section by obstructed labour.

Authors+Show Affiliations

Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Catalonia, Spain. Universitat Autònoma de Barcelona, Campus d'Excelència Internacional Bellaterra, Catalonia, Spain.Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Department of Health of the Basque Government, Subdirección de Salud Pública de Gipuzkoa, San Sebastian, Spain. BIODONOSTIA Health Research Institute, San Sebastian, Spain.BIODONOSTIA Health Research Institute, San Sebastian, Spain. Universidad del País Vasco, EHU-UPV, País Vasco, Spain.CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Center for Public Health Research (CSISP-FISABIO), Valencia, Spain.CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Center for Public Health Research (CSISP-FISABIO), Valencia, Spain. University of Valencia, Valencia, Spain.Hospital San Agustín, Avilés, Spain.CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Universidad de Oviedo, Oviedo, Spain.Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Euskadi, Spain.Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25208685

Citation

Rodriguez, A, et al. "Associations of Maternal Circulating 25-hydroxyvitamin D3 Concentration With Pregnancy and Birth Outcomes." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 122, no. 12, 2015, pp. 1695-704.
Rodriguez A, García-Esteban R, Basterretxea M, et al. Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. BJOG. 2015;122(12):1695-704.
Rodriguez, A., García-Esteban, R., Basterretxea, M., Lertxundi, A., Rodríguez-Bernal, C., Iñiguez, C., Rodriguez-Dehli, C., Tardón, A., Espada, M., Sunyer, J., & Morales, E. (2015). Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. BJOG : an International Journal of Obstetrics and Gynaecology, 122(12), 1695-704. https://doi.org/10.1111/1471-0528.13074
Rodriguez A, et al. Associations of Maternal Circulating 25-hydroxyvitamin D3 Concentration With Pregnancy and Birth Outcomes. BJOG. 2015;122(12):1695-704. PubMed PMID: 25208685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. AU - Rodriguez,A, AU - García-Esteban,R, AU - Basterretxea,M, AU - Lertxundi,A, AU - Rodríguez-Bernal,C, AU - Iñiguez,C, AU - Rodriguez-Dehli,C, AU - Tardón,A, AU - Espada,M, AU - Sunyer,J, AU - Morales,E, Y1 - 2014/09/11/ PY - 2014/07/18/accepted PY - 2014/9/12/entrez PY - 2014/9/12/pubmed PY - 2016/2/19/medline KW - Birthweight KW - caesarean section KW - gestational diabetes KW - pregnancy KW - preterm delivery KW - vitamin D SP - 1695 EP - 704 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 122 IS - 12 N2 - OBJECTIVE: To investigate the association of maternal circulating 25-hydroxyvitamin D3 [25(OH)D3] concentration with pregnancy and birth outcomes. DESIGN: Prospective cohort study. SETTING: Four geographical areas of Spain, 2003-2008. POPULATION: Of 2382 mother-child pairs participating in the INfancia y Medio Ambiente (INMA) Project. METHODS: Maternal circulating 25(OH)D3 concentration was measured in pregnancy (mean [SD] 13.5 [2.2] weeks of gestation). We tested associations of maternal 25(OH)D3 concentration with pregnancy and birth outcomes. MAIN OUTCOME MEASURES: Gestational diabetes mellitus (GDM), preterm delivery, caesarean section, fetal growth restriction (FGR) and small-for-gestational age (SGA), anthropometric birth outcomes including weight, length and head circumference (HC). RESULTS: Overall, 31.8% and 19.7% of women had vitamin D insufficiency [25(OH)D3 20-29.99 ng/ml] and deficiency [25(OH)D3 < 20 ng/ml], respectively. After adjustment, there was no association between maternal 25(OH)D3 concentration and risk of GDM or preterm delivery. Women with sufficient vitamin D [25(OH)D3 ≥ 30 ng/ml] had a decreased risk of caesarean section by obstructed labour compared with women with vitamin D deficiency [relative risk (RR) = 0.60, 95% CI 0.37, 0.97). Offspring of mothers with higher circulating 25(OH)D3 concentration tended to have smaller HC [coefficient (SE) per doubling concentration of 25(OH)D3, -0.10 (0.05), P = 0.038]. No significant associations were found for other birth outcomes. CONCLUSION: This study did not find any evidence of an association between vitamin D status in pregnancy and GDM, preterm delivery, FGR, SGA and anthropometric birth outcomes. Results suggest that sufficient circulating vitamin D concentration [25(OH)D3 ≥ 30 ng/ml] in pregnancy may reduce the risk of caesarean section by obstructed labour. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/25208685/Associations_of_maternal_circulating_25_hydroxyvitamin_D3_concentration_with_pregnancy_and_birth_outcomes_ L2 - https://doi.org/10.1111/1471-0528.13074 DB - PRIME DP - Unbound Medicine ER -