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Vitamin D supplementation, cord 25-hydroxyvitamin D and birth weight: Findings from the Odense Child Cohort.
Clin Nutr. 2017 Dec; 36(6):1621-1627.CN

Abstract

BACKGROUND & AIMS

Hypovitaminosis D, defined as serum 25-hydroxyvitamin D (s-25(OH)D) <50 nmol/L, is frequent in pregnant women and neonates worldwide and has been associated with both low birth weight (BW) and placental weight (PW) as well as reduced placental development. We aimed to assess the prevalence and the risk factors of cord vitamin D deficiency (s-25(OH)D <25 nmol/L) and insufficiency (s-25(OH)D 25-50 nmol/L) and to evaluate the association between cord s-25(OH)D levels and neonatal outcomes (BW, PW and PW/BW ratio).

METHODS

Women enrolled in Odense Child Cohort, a Danish observational prospective population-based cohort, who gave birth to singletons and donated a blood sample for s-25(OH)D measurements were included (n = 2082).

RESULTS

The prevalence of cord vitamin D deficiency was 16.7% and 41.0% for insufficiency. White skin, winter season at birth, maternal supplementation dose of <15 μg/day, non-western ethnicity and high body mass index (BMI) were identified as independent risk factors of both vitamin D deficiency and insufficiency. Adherence to the recommended vitamin D supplementation dose (10 μg/day) was reported by 87% (primipara 91% vs. multipara 81%, p < 0.0001). An U-shaped relationship between cord s-25(OH)D and BW was visualized by spline regression (p = 0.003). After adjustment, cord s-25(OH)D was positively associated with BW (β = 1.522, p = 0.026), PW (β = 0.927, p < 0.001) and PW/BW ratio (β = 0.018, p < 0.001), largely driven by positive associations for cord s-25(OH)D >60 nmol/L.

CONCLUSION

Cord hypovitaminosis D was present in 57.7%. Multipara was identified as a novel risk factor of non-adherence to vitamin D supplementation recommendations; and a maternal supplementation dose <15 μg/day as a novel, independent risk factor of cord hypovitaminosis D. Higher BW, PW, and PW/BW ratio were associated to higher cord s-25(OH)D levels with a suggested cut-off at 60 nmol/L. More studies are encouraged to elucidate the impact of cord s-25(OH)D levels on offspring health and to establish optimal cut-offs for these outcomes.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Lykkedegn S
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Beck-Nielsen SS
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Sorensen GL
Institute of Molecular Medicine, Department of Cancer and Inflammation, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Andersen LB
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Fruekilde PBN
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
Nielsen J
Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Region Southern Denmark, Denmark.
Kyhl HB
Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense, Denmark; Odense Patient data Explorative Network (OPEN), Denmark.
Joergensen JS
Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.
Husby S
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Christesen HT
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. Electronic address: henrik.christesen@rsyd.dk.

MeSH

AdolescentAdultBirth WeightBody Mass IndexDenmarkDietary SupplementsFemaleFetal BloodHumansMaleMaternal Nutritional Physiological PhenomenaPrevalenceProspective StudiesRisk FactorsSeasonsTreatment OutcomeVitamin DVitamin D DeficiencyYoung Adult

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

27817876

Clinical Trial Links

Vitamin D and Hand Grip Strength at 5 Years in Odense Child Cohort

Citation

Lykkedegn, Sine, et al. "Vitamin D Supplementation, Cord 25-hydroxyvitamin D and Birth Weight: Findings From the Odense Child Cohort." Clinical Nutrition (Edinburgh, Scotland), vol. 36, no. 6, 2017, pp. 1621-1627.
Lykkedegn S, Beck-Nielsen SS, Sorensen GL, et al. Vitamin D supplementation, cord 25-hydroxyvitamin D and birth weight: Findings from the Odense Child Cohort. Clin Nutr. 2017;36(6):1621-1627.
Lykkedegn, S., Beck-Nielsen, S. S., Sorensen, G. L., Andersen, L. B., Fruekilde, P. B. N., Nielsen, J., Kyhl, H. B., Joergensen, J. S., Husby, S., & Christesen, H. T. (2017). Vitamin D supplementation, cord 25-hydroxyvitamin D and birth weight: Findings from the Odense Child Cohort. Clinical Nutrition (Edinburgh, Scotland), 36(6), 1621-1627. https://doi.org/10.1016/j.clnu.2016.10.008
Lykkedegn S, et al. Vitamin D Supplementation, Cord 25-hydroxyvitamin D and Birth Weight: Findings From the Odense Child Cohort. Clin Nutr. 2017;36(6):1621-1627. PubMed PMID: 27817876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D supplementation, cord 25-hydroxyvitamin D and birth weight: Findings from the Odense Child Cohort. AU - Lykkedegn,Sine, AU - Beck-Nielsen,Signe Sparre, AU - Sorensen,Grith Lykke, AU - Andersen,Louise Bjoerkholt, AU - Fruekilde,Palle Bach Nielsen, AU - Nielsen,Jan, AU - Kyhl,Henriette Boye, AU - Joergensen,Jan Stener, AU - Husby,Steffen, AU - Christesen,Henrik Thybo, Y1 - 2016/10/27/ PY - 2016/1/5/received PY - 2016/9/6/revised PY - 2016/10/10/accepted PY - 2016/11/8/pubmed PY - 2018/7/18/medline PY - 2016/11/8/entrez KW - Birth weight KW - Supplementation KW - Vitamin D SP - 1621 EP - 1627 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 36 IS - 6 N2 - BACKGROUND & AIMS: Hypovitaminosis D, defined as serum 25-hydroxyvitamin D (s-25(OH)D) <50 nmol/L, is frequent in pregnant women and neonates worldwide and has been associated with both low birth weight (BW) and placental weight (PW) as well as reduced placental development. We aimed to assess the prevalence and the risk factors of cord vitamin D deficiency (s-25(OH)D <25 nmol/L) and insufficiency (s-25(OH)D 25-50 nmol/L) and to evaluate the association between cord s-25(OH)D levels and neonatal outcomes (BW, PW and PW/BW ratio). METHODS: Women enrolled in Odense Child Cohort, a Danish observational prospective population-based cohort, who gave birth to singletons and donated a blood sample for s-25(OH)D measurements were included (n = 2082). RESULTS: The prevalence of cord vitamin D deficiency was 16.7% and 41.0% for insufficiency. White skin, winter season at birth, maternal supplementation dose of <15 μg/day, non-western ethnicity and high body mass index (BMI) were identified as independent risk factors of both vitamin D deficiency and insufficiency. Adherence to the recommended vitamin D supplementation dose (10 μg/day) was reported by 87% (primipara 91% vs. multipara 81%, p < 0.0001). An U-shaped relationship between cord s-25(OH)D and BW was visualized by spline regression (p = 0.003). After adjustment, cord s-25(OH)D was positively associated with BW (β = 1.522, p = 0.026), PW (β = 0.927, p < 0.001) and PW/BW ratio (β = 0.018, p < 0.001), largely driven by positive associations for cord s-25(OH)D >60 nmol/L. CONCLUSION: Cord hypovitaminosis D was present in 57.7%. Multipara was identified as a novel risk factor of non-adherence to vitamin D supplementation recommendations; and a maternal supplementation dose <15 μg/day as a novel, independent risk factor of cord hypovitaminosis D. Higher BW, PW, and PW/BW ratio were associated to higher cord s-25(OH)D levels with a suggested cut-off at 60 nmol/L. More studies are encouraged to elucidate the impact of cord s-25(OH)D levels on offspring health and to establish optimal cut-offs for these outcomes. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/27817876/Vitamin_D_supplementation_cord_25_hydroxyvitamin_D_and_birth_weight:_Findings_from_the_Odense_Child_Cohort_ DB - PRIME DP - Unbound Medicine ER -