Vitamin D and Birth Outcomes in Pregnancy
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Date
2016-05
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The Ohio State University
Abstract
Title: Vitamin D and Birth Outcomes in Pregnancy
Purpose and Background/Significance: Vitamin D is essential for fetal growth and development and maternal wellbeing. Circulating maternal vitamin D (25[OH]D) serum levels in pregnancy influence birth outcomes, however, there is little evidence regarding the time in pregnancy when vitamin D levels have the greatest impact. Therefore, the purpose of this study was to examine the effects of maternal vitamin D throughout pregnancy.
Theoretical/conceptual framework: David Barker’s theory of the Developmental Origins of Health and Disease provided the framework of the investigation of early pregnancy maternal vitamin D status as a predictor of birth outcome, influencing future health and disease.
Methods: 25[OH]D was measured (EIA) in serum from nulliparous women (n=52) in each of three trimesters of pregnancy. We analyzed the relationship of 25[OH]D with pregnancy outcome measures including maternal early pregnancy weight, maternal weight gain across pregnancy, gestational duration, and infant birth weight (Spearman). The relationship between maternal circulating 25[OH]D levels and birth mode, gestational duration and infant birth weight were analyzed using regression models, controlling for maternal early pregnancy weight and weight gain. Significance was determined at p<0.05.
Results: Mean 25[OH]D across pregnancy did not reach the established threshold for adequacy in pregnancy (63.3 + 19.5, 65.7 + 20.4, 65.9 + 24.4 nmol/L for trimester 1, 2 and 3, respectively). 1st trimester 25[OH]D levels were positively correlated with levels across pregnancy (p<0.001). 1st trimester 25[OH]D levels were negatively correlated with maternal early pregnancy weight (p<0.001) and maternal weight prior to birth (p<0.01). 25[OH]D levels were unrelated to gestational duration or infant birth weight. Neither 1st trimester 25[OH]D levels or maternal weight gain were significant predictors of birth mode though maternal early pregnancy weight predicted risk for cesarean section birth (p=0.04, OR 1.027). When controlling for maternal early pregnancy weight and weight gain, 25[OH]D across pregnancy was not a significant predictor of infant birth weight or gestational duration.
Conclusions: High maternal early pregnancy weight predicted risk for cesarean section and was correlated with low vitamin D levels. Nutritional counseling to promote optimal weight and vitamin D adequacy may promote optimal pregnancy outcomes.
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Keywords
Vitamin D, Pregnancy, Birth Outcomes