Association of maternal vitamin D deficiency and infants' neurodevelopmental status: A cohort study on vitamin D and its impact during pregnancy and childhood in Indonesia

Abstract

Aim: Vitamin D deficiency in early pregnancy may cause the disruption of fetal brain development and neurodevelopmental function. This study aimed to explore the extent of neurodevelopment disruption could be associated with maternal vitamin D deficiency. Methods: A cohort study was conducted in Sukabumi and Waled, West Java, Indonesia, beginning in July 2016. Maternal serum 25(OH)-vitamin D was measured between 10 and 14 weeks of gestational age. Child development was measured using the Ages and Stages Questionnaire-3 (ASQ-3) at age 3, 6 and 12 months. Results: A total of 141 mother-infant pairs participated. One pair was excluded due to anencephaly of the infant. Vitamin D deficiency was found in 27 (19%) mothers, but delays occurred in gross motor function among 104 (76.1%) infants and in problem-solving functions among 61 (43.7%) infants at 3 months old. In general, the mean ASQ score at ages 3 and 6 months were lower among infants whose mothers had a vitamin D deficiency. The mean ASQ score for gross motor function at age 3 months was found to be significantly lower among these infants (31.5 vs. 37.9; P = 0.02), with increased risk for delayed motor function at age 3 months (relative risk (95% confidence interval) = 1.22 (1.09-1.49); P = 0.03). Conclusion: Neurodevelopmental function disruptions among infants whose mothers had vitamin D deficiency during pregnancy were reflected in lower ASQ scores, in which gross motor function was significantly impaired at 3 months of age. CovariateThe covariates in this study were maternal age, parity status, parents' education status (low, middle, high) and parental income. Characteristics of infants included gestational age, gender (male/female), exclusive breastfeeding (yes/no) and complementary feeding.

Cord blood vitamin D is correlated with problem solving domain in early childhood neurodevelopment: A Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia

“…5 A previous study on vitamin D level in the first trimester of pregnancy, which is a part of this cohort study, showed that the mean value of maternal 25 (OH) vitamin D level was 17.52 ng/mL. 7 This result is similar to other previous studies 6,8 which showed that newborn vitamin D level is lower (75-90%) than maternal vitamin D level. This could happen because the mother had to fulfill her own vitamin D requirement beside her fetal.…”

“…6 This study, as a part of the first cohort study in Indonesia about Vitamin D status and its impact on pregnancy and childhood in Indonesia. 7 amygdala and hippocampus areas. 14,15 Calcitriol also works by affecting the production of cytokines and affecting neurotransmitters and synaptic plasticity, which play important roles in the learning process and neurocognitive development.…”

“…9 The previous part of this cohort study in Indonesia about associations between maternal vitamin D levels in early pregnancy (10-14 weeks gestation) with child development in the first year ages of life (3 months, 6 months, and 12 months), showed that ASQ scores in gross motor domains were significantly lower at 3 months of age, and did not have a significant difference for all developmental aspects at older ages (6 and 12 months). 7,19 In this study, we examined cord blood vitamin D samples because maternal vitamin D could pass through the placenta and enter the fetal bloodstream, with the half-life around 2 months. Therefore, it could represent vitamin D level in the newborns.…”

“…A previous study stated that a positive correlation was observed, while this positive correlation was absent in another study. 6,7 The presence of this correlation was assumed to be a result of vitamin D diffusing across the placenta from mother to fetus, therefore, fetuses are utterly dependent on their mother's vitamin D status. 6 Some observational studies had been conducted to analyze the relationship between newborn vitamin D levels taken from cord blood and neurodevelopmental status, with various results.…”

Effect of Vitamin D Status during Pregnancy on Infant Neurodevelopment: The ECLIPSES Study

“…Vitamin D therefore appears to play an important role in several child neurodevelopment issues and to have certain neuroprotective factors. However, few studies have focused on these topics and their findings are not conclusive [ 10 , 11 , 12 ]. Two recent systematic reviews concluded that low prenatal vitamin D status was associated with adverse infant neurodevelopment in cognitive, language, and motor skills [ 5 , 13 ] (Janbek, Specht, and Heitmann, 2019; Villalobos, Tous, Canals, and Arija, 2019).…”