Blood pressure in 3-year-old girls associates inversely with umbilical cord serum 25-hydroxyvitamin D: an Odense Child Cohort study

Abstract

BackgroundLow foetal vitamin D status may be associated with higher blood pressure (BP) in later life.ObjectiveTo examine whether serum 25-hydroxyvitamin D2+3 (s-25OHD) in cord and pregnancy associates with systolic and diastolic BP (SBP; DBP) in children up to 3 years of age.DesignProspective, population-based cohort study.MethodsWe included 1594 singletons from the Odense Child Cohort with available cord s-25OHD and BP data at median age 3.7 months (48% girls), 18.9 months (44% girls) or 3 years (48% girls). Maternal s-25OHD was also assessed at gestational ages 12 and 29 weeks. Multiple regression models were stratified by sex a priori and adjusted for maternal educational level, season of birth and child height, weight and age.ResultsIn 3-year-old girls, SBP decreased with −0.7 mmHg (95% CI −1.1; −0.3, P = 0.001) and DBP with −0.4 mmHg (95% CI −0.7; −0.1, P = 0.016) for every 10 nmol/L increase in cord s-25OHD in adjusted analyses. Moreover, the adjusted odds of having SBP >90th percentile were reduced by 30% for every 10 nmol/L increase in cord s-25OHD (P = 0.004) and by 64% for cord s-25OHD above the median 45.1 nmol/L (P = 0.02). Similar findings were observed between pregnancy s-25OHD and 3-year SBP, cord s-25OHD and SBP at 18.9 months, and cord s-25OHD and DBP at 3 years. No consistent associations were observed between s-25OHD and BP in boys.ConclusionCord s-25OHD was inversely associated with SBP and DBP in young girls, but not in boys. Higher vitamin D status in foetal life may modulate BP in young girls. The sex difference remains unexplained.

Early pregnancy vitamin D status is associated with blood pressure in children: an Odense Child Cohort study

“…We noted that the mean SBP/DBP of 101/64 in our cohort was high compared with the consensus guideline BP pediatric reference (50), but only slightly higher than the mean SBP/DBP of 100/63 at 3 y of age (21). These high values can partly be ascribed to the oscillometric method used in OCC, partly to a mean 5-y height in OCC comparable with the 75 th percentile height in the consensus reference population (data not shown).…”

“…This may suggest a beneficial role of optimal vitamin D status in early pregnancy on offspring BP. In former studies, only low vitamin D status in pregnancy (20), or the continuous full scale of s-25(OH)D (17)(18)(19)21), showed associations with offspring BP.…”

“…Inverse associations between pregnancy or cord s-25(OH)D and offspring BP have been found in some (17)(18)(19)(20)(21), but not all (22,23) observational studies. Of note, the large observational Dutch study by Miliku et al (22), which did not find associations between s-25(OH)D in mid-gestation pregnancy and 6y BP in the offspring, adjusted for multivitamin supplementation and calcium intake in pregnancy, unlike our and other studies.…”

“…Although no effect of vitamin D supplementation on BP was seen in a meta-analysis of RCTs in children and adolescents (11), higher vitamin D status is associated with lower BP in children in several observational studies (12)(13)(14)(15)(16). Furthermore, an association between vitamin D status [s-25(OH)D] in pregnancy or cord blood and offspring BP has been suggested in some (17)(18)(19)(20)(21), but not all studies (22,23).…”

Associations of Cord Blood Vitamin D and Preeclampsia With Offspring Blood Pressure in Childhood and Adolescence

“… 10 Vitamin D also plays a role in fetal development 11 and higher early-life vitamin D levels may be protective against childhood high BP. 12 , 13 , 14 However, to our knowledge, no study has examined whether the intergenerational association of preeclampsia with childhood and adolescent BP varies by vitamin D status.…”