Early-Pregnancy Vitamin D Deficiency and Risk of Preterm Birth Subtypes

Abstract

Objective To estimate the association between maternal hydroxyvitamin D (25-hydroxyvitamin D) concentrations and risk of preterm birth subtypes. Methods We performed a case-cohort study using data and banked samples from patients at a teaching hospital in Pittsburgh, Pennsylvania. Eligible participants were women with a prenatal aneuploidy screening serum sample at or before 20 weeks of gestation who subsequently delivered a singleton, live-born infant. Of the n=12,861 eligible women, we selected n=2327 at random as well as all remaining preterm birth cases for a total of n=1126 cases. Serum 25-hydroxyvitamin D was measured using liquid chromatography–tandem mass spectrometry. Multivariable log-binomial regression models were used to estimate associations between maternal vitamin D status and preterm birth <37 weeks (separately by spontaneous or indicated) and preterm birth <34 weeks. Results The incidence of preterm birth <37 weeks was 8.6% overall and 11.3%, 8.6%, and 7.3% among mothers with serum 25-hydroxyvitamin D<50, 50–74.9, and ≥75nmol/L, respectively (p<0.01). After adjustment for maternal race and ethnicity, prepregnancy BMI, season, smoking, and other confounders, the risk of preterm birth <37 weeks significantly decreased as 25-hydroxyvitamin D increased to approximately 90 nmol/L and then plateaued (test of nonlinearity p<0.01). Results were similar when limiting to cases that were medically indicated or occurred spontaneously and cases occurring at <34 weeks of gestation. Conclusions Our data support a protective association maternal vitamin D sufficiency and preterm birth that combined with extant epidemiologic data may provide justification for a randomized clinical trial of maternal vitamin D replacement or supplementation to prevent preterm birth.

Influence of Apa1 (rs7975232), Taq1 (rs731236) and Bsm1 (rs154410) polymorphisms of vitamin D receptor on preterm birth risk in the Polish population

“…Maternal risk of pre-eclampsia, gestation diabetes and infectious diseases has been related with low levels of maternal circulating 25(OH)D in a number of observational studies [2][3][4]. Few reports indicating an effect of vitamin D or vitamin D receptor polymorphisms on the duration of pregnancy have been published so far [5][6][7]. Spontaneous preterm birth remains a s clinical diagnosis that encompasses many diseases of multiple etiologies.…”

A Study of Vitamin D Level in Newborn with Special Reference to Correlation with Gestational Age, Morbidity and Maternal Vitamin D Level

“…[4] Pregnancy and preterm delivery are regarded as risk factors for vitamin D deficiency. [5,6] Therefore, in this study, we aimed to compare vitamin D level in term and preterm newborn-mother pairs. Based on the present findings, there was no significant difference between term and preterm newborn-mother pairs.…”

“…On the other hand, in a previous study, the prevalence of vitamin D deficiency was estimated at 65.3% among both white and black pregnant women. [5] Considering the association between vitamin D deficiency and preterm delivery and the difference in vitamin D level between women with preterm and term deliveries, [6] in this study, we aimed to compare vitamin D level in term and preterm infant-mother pairs. The active metabolite of vitamin D, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), exerts its biological actions by binding to a nuclear receptor, the vitamin D receptor (VDR) and these are present in almost every organ system in the body.…”

Host Defense Peptide Expression in Human Cervical Cells and Regulation by 1,25-Dihydroxyvitamin D3 in the Presence of Cytokines and Bacterial Endotoxin

“…has been shown to have an impact on female reproductive health 18,19 and deficiencies have been linked with preterm birth 20,21 . Indeed in a recent study, the majority of women at high risk of sPTB in our population had reduced or deficient plasma vitamin D concentrations 8 .…”