High Prevalence of Vitamin D Insufficiency in Black and White Pregnant Women Residing in the Northern United States and Their Neonates

Abstract

In utero or early-life vitamin D deficiency is associated with skeletal problems, type 1 diabetes, and schizophrenia, but the prevalence of vitamin D deficiency in U.S. pregnant women is unexplored. We sought to assess vitamin D status of pregnant women and their neonates residing in Pittsburgh by race and season. Serum 25-hydroxyvitamin D (25(OH)D) was measured at 4-21 wk gestation and predelivery in 200 white and 200 black pregnant women and in cord blood of their neonates. Over 90% of women used prenatal vitamins. Women and neonates were classified as vitamin D deficient [25(OH)D<37.5 nmol/L], insufficient [25(OH)D 37.5-80 nmol/L], or sufficient [25(OH)D>80 nmol/L]. At delivery, vitamin D deficiency and insufficiency occurred in 29.2% and 54.1% of black women and 45.6% and 46.8% black neonates, respectively. Five percent and 42.1% of white women and 9.7% and 56.4% of white neonates were vitamin D deficient and insufficient, respectively. Results were similar at <22 wk gestation. After adjustment for prepregnancy BMI and periconceptional multivitamin use, black women had a smaller mean increase in maternal 25(OH)D compared with white women from winter to summer (16.0+/-3.3 nmol/L vs. 23.2+/-3.7 nmol/L) and from spring to summer (13.2+/-3.0 nmol/L vs. 27.6+/-4.7 nmol/L) (P<0.01). These results suggest that black and white pregnant women and neonates residing in the northern US are at high risk of vitamin D insufficiency, even when mothers are compliant with prenatal vitamins. Higher-dose supplementation is needed to improve maternal and neonatal vitamin D nutriture.

Vitamin D and the Regulation of Placental Inflammation

“…The RT 2 Profiler PCR array for mouse inflammatory cytokines and their receptors (PAMM-011; SuperArray Bioscience (SAB) Corporation, Frederick, MD) was used to compare inflammatory responses to LPS (100 ng/ ml, 24 h) in placentas with a Cyp27b1 +/+ or Cyp27b1 2/2 fetal genotype. Total RNA was extracted from placenta tissue by using the TRIzol protocol (Invitrogen).…”

“…A lthough vitamin D insufficiency is increasingly recognized as a health problem across the world, inadequate vitamin D status appears to be particularly prevalent in certain populations such as the elderly (1) and pregnant women (2)(3)(4). With respect to the latter, impaired vitamin D status during gestation is associated with poor skeletal growth in childhood (3), consistent with the classical functions of vitamin D. However, low maternal levels of the major circulating form of vitamin D, 25-hydroxyvitamin D 3 (25OHD 3 ), have also been linked to adverse outcomes in pregnancy such as pre-eclampsia, a disorder involving dysregulated placental vascularization that affects up to 10% of pregnancies (5,6).…”

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

“…Cord blood from babies born to obese mothers also has a lower mean vitamin D concentration compared to those born of women with normal BMI. [81][82][83] Several mechanisms of vitamin D deficiency in obesity are proposed. Dietary deficiency of vitamin D is common and while the diet in obesity is of high calorific value, it has relatively poor nutritional benefit.…”

Prevalence and predictors of vitamin D deficiency based on maternal mid-gestation and neonatal cord bloods: The Generation R Study

“…In particular, there is widespread concern about the high prevalence of vitamin D deficiency during pregnancy (Hollis and Wagner, 2006). It can be difficult to delineate the proportion of pregnant women exposed to vitamin D deficiency because vitamin D status varies according to how deficiency is defined, as well as factors such as latitude, season of testing, and skin colour (Keim et al, 2014, Bodnar et al, 2007, Vandevijvere et al, 2012, Wuertz et al, 2013. Recent narrative reviews suggested that the prevalence of vitamin D deficiency during pregnancy can be alarmingly high (e.g.…”