Maternal Vitamin D Deficiency in Early Pregnancy Is Not Associated with Gestational Diabetes Mellitus Development or Pregnancy Outcomes in Korean Pregnant Women in a Prospective Study

Abstract

Gestational diabetes mellitus (GDM) is a worldwide, growing complication during pregnancy (1). Many risk factors for GDM have been identified, including obesity prior to and during pregnancy, older maternal age, previous history of GDM, and family history of diabetes (1). However, these risk factors are not sufficient to predict GDM development in almost half of all cases (2). Hence, it is necessary to identify other risk factors, including potential nutritional factors.Vitamin D deficiency has recently been drawing the interest of medical researchers with its link to adverse outcomes of various diseases, other than bone diseases (3-6). Serum levels of 25-hydroxyvitamin D (25-OH-D), a good measure of vitamin D status in humans, are inversely related to hypertension, diabetes, carotid atherosclerosis, myocardial infarction, congestive heart failure, stroke, microalbuminuria, and kidney dysfunction (3-6). In a recent cross-sectional study on a Korean population, women less than 50 y old with more serum 25-OH-D (75 nmol/L) had a significantly lower prevalence of type 2 diabetes than those with less 25-OH-D (25 nmol/L) (7). In addition, serum 25-OH-D levels were significantly negatively associated with fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) values in all participants. As GDM has a similar pathophysiology to type 2 diabetes (1), serum 25-OH-D levels in the first trimester may be a risk factor for GDM in Korean women. In previous studies, there is still some controversy about the association of vitamin D deficiency in the first trimester with adverse pregnancy outcomes such as GDM development, pre-eclampsia, infections, caesarean section, and fetal growth restric- Summary The association between vitamin D deficiency in the first trimester and GDM development remains controversial in various ethnicities. We prospectively assessed whether pregnant women with vitamin D deficiency during early pregnancy had an increased likelihood of GDM development or poor fetal growth or pregnancy outcomes compared to those with sufficient vitamin D levels. Serum 25-OH-D measurements and fetal ultrasonograms were carried out at 12-14, 20-22, and 32-34 wk in 523 pregnant women. Each woman was screened for GDM at 24-28 wk. There were no differences in serum 25-OH-D levels at 12-14 wk or 22-24 wk of pregnancy between GDM and non-GDM women after adjusting for maternal age, BMI at prepregnancy, BMI at first visit, BMI at GDM screening, gestational age at sampling, previous history of GDM, vitamin D intake, and seasonal variation in sampling. The risk of GDM, insulin resistance, and impaired b-cell function had no association with serum 25-OH-D levels in crude or adjusted logistic regression analysis. GDM was not associated with maternal serum 25-OH-D deficiency during the first trimester or fetal growth during the first and second trimesters. Pregnancy outcomes such as miscarriage, Apgar 1, Apgar 5 and birth weight were independent of maternal serum 25-OH-D levels during the first, second and third ...

Vitamin D status during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study in a multiracial cohort

“…We found a non-linear threshold effect of total To our knowledge, only one study has investigated the longitudinal profiles of serum 25(OH)D during pregnancy (at 12-14, 20-22, and 32-34 weeks) and prospectively examined the associations between trimester-specific vitamin D status and GDM in a cohort of 523 Korean women. 32 Similar to our study, there was no statistically significant difference in 25(OH)D between GDM cases and controls at any time points. However, they did not examine the associations between GDM risk and longitudinal changes of 25(OH)D levels, as well as other vitamin D biomarkers.…”

A Cross Sectional Study of Vitamin D Level in Patients With Gestational Diabetes Mellitus Attending Ante-Natal Care at King Abdul Aziz University Hospital, Jeddah.

“…All the results were higher in the GDM group. These findings are consistent with the study from Korea, where Park et al reported significant difference between GDM group and non-GDM group regarding several glucose measurements (Park et al, 2014). Also Parildar et al from turkey reported significant difference between GDM group and non-GDM group regarding HbA1c (p=0.004) and Fasting serum glucose (p<0.01) (Parildar et al, 2013).…”

The relationship between 25-hydroxyvitamin D concentration in early pregnancy and pregnancy outcomes in a large, prospective cohort

“…In a similarly replete population, investigators found no association between vitamin D status and pregnancy outcomes including pre-eclampsia, SGA, preterm birth and GDM (20) . However, in vitamin D-deficient populations, no association between 25-hydroxyvitamin D concentration and SGA (30) and GDM (22) was found ( Table 3).The main limitation to our study was the comparatively low prevalence of late pregnancy disorders, particularly GDM; this was due to the purpose for which SCOPE was established -that is, to investigate predictors of late pregnancy disorders in early pregnancy in low-risk, nulliparous women (12) . We did not have data on sunlight exposure -a factor that contributes most to 25-hydroxyvitamin D concentration.…”

“…Although 23 % of Auckland SCOPE participants were vitamin D deficient (25-hydroxyvitamin D <50 nmol/l), half to more than 90 % of pregnant women have been found to be deficient in previous studies (20)(21)(22) . The SCOPE Auckland cohort may be more vitamin D replete in comparison with the obstetric Auckland population and the wider New Zealand population.…”