Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis

Wei, Shuqin; Qi, Hui-Ping; Luo, Zhong‐Cheng; Fraser, William D.

doi:10.3109/14767058.2013.765849

Cited by 413 publications

(405 citation statements)

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“…There is also a body of research linking suboptimal vitamin D during pregnancy with increased risk of pregnancy related disorders such as gestational diabetes, pre-eclampsia and offspring being small for gestational age (Aghajafari et al, 2013, Wei et al, 2013, Harvey et al, 2014 and other research linking suboptimal vitamin D levels early in life with adverse health outcomes later in life (Boucher, 1998, McGrath, 2001, Brannon and Picciano, 2011, Christesen et al, 2012, Thorne-Lyman and Fawzi, 2012, Zipitis and Akobeng, 2008, Ponsonby et al, 2010.…”

Section: Discussionmentioning

confidence: 99%

“…The concern about vitamin D deficiency during pregnancy reflects the robust evidence linking this exposure to higher risk of rickets in the offspring (Wharton and Bishop, 2003) and an increased risk of obstetric complications (Aghajafari et al, 2013, Nassar et al, 2011, Wei et al, 2013. There is also preliminary evidence to suggest that vitamin D deficiency may be linked to a range of later adverse health outcomes in the offspring (Boucher, 1998, McGrath, 2001, Brannon and Picciano, 2011, Christesen et al, 2012, Thorne-Lyman and Fawzi, 2012, Zipitis and Akobeng, 2008, Ponsonby et al, 2010.…”

Section: Introductionmentioning

confidence: 99%

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

Vinkhuyzen

Eyles

Burne

et al. 2016

The Journal of Steroid Biochemistry and Molecular Biology

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of vitamin D deficiency based on maternal mid-gestation and neonatal cord bloods: the Generation R Study, Journal of Steroid Biochemistry and Molecular Biology http://dx.doi.org/10. 1016/j.jsbmb.2015.09.018 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ResultsThe prevalence of vitamin D deficiency at midgestation was 26%, while in neonates 46% were deficient. 21% of the mother-infant pairs had persistent vitamin D deficiency (i.e. deficient in maternal and cord samples) and an additional 29% were vitamin D deficient in one of the two samples only. Persistent vitamin D deficiency was strongly associated with non-European ancestry and spring birth. Conclusions

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Vinkhuyzen

Eyles

Burne

et al. 2016

The Journal of Steroid Biochemistry and Molecular Biology

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“…Vitamin D status before and during pregnancy is implicated in fetal growth (3) . In addition, vitamin D is important for the prevention of adverse pregnancy outcomes including pre-eclampsia and gestational diabetes mellitus (4)(5)(6) .The RDA for vitamin D set by the US Institute of Medicine (IOM) is 15 µg/d for ages 1-70 years with no additional amount during pregnancy or lactation (7) . As many as 41 % of all pregnancies worldwide are unplanned (8) .…”

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confidence: 99%

Validity of an FFQ assessing the vitamin D intake of young Serbian women living in a region without food fortification: the method of triads model

Djekic-Ivankovic

Weiler

Nikolić

et al. 2015

Public Health Nutr.

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Objective: The objective of the present study was to examine the external validity of an FFQ designed to estimate dietary vitamin D intake compared with a plasma biomarker and three repeated 24 h dietary recalls in women of reproductive age in Serbia, where there is no exposure to food fortified with vitamin D. The method of triads was applied. Design: In a cross-sectional study, 422 women completed the Women and Reproductive Health FFQ (WRH-FFQ) during the winter months. From a representative subgroup (n 44), three 24 h dietary recalls and anthropometric parameters were collected as well as a fasting blood sample for vitamin D biomarker analyses. Correlation coefficients were calculated between each of the dietary methods. Validity coefficients, as a correlation between the measured and estimated 'true' exposure, were calculated using the method of triads. Bland-Altman plots were also constructed. Setting: Three major universities in Serbia. Subjects: Healthy young women (n 422) aged 18-35 years. Results: The WRH-FFQ estimate of vitamin D intake for all participants was 4·0 (SD 3·3) µg/d and 3·1 (SD 2·3) µg/d for the subgroup. Bland-Altman plots for these intakes showed high agreement. Validity coefficients for the FFQ, 24 h recall and biomarker were ρ QI = 0·847 (95 % CI 0·564, 0·928), ρ RI = 0·810 (95 % CI 0·537, 0·997) and ρ BI = 0·499 (95 % CI 0·190, 0·840), while the correlation coefficients were 0·686, 0·422 and 0·404. Conclusions: The FFQ applied in the present study is a valid tool for assessing dietary vitamin D intake in women living in Serbia, a region without mandatory vitamin D food fortification.Method of triadsMaintenance of optimal nutritional status in women of reproductive age can help to ensure normal fetal development (1) . It has been shown that vitamin D has important benefits during fetal and neonatal development (2) . Vitamin D, a fat-soluble vitamin, can be attained through diet, supplements or exposure to sunlight. The primary function of vitamin D is to control Ca homeostasis and in doing so aid absorption of Ca from the intestine and ensure adequate bone metabolism (2) . Vitamin D status before and during pregnancy is implicated in fetal growth (3) . In addition, vitamin D is important for the prevention of adverse pregnancy outcomes including pre-eclampsia and gestational diabetes mellitus (4)(5)(6) .The RDA for vitamin D set by the US Institute of Medicine (IOM) is 15 µg/d for ages 1-70 years with no additional amount during pregnancy or lactation (7) . As many as 41 % of all pregnancies worldwide are unplanned (8) .To ensure that the general population and women of childbearing age consume enough vitamin D prior to becoming pregnant, many countries have introduced mandatory vitamin D fortification of food, which is not the case in Serbia. To date voluntary fortification in Serbia is limited to one milk product and imported products.Mapping low intakes of vitamin D and other micronutrients across Europe with a focus on Central Eastern European (CEE) countries showed no diff...

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“…During pregnancy, vitamin D influences calcium and phosphorous homeostasis (6) to enable fetal bone mineral accretion. More recent evidence however, suggests that maternal serum 25(OH)D levels may also influence extra-skeletal maternal and fetal health outcomes; including birthweight and the risk of pre-eclampsia (PET), gestational diabetes mellitus (GDM), pre-term birth and small for gestational age (SGA) (6,7) .This observational study examined maternal vitamin D intakes in the first trimester. Women were recruited at their convenience after sonographic confirmation of a singleton pregnancy in the first trimester.…”

mentioning

confidence: 99%

“…This is of a particular concern, as the fetus relies on maternal intakes and stores of vitamin D to meet its demands (5) . During pregnancy, vitamin D influences calcium and phosphorous homeostasis (6) to enable fetal bone mineral accretion. More recent evidence however, suggests that maternal serum 25(OH)D levels may also influence extra-skeletal maternal and fetal health outcomes; including birthweight and the risk of pre-eclampsia (PET), gestational diabetes mellitus (GDM), pre-term birth and small for gestational age (SGA) (6,7) .…”

mentioning

confidence: 99%

An exploration of the association between vitamin D intake in early pregnancy and fetal and maternal clinical outcomes

Hayden¹,

Cawley²,

Turner

et al. 2017

Proc. Nutr. Soc.

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Evidence indicates that sub-optimal vitamin D status (25(OH)D<50 nmol/l) is common amongst pregnant women in Ireland (1)(2)(3) , with mean dietary intakes estimated to be between 1·9-3·6μg/day (1,4) . This is of a particular concern, as the fetus relies on maternal intakes and stores of vitamin D to meet its demands (5) . During pregnancy, vitamin D influences calcium and phosphorous homeostasis (6) to enable fetal bone mineral accretion. More recent evidence however, suggests that maternal serum 25(OH)D levels may also influence extra-skeletal maternal and fetal health outcomes; including birthweight and the risk of pre-eclampsia (PET), gestational diabetes mellitus (GDM), pre-term birth and small for gestational age (SGA) (6,7) .This observational study examined maternal vitamin D intakes in the first trimester. Women were recruited at their convenience after sonographic confirmation of a singleton pregnancy in the first trimester. Maternal body composition was measured using 8-electrode bioelectrical impedance analysis, and dietary data collected using an interviewer-assisted 4-day retrospective diet history (DH) in combination with a food frequency questionnaire (FFQ). All reported portion sizes were fully quantified using food portion size estimation tools. Nutrient analysis was carried out using Nutritics version 3.7 University Edition which included the most up-to-date nutrient composition for fortified foods.Among the 720 women recruited, dietary intake data was available for the full sample (n = 720) and supplement data for the majority (n = 634). Of the full sample, 238 were classified as energy under-reporters. Amongst the plausible dietary reporters (n = 482/720), median vitamin D intake from diet alone was 2·7μg/day, with 2·7 % achieving the EAR (10μg/day) (8) from food only. Median intake from diet and supplements combined was 6·3μg/day, with 48·2 % of supplement users achieving the EAR. Vitamin D supplement usage for the entire sample was 61·2 %. No association was reported between achievement of the EAR and fetal or maternal health outcomes. When multivariate analyses were performed, those experiencing relative income poverty were less likely to supplement, while planning a pregnancy persisted as a positive predictor of vitamin D supplementation.This study suggests that dietary vitamin D intakes are sub-optimal in pregnancy, and that supplements make a critical contribution to overall intakes. However, it also indicates that supplementation is less common amongst low SES women, particularly those who don't plan their pregnancy. The study has implications for public health interventions in relation to vitamin D in pregnancy, and in relation to future food fortification policy.

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Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis

Abstract: Low maternal vitamin D levels in pregnancy may be associated with an increased risk of preeclampsia, GDM, preterm birth and SGA.

Cited by 413 publications

References 50 publications

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

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

Validity of an FFQ assessing the vitamin D intake of young Serbian women living in a region without food fortification: the method of triads model

An exploration of the association between vitamin D intake in early pregnancy and fetal and maternal clinical outcomes

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