Maternal Vitamin D Status in Type 1 Diabetic Pregnancy: Impact on Neonatal Vitamin D Status and Association with Maternal Glycaemic Control

Bennett, Sarah; McPeake, Jennifer; McCance, David R.; Manderson, John G.; Johnston, Pete; McGalliard, Rachel; McGinty, Ann

doi:10.1371/journal.pone.0074068

Cited by 15 publications

(8 citation statements)

References 35 publications

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“…The concentration of 25(OH)D is relatively constant throughout pregnancy [ 6 ]. The mother is the only source of vitamin D for the foetus [ 7 ]. Vitamin D concentrations in the umbilical cord are usually 60–89% of the values in the mother’s blood.…”

Section: Physiology Of Vitamin D During Pregnancymentioning

confidence: 99%

The Association of Vitamin D Levels with Common Pregnancy Complications

Dovnik

Mujezinović

2018

Nutrients

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The association between vitamin D deficiency and various adverse pregnancy outcomes has been extensively investigated in recent years. The pregnant woman is the only source of vitamin D for the foetus. The main sources of vitamin D for pregnant women are sunlight, fortified dairy products, oily fish and dietary supplements. Vitamin D deficiency during pregnancy has been associated with some adverse neonatal outcomes as well as an increased risk of late pregnancy complications. The outcomes of the published studies investigating preeclampsia and gestational diabetes mellitus vary with some large trials suggesting a potential positive effect of vitamin D supplementation during pregnancy on the decreased risk of these complications. Research also suggests a possible connection between lower vitamin D concentrations and increased risk of preterm labour. In our manuscript, we aim to review the existing literature regarding the prevalence of vitamin D deficiency during pregnancy, the factors associated with vitamin D deficiency, and possible pregnancy complications arising from it.

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Section: Physiology Of Vitamin D During Pregnancymentioning

confidence: 99%

The Association of Vitamin D Levels with Common Pregnancy Complications

Dovnik

Mujezinović

2018

Nutrients

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“…Reported associations of vitamin D deficiency in diabetic pregnancy include preterm birth, increased T1DM rates in offspring of women with T1DM, and poor glycaemic control. 11,16,19,20,23 Some studies of non-diabetic pregnant women have suggested associations between low total 25(OH)D and contemporaneous 9 or subsequent PE, 8,11 perhaps limited to early-onset disease. 12 Our present finding of no significant association is consistent with our previous study (that used different methodology to measure 25(OH)D), 24 and with a study by Vestgaard et al .. 16 The present work extends those findings by showing that, like total 25(OH)D, neither bioavailable nor free forms of 25(OH)D were predictive of PE.…”

Section: Resultsmentioning

confidence: 99%

Vitamin D metabolites and binding protein predict preeclampsia in women with Type 1 diabetes: a cohort study

Kelly

Wagner

Shary

et al. 2020

Preprint

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Objective: Preeclampsia (PE) occurs about four times more frequently in women with than without diabetes. Vitamin D is essential for healthy pregnancy. We investigated detailed measures of maternal plasma 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH) 2 D), and vitamin D binding protein (VDBP) to define associations with PE in women with Type 1 diabetes (T1DM). Design and setting: A multicentre prospective study in women at˜12,˜22 and˜32 weeks' gestation ('Visits' (V) 1, 2, and 3, respectively). Population: We studied 23 T1DM women who subsequently developed PE, 24 who remained normotensive, and 19 non-diabetic, normotensive women (reference controls). Diabetic women were complication-free at V1, and all study visits preceded PE onset. Main Outcome Measures: Total, bioavailable, and free concentrations of 25(OH)D and 1,25(OH) 2 D; and VDBP. Results: 25(OH)D deficiency was more frequent in diabetic than non-diabetic women (69% vs 22%, p<0.05), but no measure of 25(OH)D predicted PE. In contrast, higher 1,25(OH) 2 D concentrations at V2 (total and bioavailable: p<0.01; free: p<0.05) and V3 (bioavailable: p<0.05; free: p<0.01) were associated with subsequent PE in T1DM women, as were lower concentrations of VDBP at V3 (p<0.05) and elevated ratios of 1,25(OH) 2 D/VDBP (V2, V3: p<0.01) and 1,25(OH) 2 D/25(OH)D (V3, p<0.05). Significance persisted after adjustment for covariates. Conclusions:In women with T1DM, concentrations of active vitamin D were higher, and VDBP lower, in the second and third trimesters in those who developed PE than in those who did not. Active vitamin D may serve as a new marker for PE risk, and could be implicated in pathogenesis.

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“…By contrast, 25(OH)D, the standard metric for vitamin D, did not predict PE; of note, however, insufficient or deficient levels were almost universal in our diabetic cohort. Reported associations of vitamin D deficiency in diabetic pregnancy include preterm birth, increased T1DM rates in offspring of women with T1DM, and poor glycemic control [12,17,20,21,29]. Some studies in non-diabetic pregnant women have suggested that low total 25(OH)D is associated with contemporaneous [10] or subsequent PE [9,12], perhaps limited to early-onset disease [13].…”

Section: Discussionmentioning

confidence: 99%

“…Women with type 1 diabetes (T1DM) have a markedly increased risk for PE (~20% vs.~5% in the general population) [28]. Vitamin D deficiency is associated with abnormal placentation, altered angiogenesis, immune dysfunction, abnormal insulin secretion and action, adverse lipid profiles, and inflammation: problems that are also associated with diabetes [2,4,11,[13][14][15][16][17]19,29]. Vitamin D deficiency may also be implicated in PE [9,13].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Metabolites and Binding Protein Predict Preeclampsia in Women with Type 1 Diabetes

et al. 2020

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The risk for preeclampsia (PE) is enhanced ~4-fold by the presence of maternal type 1 diabetes (T1DM). Vitamin D is essential for healthy pregnancy. We assessed the total, bioavailable, and free concentrations of plasma 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), and vitamin D binding protein (VDBP) at ~12, ~22, and ~32 weeks’ gestation (“Visits” (V) 1, 2, and 3, respectively) in 23 T1DM women who developed PE, 24 who remained normotensive, and 19 non-diabetic, normotensive women (reference controls). 25(OH)D deficiency was more frequent in diabetic than non-diabetic women (69% vs. 22%, p < 0.05), but no measure of 25(OH)D predicted PE. By contrast, higher 1,25(OH)2D concentrations at V2 (total, bioavailable, and free: p < 0.01) and V3 (bioavailable: p < 0.05; free: p < 0.01), lower concentrations of VDBP at V3 (p < 0.05), and elevated ratios of 1,25(OH)2D/VDBP (V2, V3: p < 0.01) and 1,25(OH)2D/25(OH)D (V3, p < 0.05) were all associated with PE, and significance persisted in multivariate analyses. In summary, in women with T1DM, concentrations of 1,25(OH)2D were higher, and VDBP lower, in the second and third trimesters in women who later developed PE than in those who did not. 1,25(OH)2D may serve as a new marker for PE risk and could be implicated in pathogenesis.

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Maternal Vitamin D Status in Type 1 Diabetic Pregnancy: Impact on Neonatal Vitamin D Status and Association with Maternal Glycaemic Control

Cited by 15 publications

References 35 publications

The Association of Vitamin D Levels with Common Pregnancy Complications

The Association of Vitamin D Levels with Common Pregnancy Complications

Vitamin D metabolites and binding protein predict preeclampsia in women with Type 1 diabetes: a cohort study

Vitamin D Metabolites and Binding Protein Predict Preeclampsia in Women with Type 1 Diabetes

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