Circumstances verified as the several maternity, unfinished medical records, and you will nutritional D peak registered after thirteen days away from gestation were excluded
This study aimed to investigate the relationship between maternal serum vitamin D status in the first trimester of pregnancy and maternal as well as neonatal outcomes, considered the prevalence of vitamin D deficiency (serum 25(OH)D < 50 nmol/L) around the world, especially in the pregnant women.
Procedures
Away from , within this mix-sectional retrospective research, i enrolled females searching normal prenatal examinations and giving birth inside the brand new Global Peace Maternity and you will Child Wellness Healthcare. All in all, 23,394 mother-kid pairs had been incorporated at some point. Obstetric and you can neonatal suggestions have been extracted from brand new database. Maternal gel supplement D quantity was counted by chemiluminescence microparticle immunoassay. Logistic regression research (unadjusted and you may modified designs) was used to research the newest relationship between supplement D and you may maternal and neonatal consequences.
Results
The average 25(OH) D concentration was ± 0.10 nmol/L; % of patients were vitamin D deficient(25(OH) D < nmol/L), % were vitamin D insufficient (50 nmol/L ? 25(OH)D < 75 nmol/L), 3.07% were sufficient (25(OH)D ? 75 nmol/L). The maternal 25(OH)D levels varied with age, pre-pregnancy BMI, season when blood sample was collected, number of previous-pregnancy. Notably, newborns delivered by women with deficient vitamin D status had a higher incidence rate of admission to NICU (Deficiency: % vs Insufficiency: % vs Sufficiency: %, Pbonferroni = .002) and a longer stay (deficiency: 6.2 ± 4.1 days vs insufficiency: 5.9 ± 3.1 days vs sufficiency: 5.1 ± 2.1 days, Pbonferroni = .010). Moreover, maternal vitamin D deficiency was a dependent risk factor for admission to NICU (unadjusted OR = 1.35, 95% CI,1.05–1.74 Pbonferroni = .022; adjusted OR = 1.31, 95% CI,1.010–1.687 Pbonferroni = .042).
Conclusions
Maternal vitamin D deficiency (25(OH) D < 50 nmol/L) was prevalent in eastern coastal China. The incidence rate of GDM as well as preeclampsia was higher in vitamin D insufficient group while vitamin D deficiency group was liable to intrauterine infection when compared with the other two groups. Most importantly, low vitamin D status in the first trimester of pregnancy was a dependent risk factor for admission to NICU. More well-designed perspective researches are necessary to clarify the role of vitamin D in the early stage of pregnancy.
Addition
Vitamin D, with a vital role in calcium absorption and bone metabolism, also functioned in cell proliferation and differentiation, affecting the immune system as well . However, it’s worrisome that the incidence of vitamin D deficiency (VDD) is prevalent globally, especially in pregnant women . Low vitamin D status (defined as serum 25(OH)D concentrations < 50 nmol/L) was found in 33% of pregnant women in the US and 24% in Canada, respectively. In Europe, the prevalence of low vitamin D status was from 20 to 77% . According to the view of Developmental Origin of Health and Disease (DOHaD) theory, the disturbance in the uterine where the fetus is particularly sensitive to chemicals and other stressors, is related to adverse health effects in adult. Therefore, the lack of vitamin D may have effects on maternal and neonatal outcomes. Observational studies indicated an association between low vitamin D levels and an increased risk of disorders of placental implantation, impaired glucose tolerance, pre-eclampsia, fetal growth retardation, preterm birth, and caesarean section [4, 5], while Randomized Controlled Trial (RCT) found contradicted results [6,7,8]. Despite some short-term consequences in the newborns, maternal vitamin D deficiency also have long-term effects as rickets, increased susceptibility to respiratory illness, autoimmune diseases and type 1 diabetes [9, 10]. Considered the important but controversial role of vitamin D, we aimed to investigate the relationship between maternal vitamin D status in the first trimester of pregnancy and the outcomes of mothers and newborns in order to provide a practical recommendation for clinicians.