title: First-trimester maternal serum vitamin D and mode of delivery.
abstract: Low maternal vitamin D levels have been associated with adverse pregnancy outcome. A recent study has suggested that low maternal vitamin D levels at the time of delivery are also associated with an almost fourfold increase in caesarean section risk. The aim of the present study was to investigate whether there is a difference in maternal serum 25-hydroxyvitamin D (25(OH)D) levels at 11-13 weeks' gestation according to the mode of delivery. Maternal serum 25(OH)D levels were measured at 11-13 weeks' gestation in 995 singleton pregnancies resulting in the birth of phenotypically normal neonates at term. The measured 25(OH)D levels were adjusted for maternal age, BMI, racial origin, smoking, method of conception and season of blood testing, and the adjusted levels (multiple of the median; MoM) were compared between those who subsequently delivered vaginally and those that delivered by caesarean section. Delivery was vaginal in 79·6 % of cases, by emergency caesarean section in 11·6 % and by elective caesarean section in 8·8 %. The median 25(OH)D level in our population was 46·82 (interquartile range (IQR) 27·75-70·13) nmol/l. The adjusted maternal median 25(OH)D levels in the emergency and elective caesarean section groups (0·99, IQR 0·71-1·46 MoM and 0·96, IQR 0·73-1·27 MoM, respectively) were not significantly different from the vaginal delivery group (0·99, IQR 0·71-1·33 MoM; P = 0·53 and P = 0·81, respectively). First-trimester maternal serum 25(OH)D levels are similar between women who subsequently have a vaginal delivery and those who deliver by elective or emergency caesarean section.
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Imperial College School of Medicine, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. msavvidou@dsla.ndo.co.uk
authors.forename: Makrina D
authors.initials: MD
authors.lastname: Savvidou
authors.forename: Mahlatse
authors.initials: M
authors.lastname: Makgoba
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Castro
authors.forename: Ranjit
authors.initials: R
authors.lastname: Akolekar
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002112:Calcifediol / Q000097:blood; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008131:London; D009752:Nutritional Status; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000503:physiopathology; D011261:Pregnancy Trimester, First / Q000097:blood*; D011446:Prospective Studies; D012306:Risk; D012621:Seasons; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol