title: Maternal vitamin D status and calcium intake interact to affect fetal skeletal growth in utero in pregnant adolescents.
abstract: BACKGROUND
  Maternal calcium intake and vitamin D status may affect fetal bone development.
  
  
  OBJECTIVE
  This study was designed to examine relations between maternal calcium intake, 25-hydroxyvitamin D [25(OH)D] status, and fetal bone growth across pregnancy.
  
  
  METHODS
  This was a prospective longitudinal design. Maternal 25(OH)D, parathyroid hormone, and 1,25-dihydroxyvitamin D [1,25(OH)(2)D] were determined at midgestation (∼26 wk) and at delivery in 171 adolescents (≤ 18 y). Dietary recalls and fetal sonograms were performed up to 3 times across gestation, and fetal femur and humerus z scores were generated.
  
  
  RESULTS
  Fetal femur and humerus z scores and neonatal birth length were significantly greater (P < 0.03) in adolescents consuming ≥ 1050 mg than in those consuming <1050 mg Ca/d. Maternal 25(OH)D > 50 nmol/L was significantly positively associated with fetal femur and humerus z scores (P < 0.01). When maternal smoking, height, race, weight gain, and gestational age were controlled for, these relations remained significant. Interactions between calcium intake and 25(OH)D were evident. Calcium intake was associated with fetal femur z scores and birth length only when maternal 25(OH)D was ≤ 50 nmol/L (P < 0.05). Similarly, maternal 25(OH)D was associated with fetal femur and humerus z scores only when maternal calcium intake was <1050 mg/d (P < 0.03).
  
  
  CONCLUSIONS
  Optimal calcium intake and adequate maternal vitamin D status are both needed to maximize fetal bone growth. Interactions between these nutrients were evident when either calcium or vitamin D status was limited. Improving maternal calcium intake and/or vitamin D status during pregnancy may have a positive effect on fetal skeletal development in pregnant adolescents.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
authors.forename: Bridget E
authors.initials: BE
authors.lastname: Young
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McNanley
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Cooper
authors.forename: Allison W
authors.initials: AW
authors.lastname: McIntyre
authors.forename: Frank
authors.initials: F
authors.lastname: Witter
authors.forename: Z Leah
authors.initials: ZL
authors.lastname: Harris
authors.forename: Kimberly O
authors.initials: KO
authors.lastname: O'Brien
mesh_terms: D000293:Adolescent; D001846:Bone Development / Q000187:drug effects*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D005260:Female; D005269:Femur / Q000187:drug effects / Q000196:embryology; D047109:Fetal Development / Q000187:drug effects; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D039382:Maternal Nutritional Physiological Phenomena; D010281:Parathyroid Hormone / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies; D014807:Vitamin D / Q000008:administration & dosage*
chemical_list: D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D