title: Maternal vitamin D status and delivery by cesarean.
abstract: We examined the association of vitamin D deficiency to risk of cesarean delivery using prospective data in a cohort of 1153 low income and minority gravidae. Circulating maternal 25-hydroxyvitamin D and intact parathyroid hormone were measured at entry to care 13.73 ± 5.6 weeks (mean ± SD). Intake of vitamin D and calcium was assessed at three time points during pregnancy. Using recent Institute of Medicine guidelines, 10.8% of the gravidae were at risk of vitamin D deficiency, and 23.8% at risk of insufficiency. Maternal 25-hydroxyvitamin D was related positively to vitamin D and calcium intakes and negatively to circulating concentrations of parathyroid hormone. Risk for cesarean delivery was increased significantly for vitamin D deficient women; there was no increased risk for gravidae at risk of insufficiency. When specific indications were examined, vitamin D deficiency was linked to a 2-fold increased risk of cesarean for prolonged labor. Results were the similar when prior guidelines for vitamin D deficiency (25(OH)D < 37.5nmol/L) and insufficiency (37.5-80 nmol/L) were utilized.
authors.affiliation: Department of Obstetrics and Gynecology, SOM, University of Medicine and Dentistry of New Jersey, Stratford, NJ 08084, USA. scholl@umdnj.edu
authors.forename: Theresa O
authors.initials: TO
authors.lastname: Scholl
authors.forename: Xinhua
authors.initials: X
authors.lastname: Chen
authors.forename: Peter
authors.initials: P
authors.lastname: Stein
mesh_terms: D002136:Calcium, Dietary / Q000008:administration & dosage; D002585:Cesarean Section / Q000706:statistics & numerical data*; D002851:Chromatography, High Pressure Liquid; D015331:Cohort Studies; D005260:Female; D006801:Humans; D009515:New Jersey / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D