title: Deficit of vitamin D in pregnancy and growth and overweight in the offspring.
abstract: BACKGROUND
  Maternal vitamin D status during fetal development may influence offspring growth and risk of obesity; however, evidence in humans is limited.
  
  
  OBJECTIVE
  To investigate whether maternal circulating 25-hydroxyvitamin D3 (25(OH)D3) concentration in pregnancy is associated with offspring prenatal and postnatal growth and overweight.
  
  
  METHODS
  Plasma 25(OH)D3 concentration was measured in pregnant women (median weeks of gestation 14.0, range 13.0-15.0) from the INMA (INfancia y Medio Ambiente) cohort (Spain, 2003-2008) (n = 2358). Offspring femur length (FL), biparietal diameter (BPD), abdominal circumference (AC) and estimated fetal weight (EFW) were evaluated at 12, 20 and 34 weeks of gestation by ultrasound examinations. Fetal overweight was defined either as AC or as EFW ⩾ 90th percentile. Child's anthropometry was recorded at ages 1 and 4 years. Rapid growth was defined as a weight gain z-score of >0.67 from birth to ages 6 months and 1 year. Age- and sex-specific z-scores for body mass index (BMI) were calculated at ages 1 and 4 years (World Health Organization referent); infant's overweight was defined as a BMI z-score ⩾ 85th percentile.
  
  
  RESULTS
  We found no association of maternal 25(OH)D3 concentration with FL and a weak inverse association with BPD at 34 weeks. Maternal deficit of 25(OH)D3 (<20 ng ml(-1)) was associated with increased risk of fetal overweight defined as AC ⩾ 90th percentile (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.01-2.21; P = 0.041) or either as EFW ⩾ 90th percentile (OR = 1.47, 95% CI: 1.00-2.16; P = 0.046). No significant associations were found with rapid growth. Deficit of 25(OH)D3 in pregnancy was associated with an increased risk of overweight in offspring at age 1 year (OR = 1.42, 95% CI: 1.02-1.97; P = 0.039); however, the association was attenuated at age 4 years (OR = 1.19, 95% CI: 0.83-1.72; P = 0.341).
  
  
  CONCLUSIONS
  Vitamin D deficiency in pregnancy may increase the risk of prenatal and early postnatal overweight in offspring. Clinical trials are warranted to determine the role of vitamin D in the early origins of obesity.
authors.affiliation: 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain [3] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [4] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Morales
authors.affiliation: 1] Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Catalonia, Spain [2] Universitat Autònoma de Barcelona, Campus d'Excelència Internacional Bellaterra, Barcelona, Catalonia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Valvi
authors.affiliation: 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Iñiguez
authors.affiliation: 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Esplugues
authors.affiliation: 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Departamento de Salud Publica, Universidad Miguel Hernandez, Alicante, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Vioque
authors.affiliation: 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Gipuzkoa, Spain [3] Health Research Institute Biodonostia, San Sebastián, Gipuzkoa, Spain.
authors.forename: L S
authors.initials: LS
authors.lastname: Marina
authors.affiliation: 1] Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Gipuzkoa, Spain [2] Health Research Institute Biodonostia, San Sebastián, Gipuzkoa, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Jiménez
authors.affiliation: Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Euskadi, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Espada
authors.affiliation: Hospital San Agustín, Avilés, Oviedo, Spain.
authors.forename: C R
authors.initials: CR
authors.lastname: Dehli
authors.affiliation: 1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain [2] Department of Preventive Medicine and Public Health, University of Oviedo, Oviedo, Asturias, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Fernández-Somoano
authors.affiliation: 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [3] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Vrijheid
authors.affiliation: 1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain [3] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [4] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sunyer
mesh_terms: D017668:Age of Onset; D015992:Body Mass Index; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D016017:Odds Ratio; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D016216:Ultrasonography, Prenatal; D014808:Vitamin D Deficiency / Q000150:complications* / Q000453:epidemiology; D015430:Weight Gain