title: Vitamin D deficiency in early pregnancy.
abstract: OBJECTIVE
  Vitamin D deficiency is a common problem in reproductive-aged women in the United States. The effect of vitamin D deficiency in pregnancy is unknown, but has been associated with adverse pregnancy outcomes. The objective of this study was to analyze the relationship between vitamin D deficiency in the first trimester and subsequent clinical outcomes.
  
  
  METHODS
  This is a retrospective cohort study. Plasma was collected in the first trimester from 310 nulliparous women with singleton gestations without significant medical problems. Competitive enzymatic vitamin D assays were performed on banked plasma specimens and pregnancy outcomes were collected after delivery. Logistic regression was performed on patients stratified by plasma vitamin D concentration and the following combined clinical outcomes: preeclampsia, preterm delivery, intrauterine growth restriction, gestational diabetes, and spontaneous abortion.
  
  
  RESULTS
  Vitamin D concentrations were obtained from 235 patients (mean age 24.3 years, range 18-40 years). Seventy percent of our study population was vitamin D insufficient with a serum concentration less than 30 ng/mL (mean serum concentration 27.6 ng/mL, range 13-71.6 ng/mL). Logistic regression was performed adjusting for age, race, body mass index, tobacco use, and time of year. Adverse pregnancy outcomes included preeclampsia, growth restriction, preterm delivery, gestational diabetes, and spontaneous abortion. There was no association between vitamin D deficiency and composite adverse pregnancy outcomes with an adjusted odds ratio of 1.01 (p value 0.738, 95% confidence intervals 0.961-1.057).
  
  
  CONCLUSIONS
  Vitamin D deficiency did not associate with adverse pregnancy outcomes in this study population. However, the high percentage of affected individuals highlights the prevalence of vitamin D deficiency in young, reproductive-aged women.
authors.affiliation: Division of Maternal-Fetal Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, United States of America.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Flood-Nichols
authors.affiliation: Department of Clinical Investigation, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, United States of America.
authors.forename: Deborah
authors.initials: D
authors.lastname: Tinnemore
authors.affiliation: Department of Clinical Investigation, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, United States of America.
authors.forename: Raywin R
authors.initials: RR
authors.lastname: Huang
authors.affiliation: Division of Maternal-Fetal Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, United States of America.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Napolitano
authors.affiliation: Department of Clinical Investigation, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, United States of America.
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Ippolito
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology; D055815:Young Adult