title: High Prevalence of Vitamin D Deficiency in Native versus Migrant Mothers and Newborns in the North of Italy: A Call to Act with a Stronger Prevention Program.
abstract: BACKGROUND
  Vitamin D status during pregnancy is related to neonatal vitamin D status. Vitamin D deficiency has been associated with an increased risk of rickets in children and osteomalacia in adults. Aim of this study was to investigate 25OHD levels in maternal serum and in neonatal blood spots in native and migrant populations living in Novara (North Italy, 45°N latitude).
  
  
  RESULTS
  We carried out a cross sectional study from April 1st 2012 to March 30th 2013, in a tertiary Care Center. Maternal blood samples after delivery and newborns' blood spots were analyzed for 25OHD levels in 533 pairs. Maternal country of origin, skin phototype, vitamin D dietary intake and supplementation during pregnancy were recorded. Multivariate regression analysis, showed a link between neonatal and maternal 25OHD levels (R-square:0.664). Severely deficient 25OHD values (<25 nmol/L) were found in 38% of Italian and in 76.2% of migrant's newborns (p <0.0001), and in 18% of Italian and 48,4% of migrant mothers (p <0.0001) while 25OHD deficiency (≥25 and <50 nmol/L) was shown in 40.1% of Italian and 21.7% of migrant's newborns (p <0.0001), and in 43.6% of Italian and 41.3% of migrant mothers (p <0.0001). Italian newborns and mothers had higher 25OHD levels (34.4±19.2 and 44.9±21.2 nmol/L) than migrants (17.7±13.7 and 29.7±16.5 nmol/L; p<0.0001). A linear decrease of 25OHD levels was found with increasing skin pigmentation (phototype I 42.1 ±18.2 vs phototype VI 17.9±10.1 nmol/l; p<0.0001). Vitamin D supplementation resulted in higher 25OHD values both in mothers and in their newborns (p<0.0001).
  
  
  CONCLUSIONS
  Vitamin D insufficiency in pregnancy and in newborns is frequent especially among migrants. A prevention program in Piedmont should urgently be considered and people identified as being at risk should be closely monitored. Vitamin D supplementation should be taken into account when considering a preventative health care policy.
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy; IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Novara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cadario
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastio
authors.affiliation: Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of "Piemonte Orientale Amedeo Avogadro" and CPO-Piemonte, Novara, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Magnani
authors.affiliation: Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of "Piemonte Orientale Amedeo Avogadro" and CPO-Piemonte, Novara, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Cena
authors.affiliation: University of Turin, Turin, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Pagliardini
authors.affiliation: Central Laboratory of Maggiore della Carità Hospital, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bellomo
authors.affiliation: Central Laboratory of Maggiore della Carità Hospital, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bagnati
authors.affiliation: Central Laboratory of Maggiore della Carità Hospital, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Vidali
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Pozzi
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Stella
authors.initials: S
authors.lastname: Pamparana
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Zaffaroni
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Genoni
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of "Piemonte Orientale Amedeo Avogadro", Novara, Italy; IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Novara, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Bona
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology / Q000208:ethnology; D008423:Maternal Age; D009035:Mothers; D011247:Pregnancy; D014171:Transients and Migrants; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D014807:Vitamin D