Early pregnancy vitamin D status and risk for adverse maternal and infant outcomes in a bi-ethnic cohort: the Behaviors Affecting Baby and You (B.A.B.Y.) Study.
Vitamin D deficiency is common during pregnancy and higher in Hispanic as compared with non-Hispanic white women. However, the association between vitamin D deficiency and adverse pregnancy outcomes remains unclear and may vary across ethnic groups, in part because of genetic variation in the metabolism of vitamin D. Few studies have included Hispanic women. Therefore, we investigated this association among 237 participants in the Behaviors Affecting Baby and You Study, a randomised trial of an exercise intervention among ethnically diverse prenatal care patients in Massachusetts. Baseline serum 25-hydroxyvitamin D (25(OH)D) was measured at 15·2 (sd 4·7) weeks' gestation. Information on adverse pregnancy outcomes was abstracted from medical records. Mean 25(OH)D was 30·4 (sd 12·0) ng/ml; 53·2 % of participants had insufficient (<30 ng/ml) and 20·7 % had deficient (<20 ng/ml) 25(OH)D levels. After adjusting for month of blood draw, gestational age at blood draw, gestational age at delivery, age, BMI and Hispanic ethnicity, women with insufficient and deficient vitamin D had infants with birth weights 139·74 (se 69·16) g (P=0·045) and 175·52 (se 89·45) g (P=0·051) lower compared with women with sufficient vitamin D levels (≥30 ng/ml). Each 1 ng/ml increase in 25(OH)D was associated with an increased risk for gestational diabetes mellitus among Hispanic women only (relative risk 1·07; 95 % CI 1·03, 1·11) in multivariable analysis. We did not observe statistically significant associations between maternal vitamin D status and other pregnancy outcomes. Our findings provide further support for an adverse impact of vitamin D deficiency on birth weight in Hispanic women.
1Department of Biostatistics and Epidemiology,School of Public Health & Health Sciences,Division of Biostatistics & Epidemiology,University of Massachusetts,Amherst,MA 01003-9304,USA.
Carrie J
CJ
Nobles
2Baystate Medical Center,Division of Maternal-Fetal Medicine,Springfield,MA 01199,USA.
Glenn
G
Markenson
1Department of Biostatistics and Epidemiology,School of Public Health & Health Sciences,Division of Biostatistics & Epidemiology,University of Massachusetts,Amherst,MA 01003-9304,USA.
Lisa
L
Chasan-Taber
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn; D008404:Massachusetts; D011247:Pregnancy; D011256:Pregnancy Outcome; D014807:Vitamin D / Q000097:blood*; D055815:Young Adult
D014807:Vitamin D
25(OH)D 25-hydroxyvitamin D; B.A.B.Y. Behaviors Affecting Baby and You; Epidemiology; GDM gestational diabetes mellitus; Gestational diabetes; LGA large for gestational age; Latina; Prospective cohort studies; RR relative risk; SGA small for gestational age; Vitamin D