title: Vitamin D Status in Pregnancy and Determinants in a Southern European Cohort Study.
abstract: BACKGROUND
  Population-based data on vitamin D status in pregnancy in southern European countries are scarce. We assessed the prevalence and determinants of vitamin D insufficiency and deficiency in pregnancy in Spain.
  
  
  METHODS
  Plasma 25-hydroxyvitamin D3 (25(OH)D3) concentration was measured at the first trimester of gestation in 2,036 pregnant women from several geographical areas of Spain (latitude 39-42°N). Uni- and multivariable regression models were conducted to identify predictors of circulating 25(OH)D3 concentration and vitamin D insufficiency (20-30 ng/mL) and deficiency (<20 ng/mL).
  
  
  RESULTS
  Thirty-one per cent and 18% of women were vitamin D insufficient and deficient, respectively. Season at blood collection, latitude, age, social class, tobacco smoking, physical activity and use of vitamin D supplements were identified as independent determinants of 25(OH)D3 concentration. Lower risk of vitamin D insufficiency and deficiency was associated with summer season at blood collection (RR for insufficiency = 0.34, confidence intervals (CI) 0.25, 0.48; and RR for deficiency = 0.07, 95% CI 0.04, 0.12), southern latitude (RR for insufficiency = 0.71, 95% CI 0.50, 1.02; RR for deficiency = 0.60, 95% CI 0.38, 0.94); use of vitamin D supplements (RR for insufficiency = 0.50, 95% CI 0.35, 0.71; RR for deficiency = 0.24, 95% CI 0.14, 0.41); and strong physical activity (RR for insufficiency = 0.80, 95% CI 0.58, 1.09; and RR for deficiency = 0.67, 95% CI 0.46, 1.03). Higher risk of vitamin D deficiency was related to lower social class (RR = 1.94, 95% CI 1.19, 3.16) and smoking (RR = 1.76, 95% CI 1.23, 2.54).
  
  
  CONCLUSIONS
  Vitamin D insufficiency and deficiency are highly prevalent in pregnancy. Recommendations and policies to detect and prevent hypovitaminosis D during pregnancy should be developed taking into account the associated factors.
authors: Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Spain.|Universitat Autònoma de Barcelona, Campus d'Excelència Internacional, Bellaterra, Spain.
authors: Agueda
authors: A
authors: Rodriguez
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain.|BIODONOSTIA Health Research Institute, San Sebastian, Spain.
authors: Loreto
authors: L
authors: Santa Marina
authors: Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain.|BIODONOSTIA Health Research Institute, San Sebastian, Spain.
authors: Ana María
authors: AM
authors: Jimenez
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|University of Valencia, Valencia, Spain.|Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain.
authors: Ana
authors: A
authors: Esplugues
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|University of Valencia, Valencia, Spain.|Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain.
authors: Ferran
authors: F
authors: Ballester
authors: Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Euskadi, Spain.
authors: Mercedes
authors: M
authors: Espada
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors: Jordi
authors: J
authors: Sunyer
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|IMIB-Arrixaca Biomedical Research Institute, Virgen de la Arrixaca University Hospital, Murcia, Spain.
authors: Eva
authors: E
authors: Morales
mesh_terms: D000328:Adult; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D037841:Pregnant People / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012621:Seasons; D013030:Spain / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014807:Vitamin D
keywords: deficiency; determinants; insufficiency; pregnancy; vitamin D