title: Severe Vitamin D Deficiency in Human Immunodeficiency Virus-Infected Pregnant Women is Associated with Preterm Birth.
abstract: BackgroundLow maternal vitamin D has been associated with preterm birth (PTB). Human immunodeficiency virus (HIV)-infected pregnant women are at risk for PTB, but data on maternal vitamin D and PTB in this population are scarce.MethodsIn a cohort of Latin American HIV-infected pregnant women from the National Institute of Child Health and Human Development International Site Development Initiative protocol, we examined the association between maternal vitamin D status and PTB. Vitamin D status was defined as the following 25-hydroxyvitamin D levels: severe deficiency (< 10 ng/mL), deficiency (10-20 ng/mL), insufficiency (21-29 ng/mL), and sufficiency (≥30 ng/mL). PTB was defined as delivery at < 37 weeks' gestational age (GA). Logistic regression was used to assess the association between maternal vitamin D status and PTB.ResultsOf 715 HIV-infected pregnant women, 13 (1.8%) were severely vitamin D deficient, 224 (31.3%) were deficient, and 233 were (32.6%) insufficient. Overall, 23.2% (166/715) of pregnancies resulted in PTB (median GA of PTBs = 36 weeks [interquartile range: 34-36]). In multivariate analysis, severe vitamin D deficiency was associated with PTB (odds ratio = 4.7, 95% confidence interval: 1.3-16.8]).ConclusionSevere maternal vitamin D deficiency is associated with PTB in HIV-infected Latin American pregnant women. Further studies are warranted to determine if vitamin D supplementation in HIV-infected women may impact PTB.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jao
authors.affiliation: Westat, Inc., Rockville, Maryland.
authors.forename: Laura
authors.initials: L
authors.lastname: Freimanis
authors.affiliation: Universidade de São Paulo, Brazil, Faculdade de Medicina de Ribeirão Preto, São Paulo, São Paulo, Brazil.
authors.forename: Marisa M
authors.initials: MM
authors.lastname: Mussi-Pinhata
authors.affiliation: Westat, Inc., Rockville, Maryland.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Cohen
authors.affiliation: Universidade de São Paulo, Brazil, Faculdade de Medicina de Ribeirão Preto, São Paulo, São Paulo, Brazil.
authors.forename: Jacqueline Pontes
authors.initials: JP
authors.lastname: Monteiro
authors.affiliation: Hospital Federal dos Servidores do Estado, Brazil, Serviço de Doenças Infecciosas e Parasitárias, Rio de Janeiro, Brazil.
authors.forename: Maria Leticia
authors.initials: ML
authors.lastname: Cruz
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Andrea
authors.initials: A
authors.lastname: Branch
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Rhoda S
authors.initials: RS
authors.lastname: Sperling
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Maternal and Pediatric Infectious Disease Branch, Bethesda, Maryland.
authors.forename: George K
authors.initials: GK
authors.lastname: Siberry
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D