title: Vitamin D Deficiency Increases the Risk of Adverse Neonatal Outcomes in Gestational Diabetes.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM.
  
  
  METHODS
  184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement. Vitamin D was measured by chemiluminescence and deficiency was defined as < 20 ng/mL. Participants were followed until puerperium and adverse neonatal outcomes were evaluated.
  
  
  RESULTS
  Newborns of women with vitamin D deficiency had higher incidences of hospitalization in intensive care units (ICU) (32 vs 19%, P = 0.048), of hypoglycemia (any, 17.3 vs 7.1%, P = 0.039requiring ICU, 15.3 vs 3.6%, P = 0.008), and were more frequently small for gestational age (SGA) (17.3 vs 5.9%, P = 0.017). After adjustment, relative risk (RR) for hypoglycemia requiring ICU was 3.63 (95%CI 1.09-12.11) and for SGA was 4.32 (95%CI 1.75-10.66). The incidence of prematurity, jaundice and shoulder dystocia was no statistically different between groups.
  
  
  CONCLUSIONS
  In this cohort of pregnant women with GDM, vitamin D deficiency was associated with a major increase in the incidence of adverse neonatal outcomes such as SGA newborns and neonatal hypoglycemia.
authors.affiliation: Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Letícia Schwerz
authors.initials: LS
authors.lastname: Weinert
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Angela Jacob
authors.initials: AJ
authors.lastname: Reichelt
authors.affiliation: Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Leonardo Rauber
authors.initials: LR
authors.lastname: Schmitt
authors.affiliation: Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Roberta
authors.initials: R
authors.lastname: Boff
authors.affiliation: Obstetrics Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Maria Lucia Rocha
authors.initials: ML
authors.lastname: Oppermann
authors.affiliation: Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Joiza Lins
authors.initials: JL
authors.lastname: Camargo
authors.affiliation: Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Sandra Pinho
authors.initials: SP
authors.lastname: Silveiro
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012306:Risk; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D