Gestational diabetes mellitus, Vitamin D status and fetomaternal outcome

Background: Diabetes is the most common medical complication of pregnancy. Vitamin D deficiency which was initially considered only to influence bone metabolism, is now known to exert a wide spectrum of extra-skeletal effects. Vitamin D deficiency is closely associated with gestational diabetes mellitus, it also leads to adverse maternal and child outcome. Objective of this study was to compare the vitamin D levels in healthy pregnant women and women with gestational diabetes mellitus and to observe the feto-maternal outcome.Methods: This prospective study was carried out on 160 pregnant women between the age group 20-40 years attending the Obstetrics and Gynaecology department of JNMC, AMU, Aligarh from October 2016 to October 2018. Women were divided into group A- normal pregnant women and group B- women with GDM. Estimation of vitamin D was done in both the groups.Results: Mean vitamin D levels were lower in women with GDM as compared to normal pregnant women.Conclusions: Women with vitamin D deficiency have an increased risk of developing GDM and adverse feto maternal outcome as compared to those who had normal level of vitamin.

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Vitamin D status and association with gestational diabetes mellitus in a pregnant cohort in Iceland

Food & Nutrition Research ◽

10.29219/fnr.v65.5574 ◽

2021 ◽

Author(s):

Kristin S. Magnusdottir ◽

Ellen A. Tryggvadottir ◽

Ola K. Magnusdottir ◽

Laufey Hrolfsdottir ◽

Thorhallur I. Halldorsson ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

First Trimester ◽

Vitamin D Status ◽

Increased Risk ◽

Vitamin D Levels ◽

25Ohd Concentration

Background: Vitamin D deficiency has been associated with an increased risk of gestational diabetes mellitus (GDM), one of the most common pregnancy complications. The vitamin D status has never previously been studied in pregnant women in Iceland. Objective: The aim of this research study was to evaluate the vitamin D status of an Icelandic cohort of pregnant women and the association between the vitamin D status and the GDM incidence. Design: Subjects included pregnant women (n = 938) who attended their first ultrasound appointment, during gestational weeks 11–14, between October 2017 and March 2018. The use of supplements containing vitamin D over the previous 3 months, height, pre-pregnancy weight, and social status were assessed using a questionnaire, and blood samples were drawn for analyzing the serum 25‑hydroxyvitamin D (25OHD) concentration. Information regarding the incidence of GDM later in pregnancy was collected from medical records. Results: The mean ± standard deviation of the serum 25OHD (S-25OHD) concentration in this cohort was 63±24 nmol/L. The proportion of women with an S-25OHD concentration of ≥ 50 nmol/L (which is considered adequate) was 70%, whereas 25% had concentrations between 30 and 49.9 nmol/L (insufficient) and 5% had concentrations < 30 nmol/L (deficient). The majority of women (n = 766, 82%) used supplements containing vitamin D on a daily basis. A gradual decrease in the proportion of women diagnosed with GDM was reported with increasing S-25OHD concentrations, going from 17.8% in the group with S-25OHD concentrations < 30 nmol/L to 12.8% in the group with S-25OHD concentrations ≥75 nmol/L; however, the association was not significant (P for trend = 0.11). Conclusion: Approximately one-third of this cohort had S-25OHD concentrations below adequate levels (< 50 nmol/L) during the first trimester of pregnancy, which may suggest that necessary action must be taken to increase their vitamin D levels. No clear association was observed between the vitamin D status and GDM in this study.

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Assessment of Polymorphism of the VDR Gene and Serum Vitamin D Values in Gestational Diabetes Mellitus

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1693678 ◽

2019 ◽

Vol 41 (07) ◽

pp. 425-431

Author(s):

Thais Walverde Siqueira ◽

Edward Araujo Júnior ◽

Rosiane Mattar ◽

Silvia Daher

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Serum Vitamin ◽

Vdr Gene ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Significant Difference

Objective To evaluate the relationship between vitamin D receptor (VDR) gene polymorphism (FokI [rs10735810]) and serum vitamin D concentration in gestational diabetes mellitus (GDM). Methods A prospective case-control study that recruited healthy pregnant women (control group) (n = 78) and women with GDM (GDM group) (n = 79), with no other comorbidities. Peripheral blood samples were collected in the 3rd trimester of gestation, and all of the pregnant women were followed-up until the end of the pregnancy and the postpartum period. Serum vitamin D concentrations were measured by high-performance liquid chromatography (HPLC). For genomic polymorphism analysis, the genomic DNA was extracted by the dodecyltrimethylammonium bromide/cetyltrimethylammonium bromide (DTAB/CTAB) method, and genotyping was performed by the polymerase chain reaction – restriction fragment length polymorphism (PCR-RFLP) technique, using the restriction enzyme FokI. The Student-t, Mann-Whitney, chi-squared, and Fischer exact tests were used for the analysis of the results. Results There was no significant difference between the pregnant women in the control and GDM groups regarding serum vitamin D levels (17.60 ± 8.89 ng/mL versus 23.60 ± 10.68 ng/mL; p = 0.1). Also, no significant difference was detected between the FokI genotypic frequency when the 2 groups were compared with each other (p = 0.41). Conclusion There was no association between the FokI polymorphism and the development of GDM, nor was there any change in serum vitamin D levels in patients with GDM.

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Vitamin D status and vitamin D deficiency risk factors among pregnancy of Shanghai in China

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03889-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chun Yang ◽

Wu Jing ◽

Sheng Ge ◽

Wenguang Sun

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density

Abstract Background There is increasing awareness that vitamin D deficiency in pregnant women may be associated with several adverse effects for the mother and newborn. The risks for vitamin D deficiency are unclear. This study was to assess vitamin D nutritional status and vitamin D deficiency risk factors among pregnant women in Shanghai in China. Methods This study is a cross-sectional study conducted in the Sixth Affiliated People’s Hospital of Shanghai Jiao Tong University. A total of 953 healthy pregnant women participated, serological examinations and other variables included serum 25-hydroxyvitamin D [25(OH)D], total blood cholesterol (TCh), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) cholesterol, triglycerides at the first antenatal visit (12–14 weeks) pregnancy parity and age, body mass index (BMI) before pregnancy, and completed OGTTs test. Associations between vitamin D deficiency and possible predictors (age group, pre-pregnancy BMI, parity, and gestational hyperlipemia) were assessed with a multinomial logistic regression analysis. And also used to investigate the effects of 25(OH)D and the other variables on the occurrence of gestational diabetes mellitus. Results The mean vitamin D level of pregnancy was 16 (a range from 11 to 21) ng/ml, and severe vitamin D deficiency was 31.8% (303); vitamin D deficiency was 40.7% (388); vitamin D insufficiency was 25.1% (239); normal vitamin D was 2.4%(23). Vitamin D deficiency risk factors were age over 30, parity over 2, overweight, obese, and hyperlipemia. The increasing level of vitamin D nutritional status in pregnancy is significantly related to reducing gestational diabetes mellitus. Vitamin D deficiency is a risk factor for gestational diabetes mellitus. Conclusions It is a high prevalence of vitamin D deficiency in Chinese pregnancy in Shanghai. Aging more than 30 years, the parity of more than 2, overweight and obesity, and hyperlipemia are risk factors for vitamin D deficiency. Vitamin D deficiency is a risk factor for gestational diabetes mellitus. Public health strategies to prevent vitamin D deficiency should focus on those risks to promote health pregnancy of Shanghai in China.

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Estimation of maternal serum vitamin D levels and its correlation with gestational diabetes mellitus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183343 ◽

2018 ◽

Vol 7 (8) ◽

pp. 3348

Author(s):

Anupriya Narain ◽

Alka Goel ◽

Parul Goyal

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Hypovitaminosis D ◽

P Value ◽

Serum Vitamin D ◽

Vitamin D Levels

Background: Several studies in the past two decades have proved beyond doubt that there is a high prevalence of hypovitaminosis D worldwide including India which has almost taken the shape of a pandemic. The study aims to determine the prevalence of hypovitaminosis D in the pregnant population of Delhi and its correlation with gestational diabetes mellitus.Methods: This prospective cross sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Dr R.M.L Hospital, New Delhi over a period of 1 year and 4 months. Four hundred term patients were enrolled randomly from amongst the patients admitted in labor room or antenatal ward at PGIMER, Dr. Ram Manohar Lohia Hospital who fulfilled the inclusion and exclusion criteria. 3-4ml of fasting blood samples were collected of all the enrolled women and were analysed for total serum calcium levels and serum vitamin D levels. History of presence of gestational diabetes mellitus was noted along with any treatment history. The 25(OH)D levels for each subject was recorded and correlation of vitamin D levels with gestational diabetes mellitus was analysed. Statistical analysis was done using ANOVA/ Kruska Wallis test and Chi-Square test/ Fisher’s exact test. A p value of <0.05 was considered statistically significant.Results: The overall prevalence of vitamin D deficiency in the present study was 86.25%. The overall mean serum vitamin D level was 14.06±9.43 ng/ml. Thirty five out of 37 GDM patients had hypovitaminosis D i.e. 94.59%. The prevalence of hypovitaminosis D among non-GDM population was 85.40%. The association between GDM and Vitamin D deficiency was statistically non- significant in the present study with p value=0.186.Conclusions: There is a very high prevalence of hypovitaminosis D in pregnant females attending present institute i.e. 86.25%. Although 94.59 % of Gestational Diabetes Mellitus patients had vitamin D deficiency, there is no statistically significant association between Gestational diabetes mellitus and serum vitamin D levels.

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Relationship Between Vitamin D Levels of Women with Gestational Diabetes Mellitus and Birthweight of Their Newborns: Preliminary Results (P11-020-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-020-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Patricia Padilha ◽

Claudia Saunders ◽

Elisabete Queiroz ◽

Barbara Nascimento ◽

Thaissa Lima ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Birth Weight ◽

Gestational Diabetes ◽

Nutritional Status ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Rio De Janeiro ◽

Vitamin D Levels ◽

The Mean

Abstract Objectives To evaluate the relationship between vitamin D levels in women with gestational diabetes and the birth weight of their newborns. Methods This is a cross-sectional study nested in a controlled clinical trial performed in a public maternity hospital in Rio de Janeiro, with a sample composed of adult pregnant women diagnosed with gestational diabetes mellitus, without other chronic morbidities. The nutritional status of vitamin D was classified as 25(OH)D, being classified as: sufficient between 30 and 100 ng/mL; insufficient: between 20 and 29 ng/mL; and deficient below 20 ng/mL. In this analysis, the data regarding the vitamin D levels at the beginning of the study (T0) of the research were considered, and the dependent variable was the birth weight. Pearson's correlation was performed to evaluate the degree of correlation between two continuous variables, being considered as a level of statistical significance the value of P < 0.05. Results The mean maternal age was 35.4 (± 5.9) years (N = 11), and among these, 18.2% (n = 2) had adequate nutritional status, 27.3% (n = 3), overweight and 54, 5% (n = 6), obesity, according to pre-gestational BMI. Among the factors admitted as a risk for hypovitaminosis D (BMI > 25kg/m², brown/black skin color, marital status (married) and occupation), 45.5% (n = 5) presented 3 or more of them. As for nutritional status of vitamin D, 63.6% (n = 7) had insufficiency, 27.3% (n = 3), deficiency and 9.1% (n = 1), sufficiency. The initial mean concentration of 25(OH)D was 21.2 n/mL. It was observed that 72.7% (n = 8) of the pregnant women presented no gestational intercurrences at delivery or in the puerperium, while 18.4% (n = 2) presented unfavorable outcomes. The mean birth weight was 2842.5 (± 1251.1) grams and the mean gestational age at birth was 36.2 (± 6.5) weeks. With respect to neonatal outcomes was observed a significant positive correlation (r = 0, 900; P = 0.037) between serum levels of 25(OH)D at baseline and birthweight. Conclusions Preliminary data indicated that best status of vitamin D is related to higher birthweight values. Funding Sources FAPERJ (FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DO RIO DE JANEIRO).

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EARLY PREGNANCY MATERNAL VITAMIN D DEFICIENCY AND RISK OF GESTATIONAL DIABETES MELLITUS IN LIBYAN PREGNANT WOMEN

10.36106/ijar/0206007 ◽

2020 ◽

pp. 1-4

Author(s):

Omaima H. Getlawi ◽

Vellanki. Lakshmi narasamma ◽

Salima M. Hawda ◽

Musa O. Busarira ◽

Eman E. Fadeel ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Risk Factor ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Early Pregnancy ◽

Vitamin D3 ◽

First Trimester ◽

Vitamin D Levels

Background Vitamin D deficiency is a common occurrence, which affects maternal health during pregnancy. Evidence is accumulating for a role of a low level of vitamin D during the early pregnancy as a risk factor for the development of gestational diabetes mellitus (GDM). Our objectives are to describe the patterns of vitamin D levels in early pregnancy in mothers attending main antenatal services in Ajdabiya city, during the first quarter of the year 2017 and to examine the relationship between vitamin D levels and glucose metabolic derangements in pregnant women among the above-described population. Methods A cohort study was conducted in healthy pregnant women attending routine antenatal care in Ajdabiya city in 2017. All mothers were screened for serum 25 (OH) D level and glycated hemoglobin (HbA1c) and anthropometric by the time of booking during the first trimester (gestational age "GA" 7-15th week of pregnancy). All women with low 25 (OH) D level were screened for GDM with non-fasting post-challenge blood glucose and confirmed by OGTT according to the American Diabetes Association (ADA) classification of GDM criteria in their 2nd trimester. Data was analyzed by using SPSS, IBM 20.0. Results All mothers in the study population were Libyan, their ages ranged from 18-43 years. Parity ranged from nulliparous to P10. More than 60% of mothers were housewives while others were either working or students and considered as having an outdoor lifestyle. In the first trimester, we detected 412 mothers had serum vitamin D3 below normal, the majority of cases had deficient serum 25 (OH) D (391, 94.9%) while 21 (5.1%) women had an insufficient serum 25 (OH) D. Serum 25 (OH) D ranged from 5.9-30.0 ng/ml. In the 2nd trimester, we confirmed 43 (10.43%) pregnant women with GDM out of 391 women with deficient serum 25 (OH) D level. 25 (OH) D deficiency was statistically significant (p = 0.035, OR = 0.963, 95% CI = 0.881-0.996) and associated with all GDM cases. Conclusion We conclude that 25 (OH) D deficiency was significantly correlated with GDM, as a consequence, the deficiency of 25 (OH) D could act as a risk factor for GDM. This result implies the necessity of focusing on vitamin D3 supplementation for women of childbearing age.

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Childhood maltreatment and inflammation among pregnant women with gestational diabetes mellitus: A pilot study

Obstetric Medicine ◽

10.1177/1753495x17701320 ◽

2017 ◽

Vol 10 (3) ◽

pp. 120-124 ◽

Cited By ~ 6

Author(s):

Margaret Bublitz ◽

Suzanne De La Monte ◽

Susan Martin ◽

Lucia Larson ◽

Ghada Bourjeily

Keyword(s):

Diabetes Mellitus ◽

Pilot Study ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Birth Outcomes ◽

Childhood Maltreatment ◽

Secondary Data ◽

Past Research ◽

Increased Risk

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.

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The Role of HIV Infection in the Pathophysiology of Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.613930 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wendy N. Phoswa

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Hiv Infection ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Post Exposure Prophylaxis ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Increased Risk ◽

Hiv Aids

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.

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Predictive Value of Immunological Parameters in the Risk of Gestational Diabetes Mellitus: A Pilot Study

10.21203/rs.3.rs-76637/v1 ◽

2020 ◽

Author(s):

Adnette Fagninou ◽

Magloire Pandoua Nekoua ◽

Salomon Ezéchiel Mahougnon Fiogbe ◽

Kabirou Moutairou ◽

Akadiri YESSOUFOU

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Biochemical Parameters ◽

Predictive Power ◽

Glycosylated Hemoglobin ◽

Operating Characteristics ◽

Immunological Parameters ◽

Increased Risk

Abstract Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.

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Hypovitaminosis D in pregnancy and its correlation with preeclampsia and gestational diabetes mellitus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170551 ◽

2017 ◽

Vol 6 (3) ◽

pp. 890 ◽

Cited By ~ 1

Author(s):

Ankita Kumari ◽

Shaila Mitra ◽

Harish C Tiwari ◽

Reena Srivastav

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Hypovitaminosis D ◽

Health Concern ◽

Control Group ◽

The Impact

Background: Hypovitaminosis D has been associated with a number of adverse pregnancy outcomes, and has been recognised as a public health concern. The objective of this study was to determine the impact of Vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM) and preeclampsia (PE) among pregnant women.Methods: This was a case control study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur, Uttar Pradesh, India. Two maternal blood samples, one at <20 weeks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=60), gestational diabetes mellitus (n=35) and control group (n=180) after abstracting past medical records at delivery. Vitamin D was estimated by 25- Hydroxyvitamin D125 RIA kit and categorized according to ACOG criteria. Statistical analysis was done by using chi square test, binary logistic regression and Pearson’s correlation coefficient to compare between two variables. P<0.05 was considered statistically significant.Results: Out of 275 women included in the study, 78% of women were Vitamin D deficient. Mean serum vitamin D was significantly lower among preeclamptic women 11.53±6.22 ng/ml and GDM women 12.62±6.69 ng/ml as compared to controls 24.25±14.44 ng/ml (median=18.2 ng/ml) (P<0.05). Vitamin D deficiency was significantly higher in pregnant women GDM (94.28% vs 68.3%) and preeclampsia (96.67% vs 68.3%) when compared to uncomplicated group.Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is significantly associated with elevated risk for GDM and preeclampsia.

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