Vitamin D Deficiency Increases the Risk of Stunting and Other Adverse Pregnancy Outcomes: Results from a Perinatal Cohort Study in Kenya

Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation.

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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

British Journal Of Nutrition ◽

10.1017/s0007114515003980 ◽

2015 ◽

Vol 114 (12) ◽

pp. 2116-2128 ◽

Cited By ~ 24

Author(s):

Carrie J. Nobles ◽

Glenn Markenson ◽

Lisa Chasan-Taber

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Hispanic Women ◽

Adverse Pregnancy Outcomes ◽

Vitamin D Status ◽

Blood Draw ◽

Baseline Serum ◽

Adverse Pregnancy

AbstractVitamin 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.

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Vitamin D deficiency can lead to adverse pregnancy outcomes in women

Nursing Standard ◽

10.7748/ns2013.05.27.35.15.s22 ◽

2013 ◽

Vol 27 (35) ◽

pp. 15-15

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Pre-Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes in 6.4 Million Women in Rural China During 2010-2016: A Population-Based, Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3235629 ◽

2018 ◽

Author(s):

Yumei Wei ◽

Ying Yang ◽

Huixia Yang ◽

Huan Chen ◽

Craig Anderson ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnancy Outcomes ◽

Rural China ◽

Population Based ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Advanced maternal age and adverse pregnancy outcomes: A cohort study

Taiwanese Journal of Obstetrics and Gynecology ◽

10.1016/j.tjog.2020.11.018 ◽

2021 ◽

Vol 60 (1) ◽

pp. 119-124

Author(s):

M. Guarga Montori ◽

A. Álvarez Martínez ◽

C. Luna Álvarez ◽

N. Abadía Cuchí ◽

P. Mateo Alcalá ◽

...

Keyword(s):

Cohort Study ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Advanced Maternal Age ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Adverse pregnancy outcomes associated with moderate elevations in blood pressure or blood glucose in Ugandan women; a prospective cohort study

AJOG Global Reports ◽

10.1016/j.xagr.2021.100007 ◽

2021 ◽

Vol 1 (2) ◽

pp. 100007

Author(s):

Jack Milln ◽

Betty Nakabuye ◽

Barnabas Natamba ◽

Isaac Sekitoleko ◽

Michael Mubiru ◽

...

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Blood Glucose ◽

Prospective Cohort Study ◽

Pregnancy Outcomes ◽

Prospective Cohort ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049075 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049075

Author(s):

Dionne V Gootjes ◽

Anke G Posthumus ◽

Vincent W V Jaddoe ◽

Eric A P Steegers

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Preterm Birth ◽

Fetal Growth ◽

Gestational Age ◽

Pregnancy Outcomes ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

Neighbourhood Deprivation ◽

Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

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