25-hydroxyvitamin-d-2 and Premature-Birth

This article presents an overview of the most recent scientific evidence of the role of maternal vitamin D on pregnancy outcomes, with a particular emphasis on those articles in the English-language literature published between 1 January 2013 and 1 July 2014 in PubMed.. Low levels of vitamin D status, as measured by 25-hydroxyvitamin D [25(OH)D], are common in pregnant women. Meta-analysis of observational studies has demonstrated positive associations between vitamin D status and adverse pregnancy outcomes such as preeclampsia, gestational diabetes mellitus, preterm birth and small-for-gestational age. There was heterogeneity among studies in terms of design, population, geographic location, definitions of exposure and outcome, gestational age at sampling, confounding factors and approach to analyses. Randomized controlled trials (RCTs) indicate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status.. Recent evidence supports that low maternal vitamin D status is associated with an increased risk of adverse pregnancy outcomes. Interventional studies demonstrate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status. Large, well designed, multicentre RCTs are required to determine whether vitamin D supplementation in pregnant women with low vitamin D status reduces the risk of adverse pregnancy outcomes.

Topics: 25-Hydroxyvitamin D 2; Calcifediol; Diabetes, Gestational; Dietary Supplements; Evidence-Based Medicine; Female; Fetal Growth Retardation; Global Health; Humans; Maternal Nutritional Physiological Phenomena; Nutritional Status; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Risk Factors; Vitamin D; Vitamin D Deficiency

Vitamin D insufficiency and deficiency have been associated with an increased risk of adverse pregnancy outcomes. Controversy remains as findings have been inconsistent between disparate populations. The aim of this study was to investigate the relationship between vitamin D status and pregnancy outcomes in a large, prospective pregnancy cohort. 25-Hydroxyvitamin D concentration was analysed in serum samples collected at 15 weeks of gestation from 1710 New Zealand women participating in a large, observational study. Associations between vitamin D status and pre-eclampsia, preterm birth, small for gestational age (SGA) and gestational diabetes were investigated. The mean 25-hydroxyvitamin D concentration was 72·9 nmol/l. In all, 23 % had 25-hydroxyvitamin D concentrations 75 nmol/l (OR 2·3; 95 % CI 1·1, 5·1). However, this effect was not significant when adjustments were made for BMI and ethnicity (OR 1·8; 95 % CI 0·8, 4·2). 25-Hydroxyvitamin D concentration at 15 weeks was not associated with development of pre-eclampsia, spontaneous preterm birth or SGA infants. Pregnancy complications were low in this largely vitamin D-replete population.

Topics: 25-Hydroxyvitamin D 2; Biomarkers; Calcifediol; Cohort Studies; Diabetes, Gestational; Female; Fetal Growth Retardation; Humans; Incidence; Maternal Nutritional Physiological Phenomena; New Zealand; Nutritional Status; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Second; Premature Birth; Prevalence; Prospective Studies; Risk; Severity of Illness Index; Vitamin D Deficiency

We investigated the vitamin D status of Korean women during pregnancy and assessed the effects of vitamin D deficiency on two pregnancy outcomes; preterm births and the births of small for gestational age. We measured the serum 25-hydroxyvitamin D levels in 220 pregnant Korean women who were recruited prospectively and compared these levels with those of 500 healthy non-pregnant women. We analyzed vitamin D status according to patient demographics, season, and obstetrical characteristics; moreover, we also assessed pregnancy outcomes. The overall prevalence of vitamin D deficiency(<20 ng/mL) in pregnant women and healthy non-pregnant women was 77.3% and 79.2%; respectively; and the prevalence of severe vitamin D deficiency (<10 ng/mL) was 28.6% and 7.2%; respectively (p < 0.05). Vitamin D deficiency was more prevalent in the winter (100%) than in the summer (45.5%) in pregnant Korean women. A higher risk of vitamin D deficiency was observed in the first trimester than in the third trimester (adjusted OR 4.3; p < 0.05). No significant association was observed between vitamin D deficiency and any of the pregnancy outcomes examined. Further research focusing on the long-term consequences of vitamin D deficiency during pregnancy in Korean women is warranted.

Topics: 25-Hydroxyvitamin D 2; Adult; Calcifediol; Cohort Studies; Female; Fetal Growth Retardation; Humans; Infant, Newborn; Male; Maternal Nutritional Physiological Phenomena; Nutritional Status; Pregnancy; Pregnancy Complications; Pregnancy Trimester, First; Premature Birth; Prevalence; Prospective Studies; Republic of Korea; Risk Factors; Seasons; Urban Health; Vitamin D Deficiency; Young Adult