151
|
Miliku K, Vinkhuyzen A, Blanken LM, McGrath JJ, Eyles DW, Burne TH, Hofman A, Tiemeier H, Steegers EA, Gaillard R, Jaddoe VW. Maternal vitamin D concentrations during pregnancy, fetal growth patterns, and risks of adverse birth outcomes. Am J Clin Nutr 2016; 103:1514-22. [PMID: 27099250 PMCID: PMC5410992 DOI: 10.3945/ajcn.115.123752] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 03/22/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Maternal vitamin D deficiency during pregnancy may affect fetal outcomes. OBJECTIVE The objective of this study was to examine whether maternal 25-hydroxyvitamin D [25(OH)D] concentrations in pregnancy affect fetal growth patterns and birth outcomes. DESIGN This was a population-based prospective cohort in Rotterdam, Netherlands in 7098 mothers and their offspring. We measured 25(OH)D concentrations at a median gestational age of 20.3 wk (range: 18.5-23.3 wk). Vitamin D concentrations were analyzed continuously and in quartiles. Fetal head circumference and body length and weight were estimated by repeated ultrasounds, and preterm birth (gestational age <37 wk) and small size for gestational age (less than the fifth percentile) were determined. RESULTS Adjusted multivariate regression analyses showed that, compared with mothers with second-trimester 25(OH)D concentrations in the highest quartile, those with 25(OH)D concentrations in the lower quartiles had offspring with third-trimester fetal growth restriction, leading to a smaller head circumference, shorter body length, and lower body weight at birth (all P < 0.05). Mothers who had 25(OH)D concentrations in the lowest quartile had an increased risk of preterm delivery (OR: 1.72; 95% CI: 1.14, 2.60) and children who were small for gestational age (OR: 2.07; 95% CI: 1.33, 3.22). The estimated population attributable risk of 25(OH)D concentrations <50 nmol/L for preterm birth or small size for gestational age were 17.3% and 22.6%, respectively. The observed associations were not based on extreme 25(OH)D deficiency, but presented within the common ranges. CONCLUSIONS Low maternal 25(OH)D concentrations are associated with proportional fetal growth restriction and with an increased risk of preterm birth and small size for gestational age at birth. Further studies are needed to investigate the causality of these associations and the potential for public health interventions.
Collapse
Affiliation(s)
- Kozeta Miliku
- Generation R Study Group, Department of Epidemiology, Department of Paediatrics
| | - Anna Vinkhuyzen
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; and Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Australia
| | - Laura Me Blanken
- Generation R Study Group, Department of Child and Adolescent Psychiatry, and
| | - John J McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; and Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Australia
| | - Darryl W Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; and Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Australia
| | - Thomas H Burne
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; and Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Australia
| | | | - Henning Tiemeier
- Department of Epidemiology, Department of Child and Adolescent Psychiatry, and
| | - Eric Ap Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Romy Gaillard
- Generation R Study Group, Department of Epidemiology, Department of Paediatrics
| | - Vincent Wv Jaddoe
- Generation R Study Group, Department of Epidemiology, Department of Paediatrics,
| |
Collapse
|
152
|
Hou W, Yan XT, Bai CM, Zhang XW, Hui LY, Yu XW. Decreased serum vitamin D levels in early spontaneous pregnancy loss. Eur J Clin Nutr 2016; 70:1004-8. [PMID: 27222154 PMCID: PMC5023787 DOI: 10.1038/ejcn.2016.83] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/21/2016] [Accepted: 04/18/2016] [Indexed: 01/03/2023]
Abstract
Background/Objectives: Effects of vitamin D deficiency in pregnancy have been associated with some adverse pregnancy outcomes. The objective of this study was to analyze the relationship between vitamin D deficiency in childbearing aged women and pregnancy loss (PL) in the first trimester. Subjects/Methods: This is a cross-sectional study. Plasma was collected from 60 nulliparous women with singleton at 7–9 weeks of gestation (30 with viable gestation and 30 with PL) and 60 non-gravid childbearing aged women (30 with a successful pregnancy history, and 30 with one or more spontaneous first-trimester PL history). Quantitation of serum 25-hydroxyvitamin D (25(OH)D) and 25-hydroxyvitamin D-1 alpha hydroxylase (CYP27B1) was assayed. Results: By pregnancy/non-gravid, normal pregnant women had higher 25(OH)D (49.32 μg/l) and CYP27B1 (82.00 pg/ml) than PL women (34.49 μg/l and 37.87 pg/ml, both P<0.01); the non-gravid women with a successful pregnancy history also had higher 25(OH)D (39.56 μg/l) and CYP27B1 (39.04 pg/ml) than women with PL history (12.30 μg/l and 12.35 pg/ml, both P<0.01). The 96.7% of non-gravid women with PL history and 43.3% of PL women had serum 25(OH)D concentrations below 30 μg/l. There was a strong association between low vitamin D levels and PL (odds ratio 1.71; 95% confidence interval: 1.2–2.4, P<0.001). The regression analyses showed that PL was significantly inversely correlated with 25(OH)D (P<0.01) and CYP27B1 levels (P<0.01). Conclusions: Vitamin D deficiency associated with PL in the first trimester of pregnancy. Decreased serum vitamin D levels among childbearing aged women with the failed clinical pregnancies history may predispose to increased risk for PL.
Collapse
Affiliation(s)
- W Hou
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Maternal Health Care, Maternal and Child Health Hospital of Shaanxi Province, Xi'an, China
| | - X-T Yan
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - C-M Bai
- Department of Maternal Health Care, Maternal and Child Health Hospital of Shaanxi Province, Xi'an, China
| | - X-W Zhang
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics & Gynecology, Fourth hospital of Xi'an City, Xi'an, China
| | - L-Y Hui
- Laboratory Department, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - X-W Yu
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
153
|
Taheri M, Baheiraei A, Foroushani AR, Nikmanesh B, Modarres M. Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial. Indian J Med Res 2016. [PMID: 26205023 PMCID: PMC4525405 DOI: 10.4103/0971-5916.160707] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background & objectives: Bacterial vaginosis (BV) is the most prevalent vaginal infection in women of reproductive age group which has been found to be associated with vitamin D deficiency. The purpose of this study was to investigate the effectiveness of the administration of 2000 IU/day edible vitamin D for 15 wk to eliminate asymptomatic BV among reproductive age women with vitamin D deficiency. Methods: A total of 208 women with asymptomatic BV, who were found to be eligible after interviews and laboratory tests, were randomly assigned to a control group (n=106) or an intervention group (n=105). They used vitamin D drops daily for 105 days. Vaginal and blood samples were taken before and after the second intervention using identical methods (Nugent score for BV diagnosis, serum 25-hydroxyvitamin D for vitamin D determination). Results: The cure rate of asymptomatic BV was 63.5 per cent in the intervention and 19.2 per cent in the control group (P <0.001). The results showed that being unmarried (P=0.02), being passive smoker (P<0.001), and being in the luteal phase of a menstrual cycle during sampling (P=0.01) were significantly associated with post-intervention BV positive results. After these elements were controlled, the odds of BV positive results in the control group was 10.8 times more than in the intervention group (P<0.001). Interpretation & conclusions: Among women in reproductive age group with vitamin D deficiency, the administration of 2000 IU/day edible vitamin D was effective in eliminating asymptomatic BV. This treatment could be useful in preventing the symptoms and side effects of BV.
Collapse
Affiliation(s)
| | | | | | | | - Maryam Modarres
- Department of Midwifery, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
154
|
Schlabritz-Loutsevitch NE, Comuzzie AG, Mahaney MM, Hubbard GB, Dick EJ, Kocak M, Gupta S, Carrillo M, Schenone M, Postlethwaite A, Slominski A. Serum Vitamin D Concentrations in Baboons (Papio spp.) during Pregnancy and Obesity. Comp Med 2016; 66:137-42. [PMID: 27053568 PMCID: PMC4825963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/08/2015] [Accepted: 10/11/2015] [Indexed: 06/05/2023]
Abstract
Obesity is associated with vitamin D deficiency, which can lead to serious problems during pregnancy. However, the mechanisms of the deficiency and guidelines for vitamin D supplementation during pregnancy are not established yet, and variations in environmental exposures combined with the difficulties of performing research in pregnant women are obstacles in the evaluation of vitamin D metabolism. Baboons (Papio spp.) are an excellent, well-established model for reproductive research and represent a unique opportunity to study vitamin D metabolism in a controlled environment. This study used secondary data and specimen analysis as well as a novel experimental design to evaluate pregnant and nonpregnant baboons that were or were not exposed to sunlight while they were obese and after weight reduction. Daily D3 intake was 71% higher in nonpregnant obese baboons than in their nonobese counterparts, but serum vitamin D concentrations did not differ between these populations. In addition, serum 25-hydroxyvitamin D concentrations correlated negatively with the obesity index. This report is the first to show the effect of obesity and pregnancy on vitamin D concentrations in a NHP population. These data underline the importance of adequate vitamin D supplementation in obese animals.
Collapse
Affiliation(s)
| | - Anthony G Comuzzie
- Departments of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | | | - Gene B Hubbard
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Edward J Dick
- Departments of Pathology, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Mehmet Kocak
- Division of Biostatistics, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Sonali Gupta
- Department of Obstetrics and Gynecology; University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Maira Carrillo
- Texas Tech University HSC School of Medicine at the Permian Basin, Odessa, Texas
| | - Mauro Schenone
- Department of Obstetrics and Gynecology; University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Arnold Postlethwaite
- Division of Connective Tissue Diseases, Department of Medicine, University of Tennessee Health Science Center, and Department of Veterans Affairs Medical Center, Memphis, Tennessee, USA
| | - Andrzej Slominski
- Department of Dermatology and Pathology, VA Medical Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
155
|
Murthi P, Yong HEJ, Ngyuen TPH, Ellery S, Singh H, Rahman R, Dickinson H, Walker DW, Davies-Tuck M, Wallace EM, Ebeling PR. Role of the Placental Vitamin D Receptor in Modulating Feto-Placental Growth in Fetal Growth Restriction and Preeclampsia-Affected Pregnancies. Front Physiol 2016; 7:43. [PMID: 26924988 PMCID: PMC4757640 DOI: 10.3389/fphys.2016.00043] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/01/2016] [Indexed: 12/31/2022] Open
Abstract
Fetal growth restriction (FGR) is a common pregnancy complication that affects up to 5% of pregnancies worldwide. Recent studies demonstrate that Vitamin D deficiency is implicated in reduced fetal growth, which may be rescued by supplementation of Vitamin D. Despite this, the pathway(s) by which Vitamin D modulate fetal growth remains to be investigated. Our own studies demonstrate that the Vitamin D receptor (VDR) is significantly decreased in placentae from human pregnancies complicated by FGR and contributes to abnormal placental trophoblast apoptosis and differentiation and regulation of cell-cycle genes in vitro. Thus, Vitamin D signaling is important for normal placental function and fetal growth. This review discusses the association of Vitamin D with fetal growth, the function of Vitamin D and its receptor in pregnancy, as well as the functional significance of a placental source of Vitamin D in FGR. Additionally, we propose that for Vitamin D to be clinically effective to prevent and manage FGR, the molecular mechanisms of Vitamin D and its receptor in modulating fetal growth requires further investigation.
Collapse
Affiliation(s)
- Padma Murthi
- Department of Medicine, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; Department of Obstetrics and Gynaecology, The University of MelbourneMelbourne, VIC, Australia; Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's HospitalMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Hannah E J Yong
- Department of Obstetrics and Gynaecology, The University of MelbourneMelbourne, VIC, Australia; Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's HospitalMelbourne, VIC, Australia
| | - Thy P H Ngyuen
- Department of Obstetrics and Gynaecology, The University of MelbourneMelbourne, VIC, Australia; Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's HospitalMelbourne, VIC, Australia
| | - Stacey Ellery
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Harmeet Singh
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Rahana Rahman
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Hayley Dickinson
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - David W Walker
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Miranda Davies-Tuck
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Euan M Wallace
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash UniversityMelbourne, VIC, Australia; The Ritchie Centre, Hudson Institute of Medical ResearchMelbourne, VIC, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University Melbourne, VIC, Australia
| |
Collapse
|
156
|
Palaniswamy S, Williams D, Järvelin MR, Sebert S. Vitamin D and the Promotion of Long-Term Metabolic Health from a Programming Perspective. Nutr Metab Insights 2016; 8:11-21. [PMID: 26843814 PMCID: PMC4737521 DOI: 10.4137/nmi.s29526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 01/14/2023] Open
Abstract
Studies linking vitamin D and long-term metabolic health have generated much debate. Recommendations for the intake of vitamin D by the general public and by the health care professionals have been complicated by a number of inconsistencies in the literature. These caveats relate to the methodological approaches, differences in the populations (and the species) of study, and the definitions used for thresholds of vitamin D status. This review addresses current evidence available for assessing the potential programming of long-term metabolic health of offspring by maternal vitamin D status in pregnancy. It summarizes knowledge on the early origins of metabolic health and analyzes evidence for an association between the vitamin D status in pregnancy and maternal and fetal health status. In addition, we analyze the link between the regulation of inflammation and the vitamin D status in the general population to inform on the general mechanisms through which early vitamin D might affect the programming of long-term health. The evidence suggests an association between the vitamin D status in early life and the programming of long-term health. However, to the best of our knowledge, the current finding is insufficient to draw a final conclusion for evidence-based preventive actions. The data warrant replication in prospective studies and additional research substantiating the causal factors and pathways.
Collapse
Affiliation(s)
- Saranya Palaniswamy
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.; Biocenter Oulu, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Dylan Williams
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Marjo-Riitta Järvelin
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.; Biocenter Oulu, Faculty of Medicine, University of Oulu, Oulu, Finland.; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.; MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College, London, UK.; Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Sylvain Sebert
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.; Biocenter Oulu, Faculty of Medicine, University of Oulu, Oulu, Finland
| |
Collapse
|
157
|
Pirdehghan A, Vakili M, Dehghan R, Zare F. High Prevalence of Vitamin D Deficiency and Adverse Pregnancy Outcomes in Yazd, a Central Province of Iran. J Reprod Infertil 2016; 17:34-8. [PMID: 26962481 PMCID: PMC4769853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is a growing concern about the high prevalence of vitamin D deficiency and its relationship with variety of diseases worldwide. The objective of this study was to determine the prevalence of vitamin D deficiency and its relationship with pregnancy adverse effects in Yazd. METHODS This was a cross sectional study conducted among 200 nulliparous women from October 2013 to April 2014. Data containing socio-demographic and personal details, vitamin D level, pregnancy complications and growth situation of newborns were collected and analyzed using Mann-Whitney, Kruskal-Wallis and Pearson's correlation coefficient by SPSS. p<0.05 was considered statistically significant. RESULTS The mean serum 1, 25 (OH)2D3 concentration was 20.3±10.8 μg/l. Totally, 78% of the women had less than sufficient levels. Mean of vitamin D was significantly higher in natural or elective cesarean in comparison with abortion and emergency cesarean (p=0.040). Risk of abortion was 3.1(1.39-6.8) and higher in severely deficient group in comparison to women with vitamin D deficiency (p=0.017) and mean of vitamin D group was significantly lower in women who had oligohydramnios or polyhydramnios complication (p=0.045). CONCLUSION The study findings revealed that vitamin D deficiency is prevalent in pregnant women and it is significantly associated with elevated risk for abortion, and oligohydramnios or polyhydramnios. Probably, a targeted screening strategy can be suggested to detect and treat women at high risk of vitamin D deficiency in early pregnancy as a simple way to reduce the risk of these adverse pregnancy outcomes in Yazd.
Collapse
Affiliation(s)
- Azar Pirdehghan
- Community and Preventive Medicine Department, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran,Corresponding Author: Azar Pirdehghan, Department of Community and Preventive Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, E-mail:
| | - Mahmood Vakili
- Community and Preventive Medicine Department, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reyhane Dehghan
- Health Research Center Community and Preventive Medicine Department, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Zare
- Gynecology Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
158
|
Is first trimester vitamin D status in nulliparous women associated with pregnancy related hypertensive disorders? Midwifery 2015; 34:117-122. [PMID: 26805604 DOI: 10.1016/j.midw.2015.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 12/11/2015] [Accepted: 12/15/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVES this study aimed to explore if maternal vitamin D status in early pregnancy was associated with pre-eclampsia and pregnancy-induced hypertension. Relationships between vitamin D status and blood pressure at the start of pregnancy as well as the occurrence of a mid-pregnancy drop in blood pressure were also explored. This secondary analysis was completed to investigate a possible mechanism for the association between vitamin D status and pregnancy related hypertensive disorders. DESIGN AND SETTING data were obtained from the Amsterdam Born Children and their Development study, a prospective community-based cohort study based in Amsterdam, The Netherlands. PARTICIPANTS a total of 2074 nulliparous women without pre-existing hypertension and with a known vitamin D status before 17 weeks gestation were included in the study. Vitamin D status was categorized into four groups: "normal" (≥50nmol/L), "insufficient" (30-49.9nmol/L) "deficient" (20-29.9nmol/L) or "severely deficient" (<20nmol/L). MEASUREMENTS logistic regression analysis was used to investigate if vitamin D status was related to the odds of experiencing pre-eclampsia or pregnancy-induced hypertension. Models were corrected for maternal age, ethnicity, pre-pregnancy BMI, smoking and socioeconomic status. χ(2) and ANOVA tests were used to investigate relationships between vitamin D status and the blood pressure parameters. FINDINGS when compared to women with a normal vitamin D status, women who were severely deficient had an increased risk for pre-eclampsia (OR 2.08; 95% CI, 1.05-4.13), but the association was rendered non-significant after correction (OR 1.88; 95% CI 0.79-4.48). There were no associations between vitamin D status and pregnancy-induced hypertension, starting blood pressure or the occurrence of a mid-pregnancy drop in blood pressure. KEY CONCLUSIONS no strong evidence was found for an association between first trimester vitamin D status and pregnancy related hypertensive disorders in nulliparous women. IMPLICATIONS FOR PRACTICE at this time, vitamin D supplementation is not warranted for the specific purpose of preventing pregnancy related hypertensive disorders.
Collapse
|
159
|
Tylavsky FA, Kocak M, Murphy LE, Graff JC, Palmer FB, Völgyi E, Diaz-Thomas AM, Ferry RJ. Gestational Vitamin 25(OH)D Status as a Risk Factor for Receptive Language Development: A 24-Month, Longitudinal, Observational Study. Nutrients 2015; 7:9918-30. [PMID: 26633480 PMCID: PMC4690051 DOI: 10.3390/nu7125499] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/05/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023] Open
Abstract
Emerging data suggest that vitamin D status during childhood and adolescence can affect neurocognitive development. The purpose of this study was to investigate whether gestational 25(OH)D status is associated with early childhood cognitive and receptive language development. The Conditions Affecting Neurocognitive Development and Learning in Early Childhood Study (CANDLE) study enrolled 1503 mother-child dyads during the second trimester of healthy singleton pregnancies from Shelby County TN. Among 1020 participants of the total CANDLE cohort for whom 25(OH)D levels were available, mean gestational 25(OH)D level during the second trimester was 22.3 ng/mL (range 5.9–68.4), with 41.7% of values <20 ng/dL. Cognitive and language scaled scores increased in a stair-step manner as gestational 25(OH)D levels in the second trimester rose from <20 ng/dL, through 20–29.99 ng/dL, to ≥30 ng/dL. When controlling for socioeconomic status, race, use of tobacco products, gestational age of the child at birth, and age at the 2-year assessment, the gestational 25(OH)D was positively related to receptive language development (p < 0.017), but not cognitive or expressive language.
Collapse
Affiliation(s)
- Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163-2181, USA.
- Urban Child Institute, 600 Jefferson Avenue, Memphis, TN 38105, USA.
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163-2181, USA.
| | - Laura E Murphy
- Department of Psychiatry, University of Tennessee Health Science Center, 711 Jefferson Avenue, Memphis, TN 38163, USA.
- Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, 711 Jefferson Avenue, Memphis, TN 38163-2167, USA.
| | - J Carolyn Graff
- Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, 711 Jefferson Avenue, Memphis, TN 38163-2167, USA.
- College of Nursing, University of Tennessee Health Science Center, 711 Jefferson Avenue, Memphis, TN 38163, USA.
| | - Frederick B Palmer
- Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, 711 Jefferson Avenue, Memphis, TN 38163-2167, USA.
- Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap Street, Memphis, TN 38103-2893, USA.
| | - Eszter Völgyi
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163-2181, USA.
- Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap Street, Memphis, TN 38103-2893, USA.
| | - Alicia M Diaz-Thomas
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap Street, Memphis, TN 38103-2800, USA.
| | - Robert J Ferry
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap Street, Memphis, TN 38103-2800, USA.
- Department of Psychology, University of Memphis, 352 Psychology Building, Memphis, TN 38152-3370, USA.
| |
Collapse
|
160
|
Gümüş P, Öztürk VÖ, Bozkurt E, Emingil G. Evaluation of the gingival inflammation in pregnancy and postpartum via 25-hydroxy-vitamin D3, prostaglandin E2 and TNF-α levels in saliva. Arch Oral Biol 2015; 63:1-6. [PMID: 26658365 DOI: 10.1016/j.archoralbio.2015.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/30/2015] [Accepted: 11/22/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Physiological changes and immunological modifications occur during pregnancy. The clinical and biological features of periodontal infections are affected by pregnancy. The aim of the present study was to evaluate saliva levels of 25-hydroxy-vitamin D3 (25(OH)D3), prostaglandin E2 (PGE2) and TNF-alpha (TNF-α) in pregnancy, postpartum and non-pregnant controls. METHODS Whole saliva samples together with full-mouth clinical periodontal recordings were obtained from 59 pregnant, 47 post partum and 70 systemically healthy non-pregnant women. Groups were also evaluated according to the periodontal health status. 25(OH)D3, PGE2 and TNF-α levels in the saliva samples were determined by enzyme-linked immunoassays. Data were statistically tested by nonparametrical tests. RESULTS Saliva TNF-α and PGE2 levels were significantly lower and 25(OH)D3 levels were significantly higher in the pregnant group than postpartum group (p<0.0001). Saliva TNF-α and 25(OH)D3 levels were significantly higher and PGE2 levels were significantly lower in the control group than postpartum group (p<0.0001). In the pregnant healthy, gingivitis and periodontitis groups saliva TNF-α levels were significantly lower than postpartum and control counterparts (p<0.0001, p=0.032, p=0.003 and p=0.013; p=0.027; p=0.007, respectively). In control healthy, gingivitis and periodontitis groups saliva 25(OH)D3 levels were significantly higher than the postpartum counterparts (p<0.0001, p<0.0001, p=0.002, respectively). In the control healthy and gingivitis groups saliva 25(OH)D3 levels were significantly higher than pregnant healthy and gingivitis (p<0.0001). CONCLUSIONS In conclusion, within the limits of the present study it seems that pregnancy have an effect on parameters in saliva in relation to the periodontal status of the women. Further studies are required for better understanding of the impact of periodontal diseases on pregnancy or otherwise.
Collapse
Affiliation(s)
- Pınar Gümüş
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
| | - V Özgen Öztürk
- Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydin, Turkey
| | - Emir Bozkurt
- Section of Molecular Biology, Department of Biology, Faculty of Science and Letters, Celal Bayar University, Manisa, Turkey
| | - Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| |
Collapse
|
161
|
Sadin B, Pourghassem Gargari B, Pourteymour Fard Tabrizi F. Vitamin D Status in Preeclamptic and Non-preeclamptic Pregnant Women: A Case-Control Study in the North West of Iran. Health Promot Perspect 2015; 5:183-90. [PMID: 26634196 PMCID: PMC4667260 DOI: 10.15171/hpp.2015.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/04/2015] [Indexed: 02/05/2023] Open
Abstract
Background: There are few studies on the
vitamin D status in preeclamptic women. The objective of this case-control
study was to determine vitamin D status, in preeclamptic women and compare it
with that of healthy pregnant controls.
Methods: Forty
preeclamptic women, aged 18 to 45yr and forty age- and pregnancy
weight-matched healthy controls participated in the study. Serum 25-hydroxy
vitamin D (25(OH)D) levels were measured and its levels of <10,
10-30, 30-90 and >90 nanogram per milliliter (ng/ml) were considered
as vitamin D deficiency, insufficiency, sufficiency, and toxicity,
respectively. Results: Sixty and forty percent of preeclamptic
women were vitamin D deficient and insufficient, while in the control group they
were 10% and 90%, respectively. No significant difference was found in the
median intake of vitamin D between preeclamptic and non preeclamptic women
(1.45 and 1.20µg/day respectively), but serum 25(OH)D concentration was
significantly lower in preeclamptic cases compared to controls (10.09 ± 6.66
and 15.73 ± 5.85ng /ml respectively, P= 0.002) .
Conclusion: Vitamin D deficiency is
common among preeclamptic and non-preeclamptic pregnant women in the north-west of Iran.
Preeclampsia can cause decreasing of serum level of 25(OH)D.
Collapse
Affiliation(s)
- Bita Sadin
- Aras International Branch, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
162
|
Khalessi N, Kalani M, Araghi M, Farahani Z. The Relationship between Maternal Vitamin D Deficiency and Low Birth Weight Neonates. J Family Reprod Health 2015; 9:113-7. [PMID: 26622309 PMCID: PMC4662754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Maternal hypovitaminosis D may impair fetal growth and cause adverse pregnancy outcomes including intrauterine growth restriction and neonatal low birth weight. The aim of this study is to evaluate the relationship between maternal vitamin D status and neonate's birth weight. MATERIALS AND METHODS A cross-sectional, descriptive analytical study was carried out in the nursery ward of 2 hospitals (Tehran-Iran) during one year (January 2011- January 2012). One hundred and two neonates were categorized into two groups, neonates with birth weight< 2500 gr (n=52) and neonates with birth weight>2500 gr (n = 50). Data regarding medical history, physical examination and anthropometric measurements of neonates were noted in a questionnaire. Birth time blood samples of their mothers were analyzed for serum 25-(OH)-vitamin D by ELISA method. Maternal vitamin D status was compared in two groups. RESULTS Mean maternal vitamin D (vit D) level was 31.46 nmol/L. Forty eight percent of mothers had vitamin D deficiency, 27.5% had vit D insufficiency and 24.5% were normal. Mean maternal vitamin D level of LBW neonates was lower than other group; 25.05 vs. 38.13 (p = 0.001). All mothers of neonates with head circumference ≤ 33 cm also had vitamin D deficiency (p = 0.007). CONCLUSION Maternal Vitamin D deficiency may increase the risk of low birth weight neonate and modifying maternal nutrition behavior and their vit D level could be beneficial on pregnancy outcome.
Collapse
Affiliation(s)
- Nasrin Khalessi
- Neonatal division, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Kalani
- Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Araghi
- Neonatal division, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Farahani
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
163
|
Hrudey EJ, Reynolds RM, Oostvogels AJJM, Brouwer IA, Vrijkotte TGM. The Association between Maternal 25-Hydroxyvitamin D Concentration during Gestation and Early Childhood Cardio-metabolic Outcomes: Is There Interaction with Pre-Pregnancy BMI? PLoS One 2015; 10:e0133313. [PMID: 26244505 PMCID: PMC4526575 DOI: 10.1371/journal.pone.0133313] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/24/2015] [Indexed: 11/18/2022] Open
Abstract
Both maternal 25-hydroxyvitamin D(25OHD) status and pre-pregnancy BMI(pBMI) may influence offspring cardio-metabolic outcomes. Lower 25OHD concentrations have been observed in women with both low and high pBMIs, but the combined influence of pBMI and 25OHD on offspring cardio-metabolic outcomes is unknown. Therefore, this study investigated the role of pBMI in the association between maternal 25OHD concentration and cardio-metabolic outcomes in 5-6 year old children. Data were obtained from the ABCD cohort study and 1882 mother-child pairs were included. The offspring outcomes investigated were systolic and diastolic blood pressure, heart rate, BMI, body fat percentage(%BF), waist-to-height ratio, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, glucose, C-peptide, and insulin resistance(HOMA2-IR). 62% of the C-peptide samples were below the detection limit and were thus imputed using survival analysis. Models were corrected for maternal and offspring covariates and tested for interaction with pBMI. Interaction with pBMI was observed in the associations with insulin resistance markers: in offspring of overweight mothers(≥25.0kg/m2), a 10 nmol/L increase in maternal 25OHD was associated with a 0.007(99%CI:-0.01,-0.001) nmol/L decrease in C-peptide and a 0.02(99%CI:-0.03,-0.004) decrease in HOMA2-IR. When only non-imputed data were analyzed, there was a trend for interaction in the relationship but the results lost significance. Interaction with pBMI was not observed for the other outcomes. A 10 nmol/L increase in maternal 25OHD was significantly associated with a 0.13%(99%CI:-0.3,-0.003) decrease in %BF after correction for maternal and child covariates. Thus, intrauterine exposure to both low 25OHD and maternal overweight may be associated with increased insulin resistance in offspring, while exposure to low 25OHD in utero may be associated with increased offspring %BF with no interactive effects from pBMI. Due to the limitations of this study, these results are not conclusive, however the observations of this study pose important research questions for future studies to investigate.
Collapse
Affiliation(s)
- E. Jessica Hrudey
- Department of Public Health, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
- * E-mail:
| | - Rebecca M. Reynolds
- BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adriëtte J. J. M. Oostvogels
- Department of Public Health, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences, VU University, de Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
| | - Tanja G. M. Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| |
Collapse
|
164
|
Abstract
PURPOSE OF REVIEW 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. RECENT FINDINGS 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. SUMMARY 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.
Collapse
|
165
|
Smith TA, Kirkpatrick DR, Kovilam O, Agrawal DK. Immunomodulatory role of vitamin D in the pathogenesis of preeclampsia. Expert Rev Clin Immunol 2015; 11:1055-63. [PMID: 26098965 DOI: 10.1586/1744666x.2015.1056780] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Worldwide, preeclampsia is a significant health risk to both pregnant women and their unborn children. Despite scientific advances, the exact pathogenesis of preeclampsia is not yet fully understood. Meanwhile, the incidence of preeclampsia is expected to increase. A series of potential etiologies for preeclampsia has been identified, including endothelial dysfunction, immunological dysregulation and trophoblastic invasion. In this literature review, we have critically reviewed existing literature regarding the research findings that link the role of vitamin D to the pathogenesis and immunoregulation of preeclampsia. The relationship of vitamin D with the suspected etiologies of preeclampsia underscores its clinical potential in the diagnosis and treatment of preeclampsia.
Collapse
Affiliation(s)
- Tyler A Smith
- Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE, USA
| | | | | | | |
Collapse
|
166
|
Zabul P, Wozniak M, Slominski AT, Preis K, Gorska M, Korozan M, Wieruszewski J, Zmijewski MA, Zabul E, Tuckey R, Kuban-Jankowska A, Mickiewicz W, Knap N. A Proposed Molecular Mechanism of High-Dose Vitamin D3 Supplementation in Prevention and Treatment of Preeclampsia. Int J Mol Sci 2015; 16:13043-64. [PMID: 26068234 PMCID: PMC4490485 DOI: 10.3390/ijms160613043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/31/2015] [Accepted: 06/01/2015] [Indexed: 12/02/2022] Open
Abstract
A randomized prospective clinical study performed on a group of 74 pregnant women (43 presenting with severe preeclampsia) proved that urinary levels of 15-F(2t)-isoprostane were significantly higher in preeclamptic patients relative to the control (3.05 vs. 2.00 ng/mg creatinine). Surprisingly enough, plasma levels of 25-hydroxyvitamin D3 in both study groups were below the clinical reference range with no significant difference between the groups. In vitro study performed on isolated placental mitochondria and placental cell line showed that suicidal self-oxidation of cytochrome P450scc may lead to structural disintegration of heme, potentially contributing to enhancement of oxidative stress phenomena in the course of preeclampsia. As placental cytochrome P450scc pleiotropic activity is implicated in the metabolism of free radical mediated arachidonic acid derivatives as well as multiple Vitamin D3 hydroxylations and progesterone synthesis, we propose that Vitamin D3 might act as a competitive inhibitor of placental cytochrome P450scc preventing the production of lipid peroxides or excess progesterone synthesis, both of which may contribute to the etiopathogenesis of preeclampsia. The proposed molecular mechanism is in accord with the preliminary clinical observations on the surprisingly high efficacy of high-dose Vitamin D3 supplementation in prevention and treatment of preeclampsia.
Collapse
Affiliation(s)
- Piotr Zabul
- Department of Obstetrics & Gynecology, the Sw. Wojciech Specialist Hospital, Independent Public Complex of Integrated Health Care Units in Gdansk, 50 Al. Jana Pawła II St., Gdansk 80-462, Poland; E-Mail:
| | - Michal Wozniak
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Andrzej T. Slominski
- Department of Dermatology, University of Alabama at Birmingham, VA Medical Center, Birmingham, AL 35294, USA; E-Mail:
| | - Krzysztof Preis
- Department of Obstetrics & Gynecology, Medical University of Gdansk, 1A Kliniczna St., Gdansk 80-402, Poland; E-Mail:
| | - Magdalena Gorska
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Marek Korozan
- Department of Obstetrics & Gynecology, the Sw. Wojciech Specialist Hospital, Independent Public Complex of Integrated Health Care Units in Gdansk, 50 Al. Jana Pawła II St., Gdansk 80-462, Poland; E-Mail:
| | - Jan Wieruszewski
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Michal A. Zmijewski
- Department of Histology, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mail:
| | - Ewa Zabul
- Department of Anesthesiology & Intensive Care, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mail:
| | - Robert Tuckey
- School of Chemistry and Biochemistry, the University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; E-Mail:
| | - Alicja Kuban-Jankowska
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Wieslawa Mickiewicz
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Narcyz Knap
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| |
Collapse
|
167
|
Pena HR, de Lima MC, Brandt KG, de Antunes MMC, da Silva GAP. Influence of preeclampsia and gestational obesity in maternal and newborn levels of vitamin D. BMC Pregnancy Childbirth 2015; 15:112. [PMID: 25967102 PMCID: PMC4457081 DOI: 10.1186/s12884-015-0547-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/05/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In recent years, a high prevalence of vitamin D deficiency amongst pregnant women and newborns has been observed throughout several regions of the world, especially in the presence of preeclampsia (PE) or obesity (OB). The aim of this study was to investigate whether nonobese and obese preeclamptic pregnant women and their newborns have low 25(OH)D compared with nonobese and obese nonpreeclamptic pregnant women; and to verify whether the maternal level of this vitamin correlates with the newborns' level. METHODS This is a cross-sectional study conducted with 179 pregnant women recruited immediately before delivery, divided into four groups: PE(+)/OB(-); PE(+)/OB(+); PE(-)/OB(+); and PE(-)/OB(-), with gestational age ≥ 34 weeks. Maternal peripheral blood and newborns umbilical cord blood were collected and 25(OH)D levels were measured by chemiluminescence (LIAISON®). RESULTS Infants born to preeclamptic mothers had a lower median 25(OH)D level than those born to nonpreeclamptic mothers (p < 0.01). Obese pregnant women and their newborns had higher frequencies of 25(OH)D deficiency, but the difference with respect to nonobese pregnant women and their newborns was not significant. The vitamin D status of preeclamptic obese women was not worse than that of their nonobese counterparts. Newborns and maternal 25(OH)D levels were significantly correlated (p = 0.01). Obesity weakened this correlation. CONCLUSIONS Preeclamptic women and their newborns presented higher frequencies of 25(OH)D deficiency, but 25(OH)D levels were not significantly influenced by obesity. Obese pregnant women transferred less 25(OH)D to their fetuses.
Collapse
Affiliation(s)
| | | | - Katia Galeão Brandt
- Department of Maternal and Child Health, Universidade Federal de Pernambuco, Recife, Brazil.
| | | | | |
Collapse
|
168
|
Pérez-López FR, Pasupuleti V, Mezones-Holguin E, Benites-Zapata VA, Thota P, Deshpande A, Hernandez AV. Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril 2015; 103:1278-88.e4. [PMID: 25813278 DOI: 10.1016/j.fertnstert.2015.02.019] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano Blesa University Hospital, Zaragoza, Spain.
| | - Vinay Pasupuleti
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Edward Mezones-Holguin
- Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru; School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Vicente A Benites-Zapata
- Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru
| | - Priyaleela Thota
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Abhishek Deshpande
- Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, Ohio
| | - Adrian V Hernandez
- School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru; Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
169
|
Vitamin D Status in Women with Gestational Diabetes Mellitus during Pregnancy and Postpartum. BIOMED RESEARCH INTERNATIONAL 2015; 2015:260624. [PMID: 26000285 PMCID: PMC4427001 DOI: 10.1155/2015/260624] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/30/2015] [Accepted: 02/11/2015] [Indexed: 02/08/2023]
Abstract
Of many vitamin D extraskeletal functions, its modulatory role in insulin secretion and action is especially relevant for gestational diabetes mellitus (GDM). The aims of the present study were to determine midgestational and early postpartum vitamin D status in pregnant women with and without GDM and to describe the relationship between midgestational and postpartum vitamin D status and parallel changes of glucose tolerance. A total of 76 pregnant women (47 GDM and 29 healthy controls) were included in the study. Plasma levels of 25(OH)D were measured using an enzyme immunoassay. Vitamin D was not significantly decreased in GDM compared to controls during pregnancy; however, both groups of pregnant women exhibited high prevalence of vitamin D deficiency. Prevalence of postpartum 25(OH)D deficiency in post-GDM women remained significantly higher and their postpartum 25(OH)D levels were significantly lower compared to non-GDM counterparts. Finally, based on the oGTT repeated early postpartum persistent glucose abnormality was ascertained in 15% of post-GDM women; however, neither midgestational nor postpartum 25(OH)D levels significantly differed between subjects with GDM history and persistent postpartum glucose intolerance and those with normal glucose tolerance after delivery.
Collapse
|
170
|
Sumarmi S, Wirjatmadi B, . K, Gumilar E, Adriani M, Retnowati E. Micronutrients Supplementation during Preconception Period Improves Fetal Survival and Cord Blood Insulin-Like Growth Factor 1. ACTA ACUST UNITED AC 2015. [DOI: 10.3923/ajcn.2015.33.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
171
|
Genetic variations in the vitamin-D receptor (VDR) gene in preeclampsia patients in the Chinese Han population. Hypertens Res 2015; 38:513-7. [DOI: 10.1038/hr.2015.29] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 12/12/2014] [Accepted: 12/31/2014] [Indexed: 11/08/2022]
|
172
|
Bobbitt KR, Peters RM, Li J, Rao SD, Woodcroft KJ, Cassidy-Bushrow AE. Early pregnancy vitamin D and patterns of antenatal inflammation in African-American women. J Reprod Immunol 2014; 107:52-8. [PMID: 25453750 DOI: 10.1016/j.jri.2014.09.054] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/29/2014] [Accepted: 09/18/2014] [Indexed: 10/24/2022]
Abstract
Vitamin D is essential for the health of both mother and fetus during pregnancy. In the nonpregnant state, vitamin D demonstrates anti-inflammatory effects, but little is known about this relationship during pregnancy. African-American women are at a higher risk of vitamin D deficiency and for altered inflammatory responses during pregnancy. Therefore, we investigated the association of early pregnancy vitamin D nutrition, as assessed by serum 25-hydroxyvitamin D (25-OHD), with second-trimester inflammatory biomarkers (high-sensitivity C-reactive protein, IL-6, IL-10, IL-1β and TNF-α) in 178 pregnant African-American women. Mean serum 25-OHD was 13.4±8.4 ng/ml, and most women (n=147, 82.6%) had inadequate or deficient levels of 25-OHD (<20 ng/ml). Both serum 25-OHD and some inflammatory cytokines (IL-1β and TNF-α) demonstrated significant seasonal variation. In univariate models, log transformed 25-OHD was significantly and inversely associated with log transformed IL-1β (p=0.002) and log transformed IL-6 (p=0.032). After adjusting for covariates, including seasonality, only the inverse association with IL-1β remained statistically significant (p=0.027). Early pregnancy vitamin D nutrition is associated with some inflammatory biomarkers in mid-pregnancy. Additional studies are needed to determine if low vitamin D nutrition is associated with birth outcomes via an inflammatory-mediated pathway.
Collapse
Affiliation(s)
- Kevin R Bobbitt
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| | - Rosalind M Peters
- College of Nursing, Wayne State University, 358 Cohn, Detroit, MI 48202, USA.
| | - Jia Li
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| | - Sudhaker D Rao
- Bone & Mineral Research Laboratory, Henry Ford Hospital, E&R Building 7th Floor, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
| | - Kimberley J Woodcroft
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| | - Andrea E Cassidy-Bushrow
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI 48202, USA.
| |
Collapse
|
173
|
Vitamin D deficiency in pregnant women of ethnic minority: a potential contributor to preeclampsia. J Perinatol 2014; 34:767-73. [PMID: 24854625 DOI: 10.1038/jp.2014.91] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 04/02/2014] [Accepted: 04/04/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We investigated risk for comorbidities and preeclampsia at low vitamin D levels in ethnic minorities. STUDY DESIGN Umbilical cord vitamin D (25(OH)D) concentration was determined in urban minorities: 80.9% African American and 17% Hispanic mothers-baby pairs. To identify the correlation between vitamin D levels and high-risk comorbidities which result in preeclampsia, multivariate logistic regression analyses were performed. RESULT Below the Institute of Medicine threshold of 25(OH)D for pregnant women (25 ng ml⁻¹), obesity (P=0.055) and pregestational diabetes (odds ratio (OR)=2.056) were observed. The study median was 16 ng ml⁻¹ (<25th percentile), at which gestational hypertension (P=0.042), chronic hypertension (OR=4.842) and pregestational diabetes (OR=3.45) became relevant. The risk for preeclampsia increased 12-fold with gestational hypertension (P=0.003) and 14-fold with combined chronic and gestational hypertension (P=0.001). CONCLUSION Pregnant women of ethnic minority had lower median vitamin D levels which may contribute to a potential risk for preeclampsia.
Collapse
|
174
|
Reichetzeder C, Chen H, Föller M, Slowinski T, Li J, Chen YP, Lang F, Hocher B. Maternal Vitamin D Deficiency and Fetal Programming - Lessons Learned from Humans and Mice. Kidney Blood Press Res 2014; 39:315-29. [DOI: 10.1159/000355809] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 11/19/2022] Open
|
175
|
Rodriguez A, García-Esteban R, Basterretxea M, Lertxundi A, Rodríguez-Bernal C, Iñiguez C, Rodriguez-Dehli C, Tardón A, Espada M, Sunyer J, Morales E. Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. BJOG 2014; 122:1695-704. [PMID: 25208685 DOI: 10.1111/1471-0528.13074] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the association of maternal circulating 25-hydroxyvitamin D3 [25(OH)D3] concentration with pregnancy and birth outcomes. DESIGN Prospective cohort study. SETTING Four geographical areas of Spain, 2003-2008. POPULATION Of 2382 mother-child pairs participating in the INfancia y Medio Ambiente (INMA) Project. METHODS Maternal circulating 25(OH)D3 concentration was measured in pregnancy (mean [SD] 13.5 [2.2] weeks of gestation). We tested associations of maternal 25(OH)D3 concentration with pregnancy and birth outcomes. MAIN OUTCOME MEASURES Gestational diabetes mellitus (GDM), preterm delivery, caesarean section, fetal growth restriction (FGR) and small-for-gestational age (SGA), anthropometric birth outcomes including weight, length and head circumference (HC). RESULTS Overall, 31.8% and 19.7% of women had vitamin D insufficiency [25(OH)D3 20-29.99 ng/ml] and deficiency [25(OH)D3 < 20 ng/ml], respectively. After adjustment, there was no association between maternal 25(OH)D3 concentration and risk of GDM or preterm delivery. Women with sufficient vitamin D [25(OH)D3 ≥ 30 ng/ml] had a decreased risk of caesarean section by obstructed labour compared with women with vitamin D deficiency [relative risk (RR) = 0.60, 95% CI 0.37, 0.97). Offspring of mothers with higher circulating 25(OH)D3 concentration tended to have smaller HC [coefficient (SE) per doubling concentration of 25(OH)D3, -0.10 (0.05), P = 0.038]. No significant associations were found for other birth outcomes. CONCLUSION This study did not find any evidence of an association between vitamin D status in pregnancy and GDM, preterm delivery, FGR, SGA and anthropometric birth outcomes. Results suggest that sufficient circulating vitamin D concentration [25(OH)D3 ≥ 30 ng/ml] in pregnancy may reduce the risk of caesarean section by obstructed labour.
Collapse
Affiliation(s)
- A Rodriguez
- Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Catalonia, Spain.,Universitat Autònoma de Barcelona, Campus d'Excelència Internacional Bellaterra, Catalonia, Spain
| | - R García-Esteban
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - M Basterretxea
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Health of the Basque Government, Subdirección de Salud Pública de Gipuzkoa, San Sebastian, Spain.,BIODONOSTIA Health Research Institute, San Sebastian, Spain
| | - A Lertxundi
- BIODONOSTIA Health Research Institute, San Sebastian, Spain.,Universidad del País Vasco, EHU-UPV, País Vasco, Spain
| | - C Rodríguez-Bernal
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Center for Public Health Research (CSISP-FISABIO), Valencia, Spain
| | - C Iñiguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Center for Public Health Research (CSISP-FISABIO), Valencia, Spain.,University of Valencia, Valencia, Spain
| | | | - A Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Oviedo, Oviedo, Spain
| | - M Espada
- Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Euskadi, Spain
| | - J Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - E Morales
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| |
Collapse
|
176
|
Knabl J, Hüttenbrenner R, Hutter S, Günthner-Biller M, Riedel C, Hiden U, Kainer F, Desoye G, Jeschke U. Gestational diabetes mellitus upregulates vitamin D receptor in extravillous trophoblasts and fetoplacental endothelial cells. Reprod Sci 2014; 22:358-66. [PMID: 25028176 DOI: 10.1177/1933719114542020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is often accompanied by low maternal vitamin D, that is, calcitriol (1,25[OH]2 vitamin D3), levels. Here, we tested the hypothesis that the placental vitamin D receptor (VDR) is regulated by calcitriol and altered in GDM with distinct changes in different placental cell types. Specifically, we aimed to localize VDR in human term placentas from normal and GDM pregnancies, to quantify its cellular expression and to study in vitro its regulation by its physiological agonist calcitriol. STUDY DESIGN Placental tissue slides of 80 patients (40 with GDM/40 controls) were double stained for VDR and human leukocyte antigen G to identify extravillous trophoblasts (EVTs). Staining intensity was semiquantified. Quantitative real time-polymerase chain reaction and Western blotting measured VDR messenger RNA (mRNA) and protein in decidual tissue. The trophoblast cell line BeWo was used to study in vitro VDR regulation by calcitriol (0.01, 0.1, and 1 nmol/mL). RESULTS Vitamin D receptor protein and mRNA levels are upregulated (P < .05) in EVT (1.8-fold) as well as in placental endothelium (5.8-fold) of patients with GDM. Expression of VDR is regulated by calcitriol in a bimodal manner: high doses (0.1 and 1 nmol/mL) caused downregulation, whereas the low dose (0.01 nmol/mL) resulted in VDR upregulation. CONCLUSION Vitamin D receptor is upregulated in EVT and endothelium of GDM placentas. This could be due to low maternal vitamin D levels in patients with GDM because in vitro low calcitriol doses upregulate VDR in trophoblast cells.
Collapse
Affiliation(s)
- Julia Knabl
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Rebecca Hüttenbrenner
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Stefan Hutter
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Maria Günthner-Biller
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Christina Riedel
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany Institut für Soziale Pädiatrie und Jugendmedizin, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ursula Hiden
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
| | - Franz Kainer
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität, Munich, Germany
| |
Collapse
|
177
|
Ciborowski M, Zbucka-Kretowska M, Bomba-Opon D, Wielgos M, Brawura-Biskupski-Samaha R, Pierzynski P, Szmitkowski M, Wolczynski S, Lipinska D, Citko A, Bauer W, Gorska M, Kretowski A. Potential first trimester metabolomic biomarkers of abnormal birth weight in healthy pregnancies. Prenat Diagn 2014; 34:870-7. [PMID: 24733416 DOI: 10.1002/pd.4386] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Macrosomia and low birth weight (LBW) can be associated with pregnancy complications and may affect the long-term health of the child. The aim of this study was to evaluate the metabolomic serum profiles of healthy pregnant women to identify early biomarkers of macrosomia and LBW and to understand mechanisms leading to abnormal fetal growth not related to mother's body mass index or presence of gestational diabetes. METHOD Serum samples from 770 women were collected between the 12th and 14th gestational week. Delivery samples were divided into three groups according to the infant birth weight as follows: low, <2500 g; normal, 2500-4000 g; and high >4000 g. Samples from women with any complications of pregnancy were excluded. Serum fingerprinting was performed by LC-QTOF-MS. RESULTS Lower levels of phospholipids, lysophospholipids, and monoacylglycerols; low vitamin D3 metabolites; and increased bilirubin level were associated with macrosomia. Because most changes involved lipids, as a concept of validation, adipocyte fatty acid-binding protein (A-FABP) levels were measured and found correlated with the studied lipids and birth weight. CONCLUSION Serum fingerprinting in early pregnancy can predict the risk of macrosomia. Serum levels of A-FABP and several lipids are promising prognostic markers for macrosomia in healthy pregnancies.
Collapse
|
178
|
Medeiros M, Saunders C, Chagas CB, Pereira SE, Saboya C, Ramalho A. Vitamin D deficiency in pregnancy after bariatric surgery. Obes Surg 2014; 23:1679-84. [PMID: 23943547 DOI: 10.1007/s11695-013-1045-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to describe the main factors related to the installation and/or aggravation of vitamin D deficiency (VDD) and its clinical consequences in pregnant women after bariatric surgery. An electronic search on VDD in pregnancy and after bariatric surgery was conducted in publications from 1998 until 2012 that presented studies performed in humans. We provided an overview of VDD after bariatric surgery, in pregnancy, and in pregnancy in women who underwent bariatric surgery. In view of the high percentage of VDD postoperatively and the role of this vitamin in pregnancy, we recommend the investigation of vitamin D nutritional status in prenatal care.
Collapse
Affiliation(s)
- Marina Medeiros
- Center for Research on Micronutrients, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil,
| | | | | | | | | | | |
Collapse
|
179
|
Bailey D, Perumal N, Yazdanpanah M, Al Mahmud A, Baqui AH, Adeli K, Roth DE. Maternal-fetal-infant dynamics of the C3-epimer of 25-hydroxyvitamin D. Clin Biochem 2014; 47:816-22. [PMID: 24462965 DOI: 10.1016/j.clinbiochem.2014.01.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/24/2013] [Accepted: 01/10/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Poor vitamin D status (i.e. low serum 25-hydroxyvitamin D (25(OH)D)) has been associated with adverse clinical outcomes during pregnancy and childhood. However, the interpretation of serum 25(OH)D levels may be complicated by the presence of the C3-epimer of 25(OH)D. We aimed to quantify C3-epi-25(OH)D3 in pregnant women and fetuses, to explore the relationship of the C3-epimer between maternal and cord samples, and to establish whether infant C3-epimer abundance is explained by prenatal formation. METHODS In a sub-study of a randomized trial of prenatal vitamin D3, 25(OH)D3 and C3-epi-25(OH)D3 were quantified by LC-MS/MS in 71 sets of mother-fetus-infant serum samples, including maternal delivery specimens, cord blood, and infant specimens acquired at 3-28 weeks of age. RESULTS Without supplementation, median concentrations of C3-epi-25(OH)D₃ were higher in infants (6.80 nmol/L) than mothers (0.45 nmol/L) and cord blood (0 nmol/L). However, there was substantial variation such that C3-epi-25(OH)D₃ accounted for up to 11% (maternal), 14% (cord), and 25% (infant) of the total 25(OH)D₃. Supplemental vitamin D₃ significantly increased maternal-fetal C3-epi-25(OH)D₃, and was a preferential source of C3-epi-25(OH)D₃ compared to basal vitamin D, possibly due to C3-epi-cholecalciferol in the supplement. Multivariate regression did not suggest transplacental transfer of C3-epi-25(OH)D₃, but rather indicated its generation within the fetal-placental unit from maternally-derived 25(OH)D₃. Neither maternal nor fetal C3-epi-25(OH)D₃ is accounted for the relatively high concentrations of infant C3-epi-25(OH)D₃, suggesting rapid postnatal generation. CONCLUSIONS C3-epi-25(OH)D₃ is present in some pregnant women and fetuses, but does not appear to be efficiently transferred transplacentally. High C3-epimer concentrations in infancy are probably due to postnatal formation rather than fetal stores.
Collapse
Affiliation(s)
- Dana Bailey
- Clinical Biochemistry, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Gamma-Dynacare Medical Laboratories, London, Ontario, Canada
| | - Nandita Perumal
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Mehrdad Yazdanpanah
- Clinical Biochemistry, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Canada
| | - Abdullah Al Mahmud
- International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Abdullah H Baqui
- International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; International Center for Maternal and Newborn Health, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Khosrow Adeli
- Clinical Biochemistry, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Canada; Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daniel E Roth
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
180
|
Taheri M, Baheiraei A, Rahimi Foroushani A, Modarres M. Resolving Vitamin D Deficiency in the Preconception Period among High-Risk Reproductive Women: A Randomized Controlled Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e11175. [PMID: 24719700 PMCID: PMC3964418 DOI: 10.5812/ircmj.11175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 08/10/2013] [Accepted: 11/25/2013] [Indexed: 11/27/2022]
Abstract
Background: Although vitamin D deficiency has been linked to potential complications in reproductive women, the recommended intake dosage of this vitamin in populations with high incidence of deficiency in preconception period has not been defined. Objectives: The study investigated the effect of consuming a dosage of 2000 IU/day oral vitamin D for 105 days, on serum levels of this vitamin in reproductive women. Materials and Methods: 229 women with 18-35 years old, who were confirmed to be vitamin D deficient (vitamin D < 75 nmol/L), were randomized into the intervention and control groups and after 15 weeks consumption of the supplement and placebo, their serum samples were obtained. Results: At baseline the mean serum levels of vitamin D in the control group was 23.34 ± 15.87 nmol/L and in intervention group was 25.13 ± 18.46 nmol/L, that these values didn’t have any significant difference (P = 0.43), while after intervention, significant differences between the two groups was noticed (P < 0.001). The affecting factors to achieve normal range of vitamin D in the intervention group included basal amounts of vitamin D and two underlying factors based on questionnaire data: use of oral supplements (except vitamin D and calcium) in daily life and perfect sun exposure. Conclusion: This study showed positive effect of the 2000 IU/day oral vitamin D on the serum level elevation of this vitamin in reproductive women.
Collapse
Affiliation(s)
- Mahshid Taheri
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Azam Baheiraei
- Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Maryam Modarres
- Department of Midwifery, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Science, Tehran, IR Iran
- Corresponding Author: Maryam Modarres, Faculty Member at Department of Midwifery, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, IR Iran, Tell: +98-2166927171, Fax: +98-2166421685, E-mail:
| |
Collapse
|
181
|
Sun J, Zhong W, Gu Y, Groome LJ, Wang Y. 1,25(OH)2D3 suppresses COX-2 up-regulation and thromboxane production in placental trophoblast cells in response to hypoxic stimulation. Placenta 2013; 35:143-5. [PMID: 24374095 DOI: 10.1016/j.placenta.2013.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/19/2013] [Accepted: 12/08/2013] [Indexed: 02/05/2023]
Abstract
In this study, we determined if vitamin D could inhibit oxidative stress-induced thromboxane production by placental trophoblasts. Trophoblast isolated from normal placentas were stimulated with CoCl2, a hypoxic mimicking agent, with or without pretreatment of 1,25(OH)2D3. Soluble phospholipase-A2, metabolites of thromboxane-A2 and prostacyclin, and 8-isoprostane were measured. Expression of cyclooxygenase-1 (COX-1), COX-2, and heme oxygenase-1 (HO-1) were determined. We found that pretreatment of trophoblasts with 1,25(OH)2D3 significantly reduced 8-isoprostane and the ratio of thromboxane-A2 to prostacyclin production, and blocked COX-2 expression induced by CoCl2. These results provide evidence of the beneficial effects of vitamin D on placental trophoblasts.
Collapse
Affiliation(s)
- J Sun
- Dept. of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, PO Box 33932, Shreveport, LA 71130, USA; Dept. of Obstetrics and Gynecology, First Hospital, Harbin Medical University, Harbin, China
| | - W Zhong
- Dept. of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, PO Box 33932, Shreveport, LA 71130, USA; Dept. of Obstetrics and Gynecology, First Hospital, Harbin Medical University, Harbin, China
| | - Y Gu
- Dept. of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, PO Box 33932, Shreveport, LA 71130, USA
| | - L J Groome
- Dept. of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, PO Box 33932, Shreveport, LA 71130, USA
| | - Y Wang
- Dept. of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, PO Box 33932, Shreveport, LA 71130, USA.
| |
Collapse
|
182
|
Cho GJ, Hong SC, Oh MJ, Kim HJ. Vitamin D deficiency in gestational diabetes mellitus and the role of the placenta. Am J Obstet Gynecol 2013; 209:560.e1-8. [PMID: 23954530 DOI: 10.1016/j.ajog.2013.08.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/18/2013] [Accepted: 08/12/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the relationships between maternal vitamin D levels and gestational diabetes mellitus (GDM) and differences in the placental production of vitamin D receptor (VDR), CYP24A, and CYP27B1. STUDY DESIGN Forty normal pregnant women and 20 women with GDM were included in this study. Serum levels of 25-hydroxyvitamin D (25[OH]D) were measured with enzyme-linked immunosorbent assay. The expression and production of VDR, CYP27B1, and CYP24A1 in the placenta were evaluated with real time-polymerase chain reaction and Western blot, respectively. RESULTS We found that 27.5% of normal pregnant women and 85% of women with GDM had vitamin D deficiency, with serum 25(OH)D levels <20 ng/mL. Serum levels of 25(OH)D were lower in women with GDM than normal pregnant women (P < .01). The production of CYP24A1 protein and messenger RNA expression was significantly higher in placental tissue from patients with GDM than in those from normal pregnancies; however, the production of CYP27B1 and VDR protein and messenger RNA expression were not different between 2 the groups. CONCLUSION In this study, vitamin D deficiency was associated with GDM. Given that 25(OH)D is hydroxylated by CYP27B1 to the bioactive 1,25(OH)2D form, and CYP24A1 catabolizes both 25(OH)D and 1,25(OH)2D to the inactive metabolites, respectively, our data indicate that the elevated activity of CYP24A1 in the placenta may play a key role in the development of vitamin D deficiency in GDM.
Collapse
Affiliation(s)
- Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | | | | | | |
Collapse
|
183
|
Saber-Tehrani M, Aberoomand-Azar P, Raziee M. HOLLOW FIBER-BASED LIQUID PHASE MICROEXTRACTION COUPLED WITH HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY FOR EXTRACTION AND DETERMINATION OF VITAMIN D3 IN BIOLOGICAL FLUIDS. J LIQ CHROMATOGR R T 2013. [DOI: 10.1080/10826076.2012.745144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M. Saber-Tehrani
- a Department of Chemistry , Science and Research Branch, Islamic Azad University , Tehran , Iran
| | - P. Aberoomand-Azar
- a Department of Chemistry , Science and Research Branch, Islamic Azad University , Tehran , Iran
| | - Maryam Raziee
- a Department of Chemistry , Science and Research Branch, Islamic Azad University , Tehran , Iran
| |
Collapse
|
184
|
Gadgil MD, Chang HY, Richards TM, Gudzune KA, Huizinga MM, Clark JM, Bennett WL. Laboratory testing for and diagnosis of nutritional deficiencies in pregnancy before and after bariatric surgery. J Womens Health (Larchmt) 2013; 23:129-37. [PMID: 24102519 DOI: 10.1089/jwh.2013.4312] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Bariatric surgery can reduce the risk of obesity-related complications of pregnancy, but may cause essential nutrient deficiencies. To assess adherence to laboratory testing guidelines, we examined frequency of testing for and diagnosis of deficiency during preconception and pregnancy using claims data in women with a delivery and bariatric surgery. METHODS Retrospective analysis of claims from seven Blue Cross/Blue Shield plans between 2002 and 2008. We included women with a delivery and bariatric surgery within the study period. We used common procedural terminology (CPT) and ICD-9 codes to define laboratory testing and deficiencies for iron, folate, vitamin B12, vitamin D, and thiamine. Using Student's t-test and chi-square testing, we compared frequency of laboratory tests and diagnoses during 12 months preconception and 280 days of pregnancy between women with pregnancy before versus after surgery. We used multivariate logistic regression to evaluate for predictors of laboratory testing. RESULTS We identified 456 women with pregnancy after bariatric surgery and 338 before surgery. The frequency of testing for any deficiency was low (9%-51%), but higher in those with pregnancy after surgery (p<0.003). The most common deficiency was vitamin B12 (12%-13%) with pregnancy after surgery (p<0.006). Anemia and number of health provider visits were independent predictors of laboratory testing. CONCLUSION Women with pregnancy after bariatric surgery were tested for and diagnosed with micronutrient deficiencies more frequently than those with pregnancy before surgery. However, most laboratory testing occurred in less than half the women and was triggered by anemia. Increased testing may help identify nutrient deficiencies and prevent consequences for maternal and child health.
Collapse
Affiliation(s)
- Meghana D Gadgil
- 1 Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine , Baltimore, Maryland
| | | | | | | | | | | | | |
Collapse
|
185
|
Darby MM, Wallace K, Cornelius D, Chatman KT, Mosely JN, Martin JN, Purser CA, Baker RC, Owens MT, Lamarca BB. Vitamin D Supplementation Suppresses Hypoxia-Stimulated Placental Cytokine Secretion, Hypertension and CD4 + T Cell Stimulation in Response to Placental Ischemia. MEDICAL JOURNAL OF OBSTETRICS AND GYNECOLOGY 2013; 1:1012. [PMID: 25414911 PMCID: PMC4235666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate a role of Vitamin D in the pathogenesis of preeclampsia (PE), and to discern any potential benefits of Vitamin D supplementation on hypertension in the RUPP rat model of PE. STUDY DESIGN Blood and placentas from normal pregnancies (NP) and PE were collected following elective cesarean delivery without evidence of infection. Circulating Vitamin D was extracted by HPLC and measured via mass spectrometry. Media for placenta explants was supplemented with Vitamin D and exposed to hypoxic (1% O2) or normoxic (6% O2) conditions for 24 hours. ELISAs were performed on media and normalized to total protein to determine cytokine secretion. RUPP rats were supplemented with vitamin D by oral gavage, and blood pressure (MAP) and pup weights were measured in NP and RUPP rats with or without Vitamin D supplementation. Flow cytometry was used to evaluate CD4+ Tcells in control RUPP rats and RUPP rats treated with Vitamin D. RESULTS Inflammatory cytokine secretion was higher (p<0.05) while the anti-inflammatory cytokine, IL-10, was significantly lower in the media of PE placentas compared to NP (p=0.005). Vitamin D supplementation decreased hypoxia stimulated pro-inflammatory cytokine secretion (p=0.003) in the media of PE placentas. Vitamin D decreased MAP and circulating CD4+ T cells in the RUPP rat model of PE (p<0.05). CONCLUSION Vitamin D supplementation may be useful in the treatment or prevention of hypertensive disorders in pregnancy.
Collapse
Affiliation(s)
- Marie M Darby
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, USA
| | - Kedra Wallace
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, USA
| | - Denise Cornelius
- Department of Pharmacology, University of Mississippi Medical Center, USA
| | - Krystal T Chatman
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, USA
| | - Janae N Mosely
- Department of Pharmacology/Toxicology, University of Mississippi Medical Center, USA
| | - James N Martin
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, USA
| | - Christine A Purser
- Department of Pharmacology/Toxicology, University of Mississippi Medical Center, USA
| | - Rodney C Baker
- Department of Pharmacology/Toxicology, University of Mississippi Medical Center, USA
| | - Michelle T Owens
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, USA
| | - B Babbette Lamarca
- Department of Pharmacology/Toxicology, University of Mississippi Medical Center, USA
| |
Collapse
|
186
|
Pavek P, Smutny T. Nuclear receptors in regulation of biotransformation enzymes and drug transporters in the placental barrier. Drug Metab Rev 2013; 46:19-32. [PMID: 24020384 DOI: 10.3109/03602532.2013.835819] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Over the past 20 years, the toxicological and protective roles of the placental barrier with respect to drug detoxification and transporter-controlled protection of the fetus have been intensively examined. Several cytochrome P450 enzymes are expressed in placental trophoblast at different stages of pregnancy, though only a few of these have functional activity to metabolize xenobiotics. Drug transporters such as P-glycoprotein/MDR1 or breast cancer resistance protein (BCRP) are highly expressed in the placenta, and their functional activities have been demonstrated in the placenta both in vitro and in vivo. In addition, several studies have reported on ligand-activated transcription factors and nuclear receptors referred to as "xenosensors" in the placenta. The xenosensors control transcriptional regulation of both xenobiotic-metabolizing enzymes and drug transporters in different organs. Their ligands include toxic compounds and environmental pollutants, drugs, as well as herbal, dietary or vitamin supplements. Nevertheless, it remains debatable whether the placental barrier adapts to toxic injuries coming either from maternal medication or environmental contamination and whether the placenta contains a mechanism to respond dynamically in protecting the developing fetus. In the present paper, we summarize current knowledge about the activity and expression of major ligand-activated transcriptional mechanisms involved in biotransformation enzymes and transporters regulation in human placenta. In particular, we highlight the emerging roles of aryl hydrocarbon (AHR), vitamin D (VDR), glucocorticoid (GR) and pregnane X (PXR) receptors in that regulation. We show that the placenta constitute a unique metabolizing organ with significant overlap of exogenous and endogenous compounds metabolism controlled by nuclear receptors.
Collapse
Affiliation(s)
- Petr Pavek
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Centre for Drug Development, Charles University in Prague , Hradec Kralove , Czech Republic
| | | |
Collapse
|
187
|
Gernand AD, Bodnar LM, Klebanoff MA, Parks WT, Simhan HN. Maternal serum 25-hydroxyvitamin D and placental vascular pathology in a multicenter US cohort. Am J Clin Nutr 2013; 98:383-8. [PMID: 23803889 PMCID: PMC3712548 DOI: 10.3945/ajcn.112.055426] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Maternal vitamin D deficiency has been linked to fetal growth restriction, but the underlying mechanisms are unclear. OBJECTIVE We tested the hypothesis that poor maternal 25-hydroxyvitamin D [25(OH)D] is associated with increased risk of placental vascular pathology. DESIGN Maternal serum 25(OH)D was measured at ≤26 wk of gestation in a random subcohort of term, singleton infants in the Collaborative Perinatal Project (1959-1966; n = 2048). A dichotomous vascular construct was created from the presence of any of 12 pathologies identified on placental examinations, including evidence of placental abruption, infarction, hypoxia, decidual vasculopathy, or thrombosis of fetal vessels (n = 240 cases). RESULTS The relation between 25(OH)D and vascular pathology was modified by infant sex (P = 0.003). A maternal 25(OH)D concentration ≥80 compared with <50 nmol/L was associated with 49% lower risk of pathology in boys [adjusted OR (95% CI): 0.27, 0.95] after conditioning on study site. No associations were observed between maternal 25(OH)D and pathology in mothers with female offspring. Subsequent analyses showed that, in pregnancies with a female fetus, vascular pathology was associated with a reduced birth-weight z score when the mother's 25(OH)D concentration was <30 nmol/L (β: -0.73; 95% CI: -1.17, -0.30). No association was observed between pathology and birth weight in mothers of female offspring with 25(OH)D concentrations ≥30 nmol/L or in boys, regardless of maternal 25(OH)D status. CONCLUSIONS Our findings suggest complex relations between vitamin D, placental vascular pathology, and birth weight that differ by infant sex. Maternal vitamin D status may be beneficial for male and female offspring through different mechanisms.
Collapse
Affiliation(s)
- Alison D Gernand
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | | | | | | |
Collapse
|
188
|
Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc 2013; 88:720-55. [PMID: 23790560 PMCID: PMC3761874 DOI: 10.1016/j.mayocp.2013.05.011] [Citation(s) in RCA: 729] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/21/2013] [Accepted: 05/23/2013] [Indexed: 02/09/2023]
Abstract
It is now generally accepted that vitamin D deficiency is a worldwide health problem that affects not only musculoskeletal health but also a wide range of acute and chronic diseases. However, there remains cynicism about the lack of randomized controlled trials to support the association studies regarding the nonskeletal health benefits of vitamin D. This review was obtained by searching English-language studies published up to April 1, 2013, in PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials (search terms: vitamin D and supplementation) and focuses on recent challenges regarding the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D concentrations from dietary sources, supplements, and sun exposure. The effect of vitamin D on fetal programming epigenetics and gene regulation could potentially explain why vitamin D has been reported to have such wide-ranging health benefits throughout life. There is potentially a great upside to increasing the vitamin D status of children and adults worldwide for improving musculoskeletal health and reducing the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and mortality.
Collapse
Affiliation(s)
- Arash Hossein-nezhad
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin, and Bone Research Laboratory, Boston University Medical Center, Boston, MA
| | | |
Collapse
|
189
|
Wei SQ, Qi HP, Luo ZC, Fraser WD. Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2013; 26:889-99. [PMID: 23311886 DOI: 10.3109/14767058.2013.765849] [Citation(s) in RCA: 312] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To estimate the associations between maternal vitamin D status and adverse pregnancy outcomes. STUDY DESIGN We searched electronic databases of the human literature in PubMed, EMBASE and the Cochrane Library up to October, 2012 using the following keywords: "vitamin D" and "status" or "deficiency" or "insufficiency" and "pregnancy". A systematic review and meta-analysis were conducted on observational studies that reported the association between maternal blood vitamin D levels and adverse pregnancy outcomes including preeclampsia, gestational diabetes mellitus (GDM), preterm birth or small-for-gestational age (SGA). RESULTS Twenty-four studies met the inclusion criteria. Women with circulating 25-hydroxyvitamin D [25(OH)D] level less than 50 nmol/l in pregnancy experienced an increased risk of preeclampsia [odds ratio (OR) 2.09 (95% confidence intervals 1.50-2.90)], GDM [OR 1.38 (1.12-1.70)], preterm birth [OR 1.58 (1.08-2.31)] and SGA [OR 1.52 (1.08-2.15)]. CONCLUSION Low maternal vitamin D levels in pregnancy may be associated with an increased risk of preeclampsia, GDM, preterm birth and SGA.
Collapse
Affiliation(s)
- Shu-Qin Wei
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Canada.
| | | | | | | |
Collapse
|
190
|
Affiliation(s)
- Maysa Alzaim
- Department of Nutrition; University of Massachusetts; Amherst; Massachusetts; USA
| | - Richard J Wood
- Department of Nutrition; University of Massachusetts; Amherst; Massachusetts; USA
| |
Collapse
|
191
|
Abstract
Vitamin D deficiency is a preventable health problem. Vitamin D deficiency among pregnant women is frequent in many populations over the world. Research indicates that adequate vitamin D intake in pregnancy is optimal for maternal, fetal and child health. Adverse health outcomes during pregnancy are preeclampsia; gestational diabetes mellitus and caesarean section. Consequences in newborns are low birth weight, neonatal rickets, a risk of neonatal hypocalcaemia, asthma and/or type 1 diabetes. Vitamin D deficiency during pregnancy is the origin for a host of future perils for the child, especially effect on neurodevelopment and immune system. Some of this damage done by maternal Vitamin D deficiency gets evident after many years. Therefore, prevention of vitamin D deficiency among pregnant women is essential. The currently recommended supplementation amount of vitamin D is not sufficient to maintain a value of 25 hydroxy vitamin D above 30 ng/ml, during pregnancy. Studies are underway to establish the recommended daily doses of vitamin D in pregnant women. Clearly, further investigation is required into the effects of vitamin D, of vitamin D supplementation, and of vitamin D analogs for improvement in human health generally and mothers and children specifically. This review discusses vitamin D metabolism, dietary requirements and recommendations and implications of vitamin D deficiency during pregnancy and lactation.
Collapse
Affiliation(s)
- Manila Kaushal
- Department of Obsteterics and Gynaecology, MGM Medical College, Indore, Madhya Pradesh, India
| | - Navneet Magon
- Department of Obstetrics and Gynaecology, Obstetrician, Gynaecologist and Endoscopic Surgeon, Air Force Hospital, Kanpur, Uttar Pradesh, India
| |
Collapse
|
192
|
Gernand AD, Simhan HN, Klebanoff MA, Bodnar LM. Maternal serum 25-hydroxyvitamin D and measures of newborn and placental weight in a U.S. multicenter cohort study. J Clin Endocrinol Metab 2013; 98:398-404. [PMID: 23162094 PMCID: PMC3537090 DOI: 10.1210/jc.2012-3275] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Inconsistent associations between maternal vitamin D status and fetal size have been published in small studies. OBJECTIVE Our objective was to examine the association between maternal 25-hydroxyvitamin D [25(OH)D] levels and measures of newborn and placental weight. DESIGN AND SETTING We measured maternal 25(OH)D in mothers from the Collaborative Perinatal Project, an observational cohort conducted in 12 U.S. medical centers from 1959 to 1965. PARTICIPANTS Women delivering singleton, term, live births with 25(OH)D measured at a gestation of 26 wk or less (n = 2146). MAIN OUTCOME MEASURES Birth weight, ponderal index, placental weight, the placental to fetal weight ratio, and small for gestational age were measured. Hypotheses were formulated after data collection. RESULTS After confounder adjustment, mothers with 25(OH)D of 37.5 nmol/liter or greater gave birth to newborns with 46 g [95% confidence interval (CI), 9-82 g] higher birth weights and 0.13 cm (0.01-0.25 cm) larger head circumferences compared with mothers with less than 37.5 nmol/liter. Birth weight and head circumference rose with increasing 25(OH)D up to 37.5 nmol/liter and then leveled off (P < 0.05). No association was observed between 25(OH)D and ponderal index, placental weight, or the placental to fetal weight ratio. Maternal 25(OH)D of 37.5 nmol/liter or greater vs. less than 37.5 nmol/liter in the first trimester was associated with half the risk of small for gestational age (adjusted odds ratio 0.5; 95% CI 0.3-0.9), but no second-trimester association was observed. CONCLUSIONS Maternal vitamin D status is independently associated with markers of physiological and pathological growth in term infants. Adequately powered randomized controlled trials are needed to test whether maternal vitamin D supplementation may improve fetal growth.
Collapse
Affiliation(s)
- Alison D Gernand
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | | | | | | |
Collapse
|
193
|
Thorp JM, Camargo CA, McGee PL, Harper M, Klebanoff MA, Sorokin Y, Varner MW, Wapner RJ, Caritis SN, Iams JD, Carpenter MW, Peaceman AM, Mercer BM, Sciscione A, Rouse DJ, Ramin SM, Anderson GB. Vitamin D status and recurrent preterm birth: a nested case-control study in high-risk women. BJOG 2012; 119:1617-23. [PMID: 23078336 PMCID: PMC3546544 DOI: 10.1111/j.1471-0528.2012.03495.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether vitamin D status is associated with recurrent preterm birth, and any interactions between vitamin D levels and fish consumption. DESIGN A nested case-control study, using data from a randomised trial of omega-3 fatty acid supplementation to prevent recurrent preterm birth. SETTING Fourteen academic health centres in the USA. POPULATION Women with prior spontaneous preterm birth. METHODS In 131 cases (preterm delivery at <35 weeks of gestation) and 134 term controls, we measured serum 25-hydroxyvitamin D [25(OH)D] concentrations by liquid chromatography-tandem mass spectrometry (LC-MS) from samples collected at baseline (16-22 weeks of gestation). Logistic regression models controlled for study centre, maternal age, race/ethnicity, number of prior preterm deliveries, smoking status, body mass index, and treatment. MAIN OUTCOME MEASURES Recurrent preterm birth at <37 and <32 weeks of gestation. RESULTS The median mid-gestation serum 25(OH)D concentration was 67 nmol/l, and 27% had concentrations of <50 nmol/l. Serum 25(OH)D concentration was not significantly associated with preterm birth (OR 1.33; 95% CI 0.48-3.70 for lowest versus highest quartiles). Likewise, comparing women with 25(OH)D concentrations of 50 nmol/l, or higher, with those with <50 nmol/l generated an odds ratio of 0.80 (95% CI 0.38-1.69). Contrary to our expectation, a negative correlation was observed between fish consumption and serum 25(OH)D concentration (-0.18, P < 0.01). CONCLUSIONS In a cohort of women with a prior preterm birth, vitamin D status at mid-pregnancy was not associated with recurrent preterm birth.
Collapse
Affiliation(s)
- J M Thorp
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7570, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
194
|
Abstract
The Peri/postnatal Epigenetic Twins Study (PETS) is a longitudinal cohort of 250 pairs of Australian twins and their mothers, who were recruited mid-way through pregnancy from January 2007 to September 2009. The study is centered on the developmental origins of health and disease paradigm (DOHaD) in which an adverse intrauterine environment predisposes the individual to complex disease in later life by reducing growth in utero and adversely altering developmental plasticity. Data concerning diet and lifestyle were collected from mothers during pregnancy, and samples of plasma and serum taken at 28 weeks’ gestation. We attended 75% of all births, at which time we collected multiple biological samples including placenta, cord blood, and neonatal cheek cells, the latter from 91% of pairs. Chorionicity was recorded and zygosity was determined by DNA testing where necessary. Approximately 40% of the twins are monozygotic, two-thirds of which are dichorionic. Twins were seen again at 18 months of age and repeat blood and cheek swabs taken where possible. Studies of gene expression and the epigenetic marks of DNA methylation have so far revealed that twins exhibit a wide range of epigenetic discordance at birth, that one-third of the epigenome changes significantly between birth and 18 months; shared (maternal) environment, genetic factors, and non-shared intrauterine environment contribute to an increasing proportion of epigenetic variation at birth, respectively, and affect tissues differently, and that within-pair birth weight discordance correlates with epigenetic discordance in genes associated with lipid metabolism, supporting an epigenetic mechanism for DOHaD.
Collapse
|
195
|
Abstract
PURPOSE OF REVIEW Vitamin D has received global attention because of its many health benefits. Although there is general agreement about the importance of vitamin D for bone health, there remains skepticism about the nonskeletal health benefits of vitamin D. This review will not only focus on the vitamin D deficiency pandemic and ways to treat and prevent vitamin D deficiency but will also explore the epigenetic mechanisms of vitamin D that could help explain many of the nonskeletal benefits of enhancing vitamin D status. RECENT FINDINGS The Institute of Medicine and the Endocrine Society have made new recommendations for vitamin D intake to prevent vitamin D deficiency. Vitamin D deficiency is defined as a 25-hydroxyvitamin D level below 20 ng/ml and vitamin D insufficiency is defined as 21-29 ng/ml. Recent observations have suggested that vitamin D can influence epigenetics which may help explain the nonskeletal health benefits that have been reported for vitamin D. SUMMARY There is general agreement that vitamin D deficiency is a worldwide health problem. This is due in part to the lack of appreciation that sunlight is an important source of vitamin D. There is no downside to increasing vitamin D intake and recent observations suggesting that vitamin D influences epigenetics provide a new insight for the importance of vitamin D in utero in reducing risk of chronic diseases later in life.
Collapse
Affiliation(s)
- Arash Hossein-nezhad
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, Massachusetts 02118, USA
| | | |
Collapse
|
196
|
Cassidy-Bushrow AE, Peters RM, Johnson DA, Li J, Rao DS. Vitamin D Nutritional Status and Antenatal Depressive Symptoms in African American Women. J Womens Health (Larchmt) 2012; 21:1189-95. [DOI: 10.1089/jwh.2012.3528] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Dayna A. Johnson
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan
| | - Jia Li
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan
| | - D. Sudhaker Rao
- Bone & Mineral Research Laboratory, Henry Ford Hospital, Detroit, Michigan
| |
Collapse
|
197
|
Rajaei S, Mirahmadian M, Jeddi-Tehrani M, Tavakoli M, Zonoobi M, Dabbagh A, Zarnani AH. Effect of 1,25(OH)2 vitamin D3 on cytokine production by endometrial cells of women with repeated implantation failure. Gynecol Endocrinol 2012; 28:906-11. [PMID: 22616713 DOI: 10.3109/09513590.2012.683062] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Repeated implantation failure (RIF) is a worldwide health problem that imposes a great deal of cost on patients and health care system. Vitamin D(3) has been proposed to have positive impact on the process of implantation. The present study was performed to compare the effect of 1,25-dihydroxy vitamin D(3) (1,25(OH)(2)D(3)) on cytokine production by endometrial cells of women with RIF and healthy fertile controls. Whole endometrial cells (WECs) and endometrial stromal cells (ESCs) from RIF and normal fertile women were treated with 1,25(OH)(2)D(3). The levels of IL-10, TGF-β, IFNγ, Il-6, IL-8 and IL-17 in culture supernatants were assayed by ELISA. Also, ability of the cells from both groups to produce 1,25(OH)(2)D(3) was evaluated and compared. 1,25(OH)(2)D(3) down-regulated cytokine production in WECs from both groups except for IL-8 which was upraised. Similar trends were also observed in ESCs except up-regulation of TGF-β in RIF group. Endometrial cells of both groups had comparable capacity to produce 1,25(OH)(2)D(3). Based on the minimal differential immunoregulatory effect of vitamin D(3) on endometrial cells from RIF and control women, it may be suggested that circulating levels of maternal vitamin D(3) be the subject of further investigation.
Collapse
Affiliation(s)
- Samira Rajaei
- Department of Laboratory Sciences, Faculty of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | |
Collapse
|
198
|
Ma R, Gu Y, Zhao S, Sun J, Groome LJ, Wang Y. Expressions of vitamin D metabolic components VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR in placentas from normal and preeclamptic pregnancies. Am J Physiol Endocrinol Metab 2012; 303:E928-35. [PMID: 22871339 PMCID: PMC3469619 DOI: 10.1152/ajpendo.00279.2012] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Vitamin D insufficiency/deficiency during pregnancy has been linked to increased risk of preeclampsia. Placenta dysfunction plays an important role in the pathogenesis of this pregnancy disorder. In this study, we tested the hypothesis that disturbed vitamin D metabolism takes place in preeclamptic placentas. Protein expressions of vitamin D binding protein (VDBP), 25-hydroxylase (CYP2R1), 1α-hydroxylase (CYP27B1), 24-hydroxylase (CYP24A1), and vitamin D receptor (VDR) were examined in placentas from normotensive and preeclamptic pregnancies. By immunostaining we found that in normal placenta VDBP, CYP24A1, and VDR expressions are localized mainly in trophoblasts, whereas CYP2R1 and CYP27B1 expressions are localized mainly in villous core fetal vessel endothelium. Protein expressions of CYP2R1 and VDR are reduced, but CYP27B1 and CYP24A1 expressions are elevated, in preeclamptic compared with normotensive placentas. Because increased oxidative stress is an underlying pathophysiology in placental trophoblasts in preeclampsia, we further determined whether oxidative stress contributes to altered vitamin D metabolic system in placental trophoblasts. Trophoblasts isolated from normal-term placentas were treated with hypoxic-inducing agent CoCl(2), and protein expressions of VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR were determined. We found that hypoxia-induced downregulation of VDBP, CYP2R1, and VDR and upregulation of CYP27B1 and CYP24A1 expressions were consistent with that seen in preeclamptic placentas. CuZnSOD expression was also downregulated in trophoblasts treated with CoCl(2). These results provide direct evidence of disrupted vitamin D metabolic homeostasis in the preeclamptic placenta and suggest that increased oxidative stress could be a causative factor of altered vitamin D metabolism in preeclamptic placentas.
Collapse
Affiliation(s)
- Rong Ma
- Dept. of Obstetrics and Gynecology, LSUHSC-Shreveport, P. O. Box 33932, Shreveport, LA 71130, USA
| | | | | | | | | | | |
Collapse
|
199
|
Lamarca B. Endothelial dysfunction. An important mediator in the pathophysiology of hypertension during pre-eclampsia. MINERVA GINECOLOGICA 2012; 64:309-20. [PMID: 22728575 PMCID: PMC3796355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pre-eclampsia is defined as new onset hypertension with proteinuria during pregnancy. It affects approximately 5% of pregnancies in the US with a subset of those progressing into more severe forms of the disease, known as HELLP or eclampsia. Pre-eclampsia is associated with intrauterine growth restriction, chronic immune activation and multi-organ endothelial dysfunction thus contributing to the clinically visible elevation in maternal blood pressure. The end result is increased infant and maternal morbidity and mortality thereby contributing to the gross health care expenditure nationwide. Although the underlying cause of this disease is still unknown, the most well accepted hypothesis is that placental ischemia/hypoxia results from inadequate uteroplacental vascular remodeling, which leads to a decrease in placental blood flow. The ischemic placenta releases factors such as the soluble VEGF receptor-1 (sFlt-1), the angiotensin II type-1 receptor autoantibody (AT1-AA), and cytokines such as TNF-α and Interleukin 6 which cause maternal endothelial dysfunction characterized by elevated circulating endothelin (ET-1), reactive oxygen species (ROS), and enhanced vascular sensitivity to angiotensinII. These factors act in concert to decrease renal function and cause hypertension during pregnancy. Understanding the link between placental ischemia, endothelial dysfunction and hypertension during pregnancy will lend to better prediction, prevention and treatment strategies for women and children stricken by this devastating disease.
Collapse
Affiliation(s)
- B Lamarca
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, USA.
| |
Collapse
|
200
|
Novakovic B, Galati JC, Chen A, Morley R, Craig JM, Saffery R. Maternal vitamin D predominates over genetic factors in determining neonatal circulating vitamin D concentrations. Am J Clin Nutr 2012; 96:188-95. [PMID: 22648713 DOI: 10.3945/ajcn.112.035683] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There are multiple potential regulators of neonatal vitamin D status of environmental, genetic, and epigenetic origins. The relation between these factors and circulating neonatal vitamin D has yet to be fully characterized. OBJECTIVE The aim of this study was to examine the relative contribution of genetic factors, maternal circulating 25-hydroxyvitamin D [25(OH)D] concentrations, and the placental methylation level of the gene that encodes the primary catabolic enzyme of active vitamin D [25(OH)D-24-hydroxylase encoded by CYP24A1] to neonatal 25(OH)D concentrations. DESIGN We used the classical twin study design to determine the genetic contribution to neonatal 25(OH)D. A total of 86 twin pairs (32 monozygotic and 54 dizygotic twin pairs) were included in this study. Serum 25(OH)D was measured by using a 25(OH)D kit. CYP24A1 promoter DNA methylation was measured by means of matrix-assisted laser desorption time-of-flight mass spectrometry. RESULTS Maternal and neonatal 25(OH)D showed a strong association (R² = 0.19). Monozygotic and dizygotic within-pair serum 25(OH)D correlations were similar (R² = 0.71 and 0.67, respectively), which suggested no genetic effect. Placental CYP24A1 methylation did not show an association with maternal or neonatal 25(OH)D concentrations. CONCLUSIONS Our results suggest that maternal circulating 25(OH)D is the most significant regulator of neonatal circulating 25(OH)D concentrations, with underlying genetic factors playing a limited role. The placental methylation of the CYP24A1 promoter appears subject to a genetic influence, although no evidence of a relation between the methylation level of this gene and circulating maternal or neonatal 25(OH)D was apparent.
Collapse
Affiliation(s)
- Boris Novakovic
- Cancer and Disease Epigenetics Group, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia
| | | | | | | | | | | |
Collapse
|