[Factors associated with the prevalence of hypovitaminosis D in pregnant women and their newborns]

The relationship between vitamin D levels in umbilical cord blood and infantile eczema

A total of 179 normal full-term pregnant women and their newborns were randomly selected. Umbilical venous blood was extracted after the delivery, and the serum level of 25(OH)D3 was measured. Forty 2 days, 3 months, 6 months, and one year after the birth to be asked about the occurrence and development of infant eczema. Thirteen cases were lost to follow-up. The median concentration of 25(OH)D3 in the cord blood was 25.40 ng/mL. Thirty eight cases (22.9%) were vitamin D deficient (<20 ng/mL), 77 cases (46.4%) were vitamin D insufficient (20-30 ng/mL), and 51 cases (30.7%) were vitamin D sufficient (≥30 ng/mL). The incidence of eczema in the umbilical cord blood vitamin D sufficient group was lower than that in the deficient and insufficient groups (p < .05). Sufficient umbilical cord blood vitamin D levels are associated with a lower incidence of eczema in infants up to one year of age. IMPACT STATEMENTWhat is already known on this subject? A number of studies have suggested that vitamin D levels in early life are related to the occurrence of allergic diseases, but the conclusions are not uniform.What do the results of this study add? The rate of sufficient umbilical cord blood vitamin D was low in the Songjiang area of Shanghai. Sufficient umbilical cord blood vitamin D levels (≥30 ng/mL) are associated with a lower incidence of eczema in infants up to 1 year of age.What are the implications of these findings for clinical practice and/or further research? At present, the dose of vitamin D for pregnant women at home and abroad is not consistent, so the specific dose of vitamin D for pregnant women to maintain the foetus needs further discussion. It is expected that a reasonable recommended dose can be developed to reduce the risk of allergic diseases in future generations from a primary prevention perspective.

25(OH)Vitamin D Deficiency and Calcifediol Treatment in Pediatrics

Vitamin D is essential for the normal mineralization of bones during childhood. Although diet and adequate sun exposure should provide enough of this nutrient, there is a high prevalence of vitamin D deficiency rickets worldwide. Children with certain conditions that lead to decreased vitamin D production and/or absorption are at the greatest risk of nutritional rickets. In addition, several rare genetic alterations are also associated with severe forms of vitamin-D-resistant or -dependent rickets. Although vitamin D3 is the threshold nutrient for the vitamin D endocrine system (VDES), direct measurement of circulating vitamin D3 itself is not a good marker of the nutritional status of the system. Calcifediol (or 25(OH)D) serum levels are used to assess VDES status. While there is no clear consensus among the different scientific associations on calcifediol status, many clinical trials have demonstrated the benefit of ensuring normal 25(OH)D serum levels and calcium intake for the prevention or treatment of nutritional rickets in childhood. Therefore, during the first year of life, infants should receive vitamin D treatment with at least 400 IU/day. In addition, a diet should ensure a normal calcium intake. Healthy lifestyle habits to prevent vitamin D deficiency should be encouraged during childhood. In children who develop clinical signs of rickets, adequate treatment with vitamin D and calcium should be guaranteed. Children with additional risk factors for 25(OH)D deficiency and nutritional rickets should be assessed periodically and treated promptly to prevent further bone damage.

Prevalence and Correlates of Vitamin D Deficiency among Young South African Infants: A Birth Cohort Study

Early-life vitamin D deficiency is associated with adverse child health outcomes, but the prevalence of vitamin D deficiency and its correlates in infants remains underexplored, particularly in sub-Saharan Africa. We aimed to investigate the prevalence of vitamin D deficiency and its correlates among young infants in South Africa. This study included 744 infants, aged 6–10 weeks from the Drakenstein Child Health Study, a population-based birth cohort. Infants were categorized into distinct categories based on serum 25(OH)D concentration level including deficient (<50 nmol/L), insufficient (50–74 nmol/L), and sufficient (≥75 nmol/L). Using multivariable Tobit and logistic regression models, we examined the correlates of serum 25(OH)D₃ levels. The overall prevalence of vitamin D deficiency was 81% (95% confidence intervals (CI]) 78–83). Multivariable regression analysis showed that serum 25(OH)D₃ concentration was independently associated with study site, socioeconomic status, and sex. Birth in winter and breastfeeding were the strongest predictors of lower serum 25(OH)D₃ concentration levels. Compared to non-breastfed children, children breastfed were at higher risk of vitamin D deficiency (AOR, 1.96; 95% CI, 1.04–3.67) and breastfeeding for more than one month was associated with greater likelihood of vitamin D deficiency (AOR, 5.40; 95% CI, 2.37–12.32) and lower vitamin D concentrations (−16.22 nmol/L; 95% CI, −21.06, −11.39). Vitamin D deficiency in infants is ubiquitous, under-recognised, and strongly associated with season of birth and breastfeeding in this setting. Nutritional interventions with vitamin D supplementation in national health programs in low- and middle-income countries are urgently needed to improve early-life vitamin D status in infants.

Micronutrients in Multiple Pregnancies-The Knowns and Unknowns: A Systematic Review

Maternal diet and nutritional status are of key importance with regard to the short- and long-term health outcomes of both the mother and the fetus. Multiple pregnancies are a special phenomenon in the context of nutrition. The presence of more than one fetus may lead to increased metabolic requirements and a faster depletion of maternal macro- and micro- nutrient reserves than in a singleton pregnancy. The aim of this systematic review was to gather available knowledge on the supply and needs of mothers with multiple pregnancies in terms of micronutrients and the epidemiology of deficiencies in that population. It was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). The authors conducted a systematic literature search with the use of three databases: PubMed/MEDLINE, Scopus and Embase. The last search was run on the 18 October 2020 and identified 1379 articles. Finally, 12 articles and 1 series of publications met the inclusion criteria. Based on the retrieved studies, it may be concluded that women with multiple pregnancies might be at risk of vitamin D and iron deficiencies. With regard to other microelements, the evidence is either inconsistent, scarce or absent. Further in-depth prospective and population studies are necessary to determine if nutritional recommendations addressed to pregnant women require adjustments in cases of multiple gestations.

Prevalence and risk factors of hypovitaminosis D in pregnant Spanish women

The hypovitaminosis D epidemic is a global health problem. Our aim was to assess the prevalence and potential risk factors of hypovitaminosis D among pregnant women on the eastern Mediterranean coast. Cross-sectional analysis involved 793 healthy pregnant women (35.3 ± 5.0 years) participating in ECLIPSES, a multicenter randomized trial. Socio-demographic, obstetric, anthropometric, lifestyle, dietary variables and blood draw was collected in the first trimester. Vitamin D deficiency was identified in 50.2% and insufficiency in 30.3% of pregnant women. The mean vitamin D level in the overall sample was 33.9 nmol/L (SD, 17.0). Multivariable logistic regression analysis applying AIC-based backward selection identified excess weight during the 1st trimester (BMI ≥ 25 kg/m²) (OR = 1.950, 95% CI = 1.409, 2.699), Arab ethnic group/dark skin colour (OR = 4.005, 95% CI = 2.488, 6.447), winter/spring (OR = 4.319, 95% CI = 3.112, 5.994), and consumption of milk (OR = 0.754, 95% CI = 0.572, 0.993) and yogurt (OR = 0.635, 95% CI = 0.436, 0.922) as independent risk factors for vitamin D deficiency. All of these factors (except yogurt consumption) and physical activity were independently associated with vitamin D deficiency/insufficiency risk in the final multivariable model (all p < 0.05). All these factors and social class were the most important determinants of circulating 25(OH)D concentrations. Our results confirm a high prevalence of vitamin D deficiency and insufficiency among pregnant women from the eastern Mediterranean coast.