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Meirina F, Sari DK, Lubis IND, Daulay RS, Yani FF, Lubis BM, Sembiring RJ, Pandia P, Rusda M, Amin MM. Comprehension of Calcitriol Levels in Pregnant Women With Latent Tuberculosis and Immune Function in their Newborns. Immunotargets Ther 2024; 13:195-204. [PMID: 38617600 PMCID: PMC11012620 DOI: 10.2147/itt.s436765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/08/2024] [Indexed: 04/16/2024] Open
Abstract
Background Pregnant women with latent tuberculosis infection (LTBI) may develop active tuberculosis infection and could infect their neonates, which could impair the child's immune system due to infection-mediated immunological responses. In order to develop a preventative TB program in this study, we desired to understand the impact of calcitriol in LTBI pregnant women and immunological responses in neonates. Patients and Methods In three hospitals in Medan, North Sumatra, we implemented a case-control design with 84 pregnant women in their third trimester and their newborns. We determined the levels of calcitriol, cathelicidin, and interferon gamma (IFN-γ) in women between December 2021 and July 2022. These measurements were then compared to the newborns' levels of calcitriol, cathelicidin, IFN-γ, and Toll-Like Receptor (TLR) 2. Analyses were performed using the Chi-squared and Fisher's tests, while Spearman correlations were employed to assess for correlations. Results 42 pregnant women with LTBI (interferon gamma release assay (IGRA) positive) and 42 pregnant women without LTBI (IGRA negative) participated in the study. The findings demonstrated that pregnant women with LTBI were at increased risk for calcitriol deficiency (Odds Ratio (OR) = 3.667, p = 0.006), which had an impact on the calcitriol levels of their unborn children (p = 0.038). TLR2 levels and calcitriol levels were substantially associated with LTBI pregnant women and their healthy neonates (p = 0.048; p = 0.005). Cathelicidin levels in the newborns of non-LTBI pregnant women were influenced by their higher calcitriol levels (p = 0.043). Pregnant women with LTBI had higher levels of cathelicidin and IFN-γ than those without it (p = 0.03; p = 0.001). Conclusion Pregnant LTBI women's calcitriol levels had an impact on the calcitriol levels of their newborns. Mother's immunological responses and babies' calcitriol levels affected the levels of cathelicidin, IFN-γ, and TLR2 in newborns.
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Affiliation(s)
- Fathia Meirina
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dina Keumala Sari
- Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Rini Savitri Daulay
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Finny Fitry Yani
- Department of Pediatrics, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | - Bugis Mardina Lubis
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Rosita Juwita Sembiring
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Pandiaman Pandia
- Department of Pulmonology and Respiratory, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Muhammad Rusda
- Department of Obstetrics & Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Mustafa Mahmud Amin
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Palmrich P, Thajer A, Schirwani N, Haberl C, Zeisler H, Ristl R, Binder J. Longitudinal Assessment of Serum 25-Hydroxyvitamin D Levels during Pregnancy and Postpartum-Are the Current Recommendations for Supplementation Sufficient? Nutrients 2023; 15:nu15020339. [PMID: 36678210 PMCID: PMC9863354 DOI: 10.3390/nu15020339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
(1) Background: Pregnant women are at risk of vitamin D deficiency. Data on pregnancy outcomes in women with vitamin D deficiency during pregnancy are controversial, and prospective longitudinal data on vitamin D deficiency with consistent definitions in pregnant women are scarce. (2) Methods: The aim of this prospective longitudinal cohort study was to investigate 25-hydroxyvitamin D levels over the course of pregnancy and postpartum in singleton and twin pregnancies with regard to dietary and supplemental vitamin D intake and environmental factors influencing vitamin D levels, evaluated by a standardized food frequency questionnaire. (3) Results: We included 198 healthy singleton and 51 twin pregnancies for analysis. A total of 967 study visits were performed over a 3-year period. Overall, 59.5% of pregnant women were classified as vitamin D deficient in the first trimester, 54.8% in the second trimester, 58.5% in the third trimester, 66.9% at birth, and 60% 12 weeks postpartum, even though 66.4% of the study population reported daily pregnancy vitamin intake containing vitamin D. Dietary vitamin D intake did not affect vitamin D levels significantly. (4) Conclusions: The majority of pregnant women evaluated in this study were vitamin D deficient, despite administration of pregnancy vitamins containing vitamin D. Individualized vitamin D assessment during pregnancy should be considered to ensure adequate supplementation and prevention of hypovitaminosis D.
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Affiliation(s)
- Pilar Palmrich
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence:
| | - Alexandra Thajer
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Pediatric Intensive Care Medicine and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
| | - Nawa Schirwani
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Christina Haberl
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Harald Zeisler
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Robin Ristl
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, 1090 Vienna, Austria
| | - Julia Binder
- Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
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Tareke AA, Alem A, Debebe W, Bayileyegn NS, Abebe MS, Abdu H, Zerfu TA. Maternal vitamin D and growth of under-five children: a systematic review and meta-analysis of observational and interventional studies. Glob Health Action 2022; 15:2102712. [PMID: 36043560 PMCID: PMC9448399 DOI: 10.1080/16549716.2022.2102712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Even though previous systematic reviews have reported on the role of prenatal vitamin D on birth outcomes, its effect on child growth is poorly understood. Objective To synthesize a systematic summary of the literature on the effect of maternal vitamin D supplementation on the linear growth of under-five children. Method This study includes studies (both observational and interventional with a control group) that evaluated the effects of prenatal vitamin D status on child linear growth. The mean child length/length for age with 95% confidence interval (CI) was pooled as the weighted mean difference using a random-effects model. A funnel plot was used to assess potential publication bias. Results A total of 45 studies and 66 reports covering a total population of 44,992 (19,683 intervention or high vitamin D group, and 25,309 control or low vitamin D group) were analyzed. Studies spanned from 1977 to 2022. The pooled weighted mean difference was 0.4 cm (95% CI: 0.15–0.65). A subgroup analysis, based on vitamin D supplementation frequency, showed that mothers who supplemented monthly or less frequently had a 0.7 cm (95% CI: 0.2–1.16 cm) longer child. Supplementation with a dose of >2000 international units increased child length at birth. The weighted mean difference was 0.35 cm (95% CI: 0.11–0.58). Conclusion The evidence from this review shows that maternal supplementation of vitamin D is associated with increased birth length. This is apparent at higher doses, low frequency (monthly or less frequent), and during the second/third trimester. It appears that vitamin D supplementation during pregnancy is protective of future growth in under-five children. Clinical trials are needed to establish evidence of effectiveness for the frequency and dose of supplementation.
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Affiliation(s)
- Amare Abera Tareke
- Department of Biomedical Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Addis Alem
- Department of Biomedical Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Wondwosen Debebe
- Department of Biomedical Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Melese Shenkut Abebe
- Department of Biomedical Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Hussen Abdu
- Department of Biomedical Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Taddese Alemu Zerfu
- Global Academy of Agriculture and Food security, Royal (Dick) School of Veterinary Studies, University of Edinburgh (UoE), UK.,College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
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Aghaei F, Heidarnia A, Allahverdipour H, Eslami M, Ghaffarifar S. Knowledge, attitude, performance, and determinant factors of Vitamin D deficiency prevention behaviours among Iranian pregnant women. Arch Public Health 2021; 79:224. [PMID: 34893075 PMCID: PMC8662894 DOI: 10.1186/s13690-021-00712-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 10/17/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Pregnancy is a high-risk period for vitamin D (Vit D) deficiency, and there is a direct relationship between Vit D deficiency during this period and maternal and fetal complications. Therefore, this study aimed to assess the knowledge, attitude, and practice of pregnant women concerning the adoption of behaviors to prevent Vit D deficiency and identify the determinant factors of such behaviors. METHODS In this cross-sectional study, 185 pregnant women with a mean age of 27.52 ± 5.9 years were selected from the Health Centers in Tabriz, Iran, using the stratified random sampling between 2018 September 23 and 2019 June 21. Data were collected using a researcher-made questionnaires comprising demographic information, knowledge, attitude, and practice of pregnant women towards Vit D deficiency. The chi-square test and Fisher's exact test were used to determine the relationship between the demographics of pregnant women and their knowledge and attitude. Moreover, the general linear model test was used to determine the predictors of performance. The p-value< 0.05 was considered to be significant in this study. RESULTS The findings showed that 85.6% of pregnant women were well aware of the importance and role of Vit D in pregnancy. In addition, 76.7 and 75% of the participants had good knowledge of getting enough Vit D from sunlight and preventing Vit D deficiency in pregnancy, respectively. Moreover, 91.7% of the pregnant women believed that Vit D has a vital role in maternal and fetal health, and 61.1% showed a high level of perceived self-efficiency in preventing Vit D deficiency. In addition, 67.2% of women regarded the unpleasant taste and price of Vit D rich foods, such as seafood, as barriers to get Vit D, and 91.7% mentioned the lack of public places specific to women and living in apartments as barriers to getting enough Vit D from sunlight. According to the results, 57.8 and 79.4% of pregnant women performed at a moderate level in getting Vit D from food and sunlight, respectively. In general, educational attainment (Pvalue = 0.02, B = 0.56), pregnancy age (Pvalue = 0.04, B = -0.26), parity (Pvalue = 0.03, B = -0.45), and perceived self-efficacy of mothers (Pvalue < 0.001, B = 0.340) were the determinant factors of getting Vit D from food and sunlight as behaviours to prevent Vit D deficiency in pregnancy. CONCLUSION The findings of the current study revealed that despite the good knowledge of women about the Vit D deficiency during pregnancy, their performance was moderate. The unpleasant taste and high price of seafood were barriers to using them, and the lack of public places specific to women and living in apartments, were barriers to using sunlight. The most important determinant of preventive behaviours was perceived self-efficacy. Developing an awareness program to promote best practices in pregnant women is essential to prevent vitamin D deficiency.
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Affiliation(s)
- Farideh Aghaei
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Alireza Heidarnia
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, School of Health, Tabriz, Iran
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Eslami
- Department of Population Health, Family and Schools Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Saeideh Ghaffarifar
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Chen B, Chen Y, Xu Y. Vitamin D deficiency in pregnant women: Influenced by multiple risk factors and increase the risks of spontaneous abortion and small-for-gestational age. Medicine (Baltimore) 2021; 100:e27505. [PMID: 34731133 PMCID: PMC8519205 DOI: 10.1097/md.0000000000027505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/23/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To analyze the level of vitamin D and its influencing factors in pregnant women, and to explore the influence of vitamin D deficiency on common adverse pregnancy outcomes in pregnant women, providing evidence for prevention and intervention of vitamin D deficiency in pregnant women. METHODS The basic data and blood samples of pregnant women in our hospital from January 2019 to June 2020 were collected, and the 25-(OH) D levels of the serum samples were detected. Then the vitamin D levels and its influencing factors were analyzed, and the relationships between vitamin D levels and common adverse pregnancy outcomes in the pregnant women as well as the incidence of small-for-gestational-age newborns were analyzed. RESULTS The vitamin D deficiency rate, insufficiency rate and sufficiency rate of pregnant women were 83.28%, 15.36%, and 1.36% respectively, with vast majority of the pregnant women in a state of vitamin D deficiency. Analysis of the influencing factors on the vitamin D level of pregnant women showed "28 weeks ≤ gestational age ≤32 weeks, summer and autumn, high school education and above, weekly time outdoors ≥10 hours, supplement of vitamin D and trace elements during pregnancy" were protective factors for vitamin D sufficiency in pregnant women. Linear correlation analysis showed the vitamin D level of pregnant women was highly positively correlated with temperature, the higher the temperature, the higher the vitamin D level (r = 0.907, t = 6.818, P < .001). The level of vitamin D in pregnant women was related to the occurrence of spontaneous abortion and small-for-gestational age (SGA), with the incidence of spontaneous abortion and SGA in the "vitamin D deficiency group" higher than those of other groups (P = .018, P = .016). CONCLUSIONS The vitamin D level of pregnant women in this area is relatively low, which is affected by multiple factors such as gestational age, season, education level of pregnant women, weekly time outdoors, vitamin D and trace element supplement during pregnancy. Low vitamin D levels can increase the risk of spontaneous abortion and SGA in pregnant women, so relevant measures should be adopted to improve the vitamin D status of pregnant women.
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Affiliation(s)
- Bo Chen
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Nuclear Medicine, Chaohu Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yongquan Chen
- Xiamen Key Laboratory of Biomarker Translational Medicine, Medical Laboratory of Xiamen Humanity Hospital Fujian Medical University, Xiamen, Fujian, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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The Association between Maternal Serum Vitamin D Levels and Gestational Diabetes Mellitus among Filipino Patients: A Cross-Sectional Study. J ASEAN Fed Endocr Soc 2021; 35:169-175. [PMID: 33442188 PMCID: PMC7784173 DOI: 10.15605/jafes.035.02.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/16/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To determine the association between low maternal serum vitamin D and gestational diabetes mellitus (GDM) among Filipino women in St. Luke’s Medical Center, Quezon City. Methodology A cross-sectional study involving pregnant women at outpatient clinics in a tertiary hospital in the Philippines. Simultaneous testing for fasting blood sugar, 75g oral glucose tolerance test and serum vitamin D was done. Participants were classified as GDM versus non-GDM, and normal versus low serum vitamin D. Univariate and multivariate statistics were done to determine relationship between vitamin D and GDM. Results Of 211 included women, 198 (93.8%) had low vitamin D levels, and 56 (26.5%) had GDM. Vitamin D was significantly higher in the GDM group (21.0±8.1 vs 18.8±5.3 ng/mL, p=0.0189). The proportion of women with low vitamin D levels was significantly higher among those without GDM (96.1% vs 87.5%, OR=0.28, p=0.029]. After adjusting for age, parity, history of GDM and pre-pregnancy BMI, no significant association was observed (adjusted OR=0.66, p=0.522). No correlation was seen between vitamin D and FBS (r=0.28, p=0.095), 1-hour post-75 g OGTT (r=0.26, p=0.643), and 2-hour post-75 g OGTT (r=0.28, p=0.113). Conclusion There was an association found between maternal serum vitamin D level and GDM in the univariate analysis, but none was evident after adjusting for possible confounders. The unanticipated high prevalence of low vitamin D levels among pregnant Filipinos needs to be verified in future studies.
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