The Association of Prenatal Vitamin D Status With Pregnancy and Neonatal Outcomes

Di Mao; Lai-Yuk Yuen; Chung-Shun Ho; Chi-Chiu Wang; Claudia Ha-Ting Tam; Michael Ho-Ming Chan; William L Lowe Jr; Ronald Ching-Wan Ma; Wing-Hung Tam

doi:10.1210/jendso/bvad142

The Association of Prenatal Vitamin D Status With Pregnancy and Neonatal Outcomes

J Endocr Soc. 2023 Nov 20;8(1):bvad142. doi: 10.1210/jendso/bvad142. eCollection 2023 Dec 1.

Authors

Di Mao¹, Lai-Yuk Yuen¹, Chung-Shun Ho², Chi-Chiu Wang^{1

3

4}, Claudia Ha-Ting Tam⁵, Michael Ho-Ming Chan², William L Lowe Jr⁶, Ronald Ching-Wan Ma^{3

5

7}, Wing-Hung Tam¹

Affiliations

¹ Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
² Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China.
³ Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁴ School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁵ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁶ Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
⁷ Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.

Abstract

Context: Vitamin D inadequacy is globally prevalent among pregnant women; however, its impact on pregnancy remains inconclusive.

Objective: This study aims to explore the associations of maternal and umbilical cord serum 25-hydroxyvitamin D (25(OH)D) levels with pregnancy and neonatal outcomes.

Method: We used archived serum samples from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study participants in the Hong Kong center and assayed maternal 25(OH)D levels at midgestation and umbilical cord 25(OH)D at birth using liquid chromatography-tandem mass spectroscopy. Data regarding pregnancy and perinatal outcomes were extracted from the HAPO study dataset and the hospital computerized medical system.

Results: Only 247 (16.4%) mothers and 66 (5.0%) neonates met the criteria for vitamin D sufficiency (ie, 25(OH)D ≥ 75 nmol/L). The ratio of umbilical cord to maternal vitamin D levels was positively associated with maternal age and ambient solar radiation at the month of delivery, while negatively associated with maternal serum total 25(OH)D at midgestation (all P < .001). Umbilical cord serum 25(OH)D was independently associated with a lower primary cesarean section rate (OR 0.990, 95% CI 0.982-0.999; P = .032). There were no associations of maternal and umbilical cord 25(OH)D levels with other adverse pregnancy and neonatal outcomes.

Conclusion: Placental vitamin D transfer was found to be higher with a lower maternal vitamin D level, older maternal age, and higher ambient solar radiation at the time of the delivery. The protective effect of sufficient vitamin D in a cesarean section will require further studies.

Keywords: maternal; neonatal outcomes; placental transfer; pregnancy outcomes; umbilical cord; vitamin D.

Abstract

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