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Association of Modifiable and Nonmodifiable Factors with Vitamin D Status in Pregnant Women and Neonates in Oakland, CA

      Abstract

      There is little information on the contribution of modifiable vs nonmodifiable factors to maternal and neonatal vitamin D status in temperate regions of the United States. The purpose of this cross-sectional observation study conducted between December 2006 and February 2008 was to identify associations between observed and measured maternal characteristics and vitamin D status at term in pregnant women and their infants in a multiethnic community in Oakland, CA. Two hundred seventy-five pregnant women aged 18 to 45 years and carrying a singleton fetus were recruited and data from 210 mother-infant pairs were included in analyses. Analysis of covariance identified predictors of maternal and cord serum 25-hydroxyvitamin D [25(OH)D] in a multivariate model considering vitamin D intake, lifestyle factors, and skin pigmentation. Maternal serum 25(OH)D was significantly associated with season of delivery (P=0.0002), average daily D intake (P=0.0008), right upper inner arm pigmentation (P=0.0035), and maternal pre- or early-pregnancy body mass index (calculated as kg/m2) (P=0.0207). The same factors were significant for cord serum 25(OH)D, which was highly correlated with maternal serum 25(OH)D (r=0.79; P<0.0001). During the year, 54% of mothers and 90% of neonates had 25(OH)D <30 ng/mL (<75 nmol/L). Of women taking daily prenatal vitamin/mineral supplements (400 IU vitamin D), 50.7% had serum 25(OH)D <30 ng/mL (<75 nmol/L). In conclusion, 25(OH)D <30 ng/mL (<75 nmol/L) was prevalent in mothers and neonates across racial groups and seasons, and vitamin D status was associated with both modifiable and nonmodifiable risk factors.
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      References

        • Bodnar L.M.
        • Simhan H.N.
        • Powers R.W.
        • Frank M.P.
        • Cooperstein E.
        • Roberts J.M.
        High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates.
        J Nutr. 2007; 137: 447-452
        • Bowyer L.
        • Catling-Paull C.
        • Diamond T.
        • Homer C.
        • Davis G.
        • Craig M.E.
        Vitamin D, parathyroid hormone and calcium levels in pregnant women and their neonates.
        Clin Endocrinol (Oxf). 2009; 70: 372-377
        • Farrant H.J.
        • Krishnaveni G.V.
        • Hill J.C.
        • Boucher B.J.
        • Fisher D.J.
        • Noonan K.
        • Osmond C.
        • Veena S.R.
        • Fall C.H.
        Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size.
        Eur J Clin Nutr. 2009; 63: 646-652
        • Holmes V.A.
        • Barnes M.S.
        • Alexander H.D.
        • McFaul P.
        • Wallace J.M.
        Vitamin D deficiency and insufficiency in pregnant women: A longitudinal study.
        Br J Nutr. 2009; 102: 876-881
        • Kazemi A.
        • Sharifi F.
        • Jafari N.
        • Mousavinasab N.
        High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population.
        J Womens Health (Larchmt). 2009; 18: 835-839
        • Lee J.M.
        • Smith J.R.
        • Philipp B.L.
        • Chen T.C.
        • Mathieu J.
        • Holick M.F.
        Vitamin D deficiency in a healthy group of mothers and newborn infants.
        Clin Pediatr (Phila). 2007; 46: 42-44
        • Maghbooli Z.
        • Hossein-Nezhad A.
        • Shafaei A.R.
        • Karimi F.
        • Madani F.S.
        • Larijani B.
        Vitamin D status in mothers and their newborns in Iran.
        BMC Pregnancy Childbirth. 2007; 7: 1
        • Nicolaidou P.
        • Hatzistamatiou Z.
        • Papadopoulou A.
        • Kaleyias J.
        • Floropoulou E.
        • Lagona E.
        • Tsagris V.
        • Costalos C.
        • Antsaklis A.
        Low vitamin D status in mother-newborn pairs in Greece.
        Calcif Tissue Int. 2006; 78: 337-342
        • Sachan A.
        • Gupta R.
        • Das V.
        • Agarwal A.
        • Awasthi P.K.
        • Bhatia V.
        High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India.
        Am J Clin Nutr. 2005; 81: 1060-1064
        • Weiler H.
        • Fitzpatrick-Wong S.
        • Veitch R.
        • Kovacs H.
        • Schellenberg J.
        • McCloy U.
        • Yuen C.K.
        Vitamin D deficiency and whole-body and femur bone mass relative to weight in healthy newborns.
        CMAJ. 2005; 172: 757-761
        • Yu C.K.
        • Sykes L.
        • Sethi M.
        • Teoh T.G.
        • Robinson S.
        Vitamin D deficiency and supplementation during pregnancy.
        Clin Endocrinol (Oxf). 2009; 70: 685-690
        • Salle B.L.
        • Delvin E.E.
        • Lapillonne A.
        • Bishop N.J.
        • Glorieux F.H.
        Perinatal metabolism of vitamin D.
        Am J Clin Nutr. 2000; 71: 1317S-1324S
        • Holick M.F.
        Resurrection of vitamin D deficiency and rickets.
        J Clin Invest. 2006; 116: 2062-2072
        • Karatekin G.
        • Kaya A.
        • Salihoglu O.
        • Balci H.
        • Nuhoglu A.
        Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers.
        Eur J Clin Nutr. 2009; 63: 473-477
        • Levenson C.W.
        • Figueiroa S.M.
        Gestational vitamin D deficiency: Long-term effects on the brain.
        Nutr Rev. 2008; 66: 726-729
        • Morley R.
        • Carlin J.B.
        • Pasco J.A.
        • Wark J.D.
        Maternal 25-hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size.
        J Clin Endocrinol Metab. 2006; 91: 906-912
        • Lucas R.M.
        • Ponsonby A.L.
        • Pasco J.A.
        • Morley R.
        Future health implications of prenatal and early-life vitamin D status.
        Nutr Rev. 2008; 66: 710-720
        • Merewood A.
        • Mehta S.D.
        • Chen T.C.
        • Bauchner H.
        • Holick M.F.
        Association between vitamin D deficiency and primary cesarean section.
        J Clin Endocrinol Metab. 2009; 94: 940-945
        • Bodnar L.M.
        • Catov J.M.
        • Simhan H.N.
        • Holick M.F.
        • Powers R.W.
        • Roberts J.M.
        Maternal vitamin D deficiency increases the risk of preeclampsia.
        J Clin Endocrinol Metab. 2007; 92: 3517-3522
        • Clifton-Bligh R.J.
        • McElduff P.
        • McElduff A.
        Maternal vitamin D deficiency, ethnicity and gestational diabetes.
        Diabet Med. 2008; 25: 678-684
        • Zhang C.
        • Qiu C.
        • Hu F.B.
        • David R.M.
        • van Dam R.M.
        • Bralley A.
        • Williams M.A.
        Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus.
        PLoS ONE. 2008; 3: e3753
        • Kreiter S.R.
        • Schwartz R.P.
        • Kirkman Jr, H.N.
        • Charlton P.A.
        • Calikoglu A.S.
        • Davenport M.L.
        Nutritional rickets in African American breast-fed infants.
        J Pediatr. 2000; 137: 153-157
        • Shah M.
        • Salhab N.
        • Patterson D.
        • Seikaly M.G.
        Nutritional rickets still afflict children in north Texas.
        Tex Med. 2000; 96: 64-68
        • Tomashek K.M.
        • Nesby S.
        • Scanlon K.S.
        • Cogswell M.E.
        • Powell K.E.
        • Parashar U.D.
        • Mellinger-Birdsong A.
        • Grummer-Strawn L.M.
        • Dietz W.H.
        Nutritional rickets in Georgia.
        Pediatrics. 2001; 107: E45
        • National Nutrient Database for Standard Reference
        USDA ARS National Nutrient Labratory.
        (Accessed August 5, 2007)
        • Hall L.M.
        • Kimlin M.G.
        • Aronov P.A.
        • Hammock B.D.
        • Slusser J.R.
        • Woodhouse L.R.
        • Stephensen C.B.
        Vitamin D intake needed to maintain target serum 25-hydroxyvitamin D concentrations in participants with low sun exposure and dark skin pigmentation is substantially higher than current recommendations.
        J Nutr. 2010; 140: 542-550
        • Webb A.R.
        Who, what, where and when-influences on cutaneous vitamin D synthesis.
        Prog Biophys Mol Biol. 2006; 92: 17-25
        • Holick M.F.
        • Chen T.C.
        • Lu Z.
        • Sauter E.
        Vitamin D and skin physiology: A D-lightful story.
        J Bone Miner Res. 2007; 22: V28-V33

      Biography

      D. K. Dror is a postdoctoral nutritionist, US Department of Agriculture, Agricultural Research Services, Western Human Nutrition Research Center, Davis, CA; at the time of the study, she was a graduate student researcher, Department of Nutrition, University of California, Davis.

      Biography

      J. C. King is a senior scientist, Children's Hospital and Research Center, Oakland, CA.

      Biography

      D. J. Durand is a neonatologist, Children's Hospital and Research Center, Oakland, CA.

      Biography

      L. H. Allen is director, US Department of Agriculture, Agricultural Research Services, Western Human Nutrition Research Center, Davis, CA.