Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population

• Published in: The American journal of clinical nutrition 2014-02, Vol.99 (2), p.287-295
• Main Authors: Schneuer, Francisco J, Roberts, Christine L, Guilbert, Cyrille, Simpson, Judy M, Algert, Charles S, Khambalia, Amina Z, Tasevski, Vitomir, Ashton, Anthony W, Morris, Jonathan M, Nassar, Natasha
• Format: Article
• Language: English
• Subjects: abortion (animals); Abortion, Spontaneous - blood; Abortion, Spontaneous - etiology; Adult; blood serum; Case-Control Studies; clinical nutrition; Clinical outcomes; Diabetes, Gestational - blood; Diabetes, Gestational - etiology; Female; fetal death; gestational diabetes; Humans; Logistic Models; Maternal & child health; Maternal Nutritional Physiological Phenomena; Medical screening; Multivariate Analysis; New South Wales; pre-eclampsia; Pre-Eclampsia - blood; Pre-Eclampsia - etiology; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - etiology; Pregnancy Outcome; Pregnancy Trimester, First - physiology; premature birth; Premature Birth - blood; Premature Birth - etiology; regression analysis; Risk Factors; ROC Curve; screening; small for gestational age; socioeconomic status; Stillbirth; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; women
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.113.065672

Background: Low serum 25-hydroxyvitamin D [25(OH)D] concentrations during pregnancy have been associated with adverse pregnancy outcomes in a few studies but not in other studies.Objectives: We assessed the serum 25(OH)D concentration at 10–14 wk of pregnancy and its association with adverse pregnancy outcomes and examined the predictive accuracy.Design: In this nested case-control study, we measured serum 25(OH)D in 5109 women with singleton pregnancies who were attending first-trimester screening in New South Wales, Australia. Multivariate logistic regression was conducted to examine the association between low 25(OH)D concentrations and adverse pregnancy outcomes (small for gestational age, preterm birth, preeclampsia, gestational diabetes, miscarriage, and stillbirth). The predictive accuracy of models was assessed.Results: The median (IQR) 25(OH)D concentration for the total population was 56.4 nmol/L (43.3–69.8 nmol/L). Serum 25(OH)D concentrations showed significant variation by parity, smoking, weight, season of sampling, country of birth, and socioeconomic status. After adjustment for maternal and clinical risk factors, low 25(OH)D concentrations were not associated with most adverse pregnancy outcomes. The area under the receiver operating characteristic curve (AUC) and likelihood ratio for a composite of severe adverse pregnancy outcomes of 25(OH)D concentrations