Vitamin D insufficiency among Danish pregnant women – prevalence and association with adverse obstetric outcomes and placental vitamin D metabolism

2020 ◽  
Author(s):  
Anna Louise Vestergaard ◽  
Signe Justesen ◽  
Tabia Volqvartz ◽  
Sissel K. Aagaard ◽  
Mette F. Andreasen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Insufficiency ◽  
Obstetric Outcomes ◽  
Vitamin D Metabolism

scholarly journals Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period

2019 ◽  
Vol 37 (14) ◽  
pp. 1446-1454 ◽  
Author(s):  
Kristi R. Van Winden ◽  
Allison Bearden ◽  
Naoko Kono ◽  
Toni Frederick ◽  
Eva Operskalski ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Group B Streptococcus ◽  
Perinatal Outcomes ◽  
Obstetric Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Vitamin D Metabolism ◽  
Vitamin D Levels ◽  
Induced Hypertension ◽  
The Impact

Objective To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women. Study Design This is a retrospective cohort study evaluating the impact of low maternal vitamin D levels on PIH and perinatal outcomes among HIV-infected pregnant women receiving care at an urban HIV center from 1991 to 2014. Results A total of 366 pregnant women were included, of which 11% developed PIH. Lower levels of 25-hydroxyvitamin D (25(OH)D) and bioactive 1,25-dihydroxyvitamin D (1,25(OH)2D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)2D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79–0.95], p = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80–0.97], p = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)2D levels were associated with group B Streptococcus colonization (OR: 0.92 [95% CI: 0.86–0.99]) and low birth weight (LBW) (OR: 0.90 [95% CI: 0.83–0.98]) on multivariate analysis. Mean 1,25(OH)2D levels were significantly lower in women with preterm delivery and LBW infants. Conclusion Lower bioactive vitamin D levels are related to PIH in HIV-infected women. This association may be related to the coexistence of abnormal placental vitamin D metabolism and abnormal placental implantation.

scholarly journals Free and Bioavailable Fractions of Vitamin D: Association with Maternal Characteristics in Brazilian Pregnant Women

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Joana N. Pereira ◽  
Julia Chactoura ◽  
Fernanda Nohra ◽  
Maria Eduarda L. Diogenes ◽  
Flávia F. Bezerra
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Free Fraction ◽  
Late Pregnancy ◽  
Normal Pregnancy ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status ◽  
Vitamin D Metabolism ◽  
Cross Sectional ◽  
Maternal Characteristics

Normal pregnancy is characterized by many changes in vitamin D metabolism, challenging the assessment of vitamin D status based exclusively on serum total 25-hydroxyvitamin D (25(OH)D). We hypothesized that measuring free and bioavailable fractions contributes to a better vitamin D status assessment in late pregnancy. Our aim was to evaluate a broad set of biomarkers of vitamin D status in Brazilian women in the third trimester of pregnancy. This cross-sectional study was conducted in women (n = 123, 18–44 y, 27–41 wk gestation) attended in a public maternity in Rio de Janeiro (2016–2018). Biomarkers included serum concentrations of total 25(OH)D3, parathyroid hormone (PTH), vitamin D-binding protein (DBP), and free and bioavailable fractions of 25(OH)D3. Vitamin D insufficiency (<50 nmol/L) was prevalent in 47.9% of the pregnant women. Serum 25(OH)D3 was inversely associated with the gestational week (β = −0.71, 95% confidence interval (CI): −1.31 to −0.16) and season, being lower in autumn (β = −9.90, 95% CI: −16.14 to -3.64) and winter (β = −16.74, 95%CI: −23.13 to −10.34). Concentrations of DBP, and free and bioavailable 25(OH)D3 were also inversely associated with winter months (P<0.05). DBP was directly associated with prepregnancy BMI (β = 5.84, 95% CI: 0.62 to 11.06). The recognized season-effect on total 25(OH)D3 appeared to also occur on free and bioavailable fractions. Although advanced gestational age was associated with lower total 25(OH)D3, our results suggest an adaptive mechanism responsible for maintaining free fraction during the 3rd trimester. We also suggest that starting pregnancy in obese condition may have an impact on vitamin D bioavailability, which deserves further investigation.

Pregnant Women with Inflammatory Bowel Disease (IBD) are at Significantly Increased Risk of Vitamin D Insufficiency

2017 ◽  
Vol 152 (5) ◽  
pp. S370
Author(s):  
Sangmin (Sarah) Lee ◽  
Amy Metcalfe ◽  
Yvette Leung ◽  
Maitreyi Raman ◽  
Catherine Field ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Pregnant Women ◽  
Bowel Disease ◽  
Vitamin D Insufficiency ◽  
Increased Risk ◽  
Inflammatory Bowel

scholarly journals Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong

2008 ◽  
Vol 99 (6) ◽  
pp. 1330-1334 ◽  
Author(s):  
Jean Woo ◽  
Christopher W. K. Lam ◽  
Jason Leung ◽  
Winny Y. Lau ◽  
Edith Lau ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hong Kong ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Vitamin D Insufficiency ◽  
Dietary Intakes ◽  
Hydroxyvitamin D ◽  
The North ◽  
25 Hydroxyvitamin D ◽  
The Relationship

We aimed to describe the vitamin D status of young women living in two Chinese cities in the spring – Beijing in the north (latitude 39° north) and Hong Kong (latitude 22° north) in the south. We also examined the relationship between serum 25-hydroxyvitamin D and parathyroid hormone (PTH) concentrations to determine a threshold for serum 25-hydroxyvitamin D above which there is no further suppression of PTH. Finally, we examined whether dietary Ca intake influences this relationship. Non-pregnant women aged 18–40 years (n 441) were recruited between February and June. Fasting blood was collected and dietary intakes were assessed using 5 d food records. Mean serum 25-hydroxyvitamin D concentration was lower in Beijing than Hong Kong women (29 v. 34 nmol/l; P < 0·001). Vitamin D deficiency ( ≤  25 nmol/l) was indicated in 40 % of Beijing and 18 % of Hong Kong women, and over 90 % of women in both cities were insufficient ( ≤ 50 nmol/l). Mean Ca and vitamin D intakes were 478 mg/d and 2·0 μg/d, respectively. The relationship between 25-hydroxyvitamin D concentration and PTH was linear throughout the range with a slope of − 0·36 (different from 0; P < 0·001; R 0·26), with no apparent threshold. There was no influence of Ca intake on the relationship between 25-hydroxyvitamin D and PTH concentration. Vitamin D deficiency is common and insufficiency is very common in non-pregnant women in Hong Kong and Beijing during spring. Serum 25-hydroxyvitamin D was inversely associated with PTH with no apparent threshold. Strategies such as vitamin D fortification or supplementation may be required.

scholarly journals Opinions and Practice of US-Based Obstetrician-Gynecologists regarding Vitamin D Screening and Supplementation of Pregnant Women

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Sara A. Mohamed ◽  
Ayman Al-Hendy ◽  
Jay Schulkin ◽  
Michael L. Power
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Patient Population ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Institute Of Medicine ◽  
Vitamin D Status ◽  
Online Questionnaire ◽  
Endocrine Society ◽  
Hydroxyvitamin D

Vitamin D deficiency/insufficiency is prevalent among pregnant women. Recommendations for adequate levels of circulating 25-hydroxyvitamin D and appropriate vitamin D supplementation during pregnancy differ between the Institute of Medicine and the Endocrine Society. Obstetrician-gynecologists must make clinical decisions in this environment of uncertain guidance. An online questionnaire regarding physician practice patterns for screening and supplementing pregnant women was administered to 225 randomly selected practicing obstetrician-gynecologists of whom 101 (45%) completed the questionnaire. A majority indicated that vitamin D insufficiency was a problem in their patient population (68.4%) and that most of their pregnant patients would benefit from vitamin D supplementation (66.3%). Half (52.5%) would recommend vitamin D supplementation during pregnancy to some patients, but only 16.8% to all. Only one in four (25.8%) routinely screen their pregnant patients for vitamin D status. Physicians who indicated that vitamin D status was a problem in their patient population were more likely to screen routinely (32.8% versus 9.7%,P=0.002) and believe their patients would benefit from supplementation (91.2% versus 16.1%,P=0.001). Opinion regarding supplementation levels and indicators of adequacy were split between the two competing recommendations, suggesting that clinical practice will likely remain variable across physicians, with uncertain public health consequences.

scholarly journals An evaluation of association of vitamin D insufficiency with gestational hypertension in pregnant women

2018 ◽  
Vol 7 (8) ◽  
pp. 3109
Author(s):  
Khan Arshiya ◽  
Srivastava Meenakshi
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Task Force ◽  
Gestational Hypertension ◽  
Fasting Blood Glucose ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Cross Sectional

Background: Preeclampsia (PE) is a disease specific to pregnancy affecting many bodily systems. This is characterized by high blood pressure and proteinuria after the 20th week of pregnancy. The objective of this study was to evaluate of association of vitamin D insufficiency with gestational hypertension in pregnant women.Methods: This was a cross-sectional study. A total of 104 pregnant women were included in the study. The diagnosis of gestational hypertension was confirmed using the “Report of the American College of Obstetricians and Gynaecologists’ Task Force on Hypertension in Pregnancy” criteria. Based on these criteria, patients with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (measured after a period of rest of four hours, twice daily) and proteinuria (≥300 mg protein/24 h) were diagnosed as gestational hypertension.Results: Vitamin D deficiency was found among 78.9% (90/114) women. There was no significant (p >0.05) difference in age of women between vitamin D deficient and sufficient. Vitamin D level was significantly (p = 0.0001) lower among the women between Vitamin D deficient (15.93±4.66) and sufficient (35.70±3.25). There was no significant (p >0.05) association of Vitamin D level with parity, family history of hypertension, blood pressure, gestational age and fasting blood glucose. There was significant (p = 0.0001) difference in BMI between Vitamin D deficient (30.10±4.95) and sufficient (24.04±2.75). Tobacco consumption was also associated with the level of Vitamin D. There was significant negative correlation between BMI and Vitamin D level (r = -0.56, p = 0.00011).Conclusions: The present study demonstrates that vitamin D plays a role in the ethology and pathophysiology of gestational hypertension. Among the population having the risk of vitamin D deficiency, the risk of pregnancy induced hypertension may be decreased through vitamin D supplementation.

scholarly journals Placental vitamin D metabolism and its associations with circulating vitamin D metabolites in pregnant women

2017 ◽  
Vol 106 (6) ◽  
pp. 1439-1448 ◽  
Author(s):  
Heyjun Park ◽  
Madeleine R Wood ◽  
Olga V Malysheva ◽  
Sara Jones ◽  
Saurabh Mehta ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Metabolites ◽  
Vitamin D Metabolism

scholarly journals Expressions of vitamin D metabolic components VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR in placentas from normal and preeclamptic pregnancies

2012 ◽  
Vol 303 (7) ◽  
pp. E928-E935 ◽  
Author(s):  
Rong Ma ◽  
Yang Gu ◽  
Shuang Zhao ◽  
Jingxia Sun ◽  
Lynn J. Groome ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Vitamin D ◽  
Causative Factor ◽  
Vitamin D Insufficiency ◽  
Metabolic System ◽  
Vitamin D Metabolism ◽  
Normal Term ◽  
Increased Risk ◽  
Protein Expressions ◽  
Fetal Vessel

Vitamin D insufficiency/deficiency during pregnancy has been linked to increased risk of preeclampsia. Placenta dysfunction plays an important role in the pathogenesis of this pregnancy disorder. In this study, we tested the hypothesis that disturbed vitamin D metabolism takes place in preeclamptic placentas. Protein expressions of vitamin D binding protein (VDBP), 25-hydroxylase (CYP2R1), 1α-hydroxylase (CYP27B1), 24-hydroxylase (CYP24A1), and vitamin D receptor (VDR) were examined in placentas from normotensive and preeclamptic pregnancies. By immunostaining we found that in normal placenta VDBP, CYP24A1, and VDR expressions are localized mainly in trophoblasts, whereas CYP2R1 and CYP27B1 expressions are localized mainly in villous core fetal vessel endothelium. Protein expressions of CYP2R1 and VDR are reduced, but CYP27B1 and CYP24A1 expressions are elevated, in preeclamptic compared with normotensive placentas. Because increased oxidative stress is an underlying pathophysiology in placental trophoblasts in preeclampsia, we further determined whether oxidative stress contributes to altered vitamin D metabolic system in placental trophoblasts. Trophoblasts isolated from normal-term placentas were treated with hypoxic-inducing agent CoCl2, and protein expressions of VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR were determined. We found that hypoxia-induced downregulation of VDBP, CYP2R1, and VDR and upregulation of CYP27B1 and CYP24A1 expressions were consistent with that seen in preeclamptic placentas. CuZnSOD expression was also downregulated in trophoblasts treated with CoCl2. These results provide direct evidence of disrupted vitamin D metabolic homeostasis in the preeclamptic placenta and suggest that increased oxidative stress could be a causative factor of altered vitamin D metabolism in preeclamptic placentas.

scholarly journals Vitamin D in Type 2 Diabetes: Genetic Susceptibility and the Response to Supplementation

2020 ◽  
Vol 52 (07) ◽  
pp. 492-499
Author(s):  
Marissa Penna-Martinez ◽  
Klaus Badenhoop ◽  
Edith Klahold ◽  
Franziska Bruns ◽  
Christian Seidl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Vitamin D Insufficiency ◽  
Vitamin D Metabolism ◽  
Risk Alleles ◽  
Before And After ◽  
Cholecalciferol Supplementation ◽  
The Impact

AbstractVariants of vitamin D metabolism-genes may predispose to type 2 diabetes (T2D). This study investigated the impact of these variants on disease susceptibility, Vitamin D, parathyroid hormone, C-peptide and HbA1c levels before and after cholecalciferol supplementation in patients with T2D.Twelve polymorphisms within CYP2R1, CYP27B1, DBP, VDR and CYP24A1 were genotyped in 553 T2D patients and 916 controls. In addition 65 patients receiving either cholecalciferol or placebo were analyzed during 6 months intervention and 6 months follow-up.T2D risk alleles are VDR rs7975232 “G” (pc=0.031), rs1544410 “G” (pc=0.027) and CYP2R1 rs10741657 “A” (pc=0.016). Patients with genotypes CYP27B1 rs10877012 “CC” (pc=4x10-5), DBP rs7041 “GG” (pc=0.003), rs4588 “CC” (pc = 3x10-4), CYP24A1 rs2585426 “CG” (pc=0.006) and rs2248137 “CG” (pc=0.001) showed lower 25(OH)D3 and DBP rs4588 “CC” lower 1,25(OH)2D3 levels (pc=0.005). Whereas DBP rs4588 “CC” (pc=0.009), CYP27B1 rs10877012 “AC” (pc=0.059), VDR rs7975323 “AG” (pc=0.033) and rs1544410 “GG” (pc=0.013) are associated with higher 25(OH)D3 levels at 6 months’ follow-up. Significant PTH suppression was detected for CYP2R1 “AG“ (pc=0.002), DBP rs4588 “CC” (pc<0.001), VDR rs110735810 “CT” (pc<0.001) and CYP24A1 rs2248137 “GG” (pc=0.021).Genetic variants of the vitamin D system predispose to type 2 diabetes and regulate – partially - vitamin D metabolism, concentrations and the vitamin D status. Vitamin D insufficiency is a T2D risk factor. The response to cholecalciferol supplementation can be measured as 25(OH)D3 increment and PTH suppression. This process is regulated by genes of the vitamin D system conferring modest T2D risk.

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