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Smoking increased 2.7X the probability of low vitamin D levels in pregnancy – Sept 2013

Parity and tanned white skin as novel predictors of vitamin D status in early pregnancy: a population-based cohort study.

Clin Endocrinol (Oxf). 2013 Sep;79(3):333-41. doi: 10.1111/cen.12147. Epub 2013 Jul 2.
Andersen LB1, Abrahamsen B, Dalgård C, Kyhl HB, Beck-Nielsen SS, Frost-Nielsen M, Jørgensen JS, Barington T, Christesen HT.

CONTEXT:
In pregnancy, vitamin D insufficiency and deficiency, defined as serum 25-hydroxyvitamin D (25(OH)D) <50 nM, and <25 nM, respectively, may have adverse effects for both mother and child. Prevalence estimates, and identification of subgroups at special risk, may be useful for the planning of preventive strategies.
OBJECTIVE:
To study the prevalence and risk factors of hypovitaminosis D in early pregnancy.
DESIGN AND METHODS:
In a cross-sectional study of 1348 women in early pregnancy from the Odense Child Cohort, Denmark, 25(OH)D was determined and correlated to demographic and lifestyle variables (age, nationality, skin tone, parity, prepregnancy body mass index (BMI), smoking and sun exposure), using multiple linear and logistic regression analyses for all year, or stratified for summer and winter. The risk of vitamin D insufficiency was expressed as odds ratios (OR) with 95% confidence intervals in brackets.
RESULTS:
The prevalence of vitamin D insufficiency and deficiency was estimated to 27·8% and 3·5% respectively.
In adjusted analyses, vitamin D insufficiency was directly associated with

  • winter season, OR = 1·89 (1·35-

but was less frequent in

  • nulliparous, OR = 0·47 (0·33-0·68) and
  • tanned Caucasians, OR = 0·63 (0·41-0·97).

Season-specific associations having parental origin from outside Europe in summer, OR = 4·13 (1·41-12·13); in winter smoking, OR = 3·15 (1·19-8·36); and prepregnancy BMI, OR = 1·12 (1·06-1·18).
CONCLUSIONS:
Vitamin D insufficiency was widespread in early pregnancy. Associations to smoking, prepregnancy BMI and origin outside Europe varied with season. Multiparity and not being tanned in Caucasians represent new risk factors of vitamin D insufficiency.

PMID: 23305099


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IU Cumulative Benefit Blood level CofactorsCalcium $*/month
200 Better bones for mom
with 600 mg of Calcium
6 ng/ml increase Not needed No effect $0.10
400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures
20-30 ng/ml Not needed No effect $0.20
2000 2X More likely to get pregnant naturally/IVF
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
42 ng/ml Desirable < 750 mg $1
4000 2X fewer pregnancy complications
2X fewer pre-term births
49 ng/ml Should have
cofactors
< 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
Should have
cofactors
< 750 mg $4
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