Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations
Obstetrics & Gynecology, July 2013 - Volume 122 - Issue 1 - p 91–98,doi: 10.1097/AOG.0b013e3182941d9a
Bodnar, Lisa M. PhD; Rouse, Dwight J. MD; Momirova, Valerija MS; Peaceman, Alan M. MD; Sciscione, Anthony DO; Spong, Catherine Y. MD; Varner, Michael W. MD; Malone, Fergal D. MD; Iams, Jay D. MD; Mercer, Brian M. MD; Thorp, John M. Jr MD; Sorokin, Yoram MD; Carpenter, Marshall W. MD; Lo, Julie MD; Ramin, Susan M. MD; Harper, Margaret MDMSc; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
OBJECTIVE: To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24–28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies.
METHODS: Serum samples from women who participated in a clinical trial of 17 α-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestations (2004–2006) were assayed for 25-hydroxyvitamin D concentrations using liquid chromatography tandem mass spectrometry (n=211). Gestational age was determined early in pregnancy using a rigorous algorithm. Preterm birth was defined as delivery of the first twin or death of either twin at less than 35 weeks of gestation.
RESULTS: The mean serum 25-hydroxyvitamin D concentration was 82.7 nmol/L (standard deviation 31.5); 40.3% of women had concentrations less than 75 nmol/L. Preterm birth at less than 35 weeks of gestation occurred in 49.4% of women with 25-hydroxyvitamin D concentrations less than 75 nmol/L compared with 26.2% among those with concentrations of 75 nmol/L or more (P<.001). After adjustment for maternal race and ethnicity, study site, parity, prepregnancy body mass index, season, marital status, education, gestational age at blood sampling, smoking status, and 17 α-hydroxyprogesterone caproate treatment, maternal 25-hydroxyvitamin D concentration of 75 nmol/L or more was associated with a 60% reduction in the odds of preterm birth compared with concentrations less than 75 nmol/L (adjusted odds ratio [OR] 0.4, 95% confidence interval [CI] 0.2–0.8). A similar protective association was observed when studying preterm birth at less than 32 weeks of gestation (OR 0.2, 95% CI 0.1–0.6) and after confounder adjustment.
CONCLUSIONS: Late second-trimester maternal 25-hydroxyvitamin D concentrations less than 75 nmol/L are associated with an increase in the risk of preterm birth in this cohort of twin pregnancies.
LEVEL OF EVIDENCE: II
PMID: 23743453 Download the PDF from VitaminDWiki
Comments by VitaminDWiki
- It would take about $20 worth of vitamin D to get > 30 ng/ml of vitamin D.
That $20 could save thousands of dollars and the anguish of premature births - The study showed that 85% of the black women were deficient and had premature twins vs only 20% of the white women
See also VitaminDWiki
- If having twins, need more vitamin D
- Infants born early had low vitamin D levels – Oct 2012
- Prevention of vitamin D deficiency in mothers and infants worldwide - a paradigm shift. – Feb 2012
- Osteopenia in preterm infants – May 2012
- Low vitamin D increased probability of low birth weight by 60 percent – meta-analysis June 2012
For 62 out of 65 countries, the rate of premature births has been increasing
VitaminDWiki suspects this is due to decreasing levels of vitamin D around the world - Low birth weight 3X more likely if mother had less than 25 nanograms of vitamin D – May 2012 low birth weight is not mentioned in the main study on this page
- In Defence of the Sun – reduce 400000 premature deaths – 2009 Dr. Grant
- Why higher levels of vitamin D reduces premature birth - April 2011 Dr. Grant
- Premature or low birth weight resulted in children 3X more likely to be anxious – meta-analysis May 2011
- Having twins takes more vitamin D - May 2011
- Premature delivery associated with low vitamin D in Japanese women – Mar 2011
- Most European infants get vitamin D supplements, vs only 1 in 50 in US – June 2013
- Chart of Vitamin D levels vs race - April 2013 notice how much less vitamin D blacks have in the US than living natively in Africa
- Dark skin pregnancies and Vitamin D - many studies which has the following graphics