Maternal Serum 25-Hydroxyvitamin D and Measures of Newborn and Placental Weight in a U.S. Multicenter Cohort Study.
J Clin Endocrinol Metab. 2012 Nov 16.
Gernand AD, Simhan HN, Klebanoff MA, Bodnar LM.
Department of Epidemiology (A.D.G.), University of Pittsburgh Graduate School of Public Health, and Departments of Epidemiology and Obstetrics and Gynecology (L.M.B.), University of Pittsburgh Graduate School of Public Health and School of Medicine, Pittsburgh, Pennsylvania 15261; Division of Maternal-Fetal Medicine (H.N.S.), Magee-Womens Hospital and Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Departments of Pediatrics and of Obstetrics and Gynecology (M.A.K.), Ohio State University College of Medicine and The Research Institute, Nationwide Children's Hospital, Columbus, Ohio 43210.
Context:Inconsistent associations between maternal vitamin D status and fetal size have been published in small studies.
Objective:Our objective was to examine the association between maternal 25-hydroxyvitamin D [25(OH)D] levels and measures of newborn and placental weight.
Design and Setting:We measured maternal 25(OH)D in mothers from the Collaborative Perinatal Project, an observational cohort conducted in 12 U.S. medical centers from 1959 to 1965.
Participants:Women delivering singleton, term, live births with 25(OH)D measured at a gestation of 26 wk or less (n = 2146).
Main Outcome Measures:Birth weight, ponderal index, placental weight, the placental to fetal weight ratio, and small for gestational age were measured. Hypotheses were formulated after data collection.
Results:After confounder adjustment, mothers with 25(OH)D of 37.5 nmol/liter or greater gave birth to newborns with 46 g [95% confidence interval (CI), 9-82 g] higher birth weights and 0.13 cm (0.01-0.25 cm) larger head circumferences compared with mothers with less than 37.5 nmol/liter. Birth weight and head circumference rose with increasing 25(OH)D up to 37.5 nmol/liter and then leveled off (P < 0.05). No association was observed between 25(OH)D and ponderal index, placental weight, or the placental to fetal weight ratio.
Maternal 25(OH)D of 37.5 nmol/liter or greater vs. less than 37.5 nmol/liter in the first trimester was associated with half the risk of small for gestational age (adjusted odds ratio 0.5; 95% CI 0.3-0.9), but no second-trimester association was observed.
Conclusions:Maternal vitamin D status is independently associated with markers of physiological and pathological growth in term infants.
Adequately powered randomized controlled trials are needed to test whether maternal vitamin D supplementation may improve fetal growth.
PMID: 2316209