Association of low serum 25-Hydroxyvitamin D levels in pregnancy with glucose homeostasis and obstetric and newborn outcomes.
Endocr Pract. 2012 May 1:1-18.
Perez-Ferre N, Torrejon MJ, Fuentes M, Fernandez MD, Ramos A, Bordiu E, Del Valle L, Rubio MA, Bedia AR, Montañez C, Calle-Pascual AL.
Endocrinology and Nutrition Department, Facultad de Medicina Universidad Complutense, Hospital Clinico San Carlos-IdISSC, Madrid, Spain.
Aim: To evaluate the associations of maternal serum 25-Hydroxyvitamin D (25-OH-D) status with glucose homeostasis and obstetric and newborn outcomes in women screened for gestational diabetes mellitus (GDM).
Methods: 266 women were screened for GDM at 24-28 week of gestation during the months with maximal sunlight exposure in Spain (June to September). Serum 25-OH-D levels and parameters of glucose homeostasis were measured. Outcomes of the delivery and newborn were collected.
Results: 25-OH-D deficiency (< 20 ng/mL) was observed in 157 (59%) women. An inverse correlation between 25-OH-D levels and HbA1c, HOMA-IR, serum insulin, fasting and 1-hour OGTT glucose levels (p<0001) were found.
The OR for 25-OH-D < 20 ng/mL for preterm birth was 3.31 (95% CI: 1.52-7.19; p < 0.002) and for caesarean section 3.93 (95% CI: 2.00-7.73; p <0.001).
A 25-OH-D level of 20 ng/mL had 79% sensitivity and 51% specificity for caesarean section and 80% sensitivity and 45% specificity for preterm birth.
The cut points with the best combination of sensitivity and specificity were 16 ng/mL (62.9% sensitivity and 61.2% specificity) for caesarean section,
and 14 ng/mL (66.7% sensitivity and 71.0% specificity) for preterm birth.
Conclusions: Vitamin D deficiency is highly prevalent during pregnancy in our population.
Lower levels of 25-OH-D are associated with disorders in glucose homeostasis and adverse obstetric and newborn outcomes. Benefits of appropriate vitamin D supplementation during pregnancy should be evaluated.
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|IU||Cumulative Benefit||Blood level||Cofactors||Calcium||$*/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 |
|< 750 mg||$3|
|6000||Probable: larger benefits for above items|
Just enough D for breastfed infant
More maternal and infant weight
|< 750 mg||$4|