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Pre-term birth 3X more likely and C-section 4X if less than 20 ng of vitamin D – May 2012

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.

PMID: 22548949
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See also VitaminDWiki

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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