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Twins, no tan, winter, and smoking all associated with low levels of vitamin D during pregnancy – Jan 2013

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

Clinical Endocrinology, Vol. 78 Issue 2
LB. Andersen 1,2,
B. Abrahamsen 3,4,
C. Dalgård 5,
HB. Kyhl 6,
SS. Beck-Nielsen 2,7,
M. Frost-Nielsen 6,
JS. Jørgensen 8,
T. Barington 3,6,9,
HT. Christesen 1,*
1 Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
2 Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
3 Odense Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
4 Copenhagen University Hospital Gentofte Hospital, Department of Medicine F, Hellerup, Denmark
5 Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
6 Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense, Denmark
7 Department of Pediatrics, Hospital of Southwest Denmark, Esbjerg, Denmark
8 Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
9 Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
*Correspondence: Henrik Thybo Christesen (MD, PhD), Hans Christian Andersen Children's Hospital, Odense University Hospital, Sdr. Blvd. 29, 5000 Odense C, Denmark. E-mail: henrik.thybo.christesen at ouh.regionsyddanmark.dk, fax +456591 1862

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 1,348 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, pre-pregnancy 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 – 2.63); increasing pre-pregnancy BMI, OR=1.06 (1.03-1.10); and smoking, OR=2.7 (1.34-5.41); 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 were 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 pre-pregnancy BMI, OR=1.12 (1.06-1.18).

Conclusions: Vitamin D insufficiency was widespread in early pregnancy. Associations to smoking, pre-pregnancy BMI, and origin outside Europe varied with season. Multiparity and not being tanned in Caucasians represent new risk factors of vitamin D insufficiency.

© 2013 Blackwell Publishing Ltd

See also VitaminDWiki