Racial disparities in cord blood vitamin D levels and its association with small-for-gestational-age infants
Journal of Perinatology advance online publication 21 April 2016; doi: 10.1038/jp.2016.64
T L Seto1, M E Tabangin2, G Langdon3, C Mangeot2, A Dawodu3, M Steinhoff3 and V Narendran1
1Division of Neonatology and Pulmonary Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
2Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
3Global Health Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Correspondence: Dr V Narendran, Division of Neonatology and Pulmonary Biology, Cincinnati Children’s Hospital Medical Center, ML 7009, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. E-mail: vivek.narendran@cchmc.org
Vitamin D Levels at birth Blacks and Whites
Table 1
Figure 1 Vitamin D deficiency vs BMI and prenatal vitamins
Note: This study defines vitamin D deficiency as < 20 nanograms
Prenal Vitamins typically have 400 IU of vitamin D
400 IU does help somewhat if you do not have a high BMI
- Dark skin pregnancies and Vitamin D - many studies
- Increase in Vitamin D deficiency with weight and skin darkness – chart – March 2016
- Obese are 3.4 X more likely to be Vitamin D deficient – meta-analysis Sept 2015
- Half as many Small for Gestational Age infants when take 600 IU of vitamin D while pregnant – June 2018
Healthy pregnancies need lots of vitamin D has the following summary
Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
Click on hyperlinks for details
Problem | Vit. D Reduces | Evidence |
| 0. Chance of not conceiving | 3.4 times | Observe |
| 1. Miscarriage | 2.5 times | Observe |
| 2. Pre-eclampsia | 3.6 times | RCT |
| 3. Gestational Diabetes | 3 times | RCT |
| 4. Good 2nd trimester sleep quality | 3.5 times | Observe |
| 5. Premature birth | 2 times | RCT |
| 6. C-section - unplanned | 1.6 times | Observe |
| Stillbirth - OMEGA-3 | 4 times | RCT - Omega-3 |
| 7. Depression AFTER pregnancy | 1.4 times | RCT |
| 8. Small for Gestational Age | 1.6 times | meta-analysis |
| 9. Infant height, weight, head size within normal limits | RCT | |
| 10. Childhood Wheezing | 1.3 times | RCT |
| 11. Additional child is Autistic | 4 times | Intervention |
| 12.Young adult Multiple Sclerosis | 1.9 times | Observe |
| 13. Preeclampsia in young adult | 3.5 times | RCT |
| 14. Good motor skills @ age 3 | 1.4 times | Observe |
| 15. Childhood Mite allergy | 5 times | RCT |
| 16. Childhood Respiratory Tract visits | 2.5 times | RCT |
RCT = Randomized Controlled Trial
The items in both categories Infant/Child and Dark Skin:
- Newly diagnosed Children with Cancer have low vitamin D, especially if black - May 2022
- Children in India – 1 in 7 extremely low Vitamin D, 1 in 10 prediabetic – Sept 2019
- Pregnant while black increases chance of death – mothers 3X, infants 2X (low Vitamin D) – Feb 2019
- Black infant recurrent wheezing rate dropped from 42 percent to 31 percent with just 400 IU of vitamin D – RCT Dec 2018
- All preteen aged girls in India taking 2,000 IU of vitamin D got levels above 20 ng – RCT Nov 2018
- Low birth weight far more likely if African-American (low vitamin D) – 1997, Aug 2018
- Indoor pollution is a problem with obese black asthmatic children – May 2018
- Crohn's disease in black children is worse in 6 ways – Dec 2015
- Black infants far less likely to be breast-fed (wonder – culture or low Vitamin D) – Aug 2017
- Vitamin D needed to get children to just 20 ng in winter 800 IU white skin, 1100 IU dark (Sweden) – RCT June 2017
- Many US kids have less than 40 ng of Vitamin D – 99 out of 100 blacks, 91 out of 100 whites – Jan 2017
- Small for gestational age with low vitamin D – 3.6X higher for blacks than whites – April 2016
- Type I diabetes in dark skin children associated with low vitamin D if far from equator – Jan 2015
- Dark skinned children were vitamin D deficient in Italy (not infants) – Nov 2014
- Breastfed Infants in Iowa got very little vitamin D, especially if winter or dark skin – July 2013
- Black infants had far lower vitamin D levels which did not vary with season – Jan 2013
- 83 percent of children had less than 20 ng of vitamin D – 15 ng avg for hispanic – Aug 2012
- Rickets in 30 percent of infants in India who had low vitamin D – March 2011
- Large increase in dark skin children with vitamin D deficiency in Glasgow – June 2010
- Dark Skinned babies probably need vitamin D to prevent nutritional rickets - 2001
Download the PDF from VitaminDWiki
Objective: To examine the relationship of race and maternal characteristics and their association with cord blood vitamin D levels and small-for-gestational-age (SGA) status.
Study Design: Cord blood vitamin D levels were measured in 438 infants (276 black and 162 white). Multivariable logistic regression models were used to evaluate associations between maternal characteristics, vitamin D status and SGA.
Results: Black race, Medicaid status, mean body mass index at delivery and lack of prenatal vitamin use were associated with vitamin D deficiency. Black infants had 3.6 greater adjusted odds (95% confidence interval (CI): 2.4, 5.6) of vitamin D deficiency when compared with white infants. Black infants with vitamin D deficiency had 2.4 greater adjusted odds (95% CI: 1.0, 5.8) of SGA. Vitamin D deficiency was not significantly associated with SGA in white infants.
Conclusion: Identification of risk factors (black race, Medicaid status, obesity and lack of prenatal vitamin use) can lead to opportunities for targeted prenatal vitamin supplementation to reduce the risk of neonatal vitamin D deficiency and SGA status.