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Maternal plasma 25-hydroxyvitamin D concentration and birthweight, growth and bone mineral accretion of Gambian infants.

Prentice A, Jarjou LM, Goldberg GR, Bennett J, Cole TJ, Schoenmakers I - Acta Paediatr. (2009)

View Article: PubMed Central - PubMed

Affiliation: MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK CB1 9NL. ann.prentice@mrc-hnr.cam.ac.uk

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Maternal vitamin D deficiency during pregnancy is a recognized risk factor for rickets and osteomalacia in infancy... The circulating plasma concentration of 25-hydroxyvitamin D (25OHD), a long-lived metabolite of vitamin D, is used to judge vitamin D status; values below 25 nmol/L are associated with an increased risk of rickets and osteomalacia... These relationships have been observed at concentrations of 25OHD higher than those associated with rickets and osteomalacia, and there are calls to raise the accepted lower threshold of vitamin D sufficiency for pregnant women, most recently to 80 nmol/L... Relationships between infant outcomes and maternal 25OHD concentration were explored using multiple linear regressions (DataDesk 6.2.1, Data Description Inc., Ithaca, NY, USA)... The following potential confounders were included in the full models: maternal weight, weight gain, height, parity, supplement group, sex of infant and season... This is illustrated in Figure 1 for birthweight as a function of maternal 25OHD concentration at P20... Comparing the results for mothers with 25OHD above and below 80 nmol/L did not alter this finding... Trends in the data were observed in a few instances for a supplement group × 25OHD interaction among the bone measures but no consistent picture emerged and they were considered to have arisen by chance... We conclude that there is no evidence for an influence of vitamin D status during pregnancy on infant growth and bone mineral accrual in the conditions prevailing in The Gambia... The children in this study, as is common in this region of The Gambia, were born small, grew well for the first months of life but experienced growth faltering during later infancy compared to Western children, as demonstrated by their weight and length SDS... The 25OHD concentrations of the women were >50 nmol/L in the second half of pregnancy, and no distinction could be drawn in infant outcomes between mothers with concentrations above or below 80 nmol/L... Thus, our study suggests that, for women with regular, adventitious UVB sunshine exposure and in situations where foetal and infant growth may be constrained by multiple factors, there would be no benefit for foetal and infant growth or bone mineral accrual in aiming to increase the vitamin D status of individual mothers during pregnancy above 50 or 80 nmol/L.

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Lack of a significant relationship between infant birthweight and maternal vitamin D status at 20 weeks of pregnancy (p = 0.8). Multiple regression model included season, maternal height, weight, weight gain, supplement group and sex of the infant.
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fig01: Lack of a significant relationship between infant birthweight and maternal vitamin D status at 20 weeks of pregnancy (p = 0.8). Multiple regression model included season, maternal height, weight, weight gain, supplement group and sex of the infant.

Mentions: Mean ± SD 25OHD (range) was: P20 = 103 ± 25 (53–167) nmol/L; P36 = 111 ± 27 (51–189) nmol/L. No subject had a 25OHD value <50 nmol/L, 20% and 16% had 25OHD <80 nmol/L, at P20 and P36, respectively. There was a high degree of within-subject consistency in 25OHD at P20 and P36 (25OHDP36 = 33.2 + [0.79 ± 0.07]× 25OHDP20, p ≤ 0.001, R2 adjusted 51.5%, n = 121); 11% of women had 25OHD <80 nmol/L at both P20 and P36. The mean birthweight of the infants was 2.99 ± 0.36 kg. The infant anthropometric and bone measures during the first year are given in Table 1. No significant relationships or trends in the data were observed between maternal 25OHD concentration using the values at P20, P36 or the mean of the two and any of the following infant measures: birthweight, infant weight, length, head circumference, BMC, BW (or BA), BMD and size-adjusted BMC of the midshaft radius and whole body at any time postpartum. This is illustrated in Figure 1 for birthweight as a function of maternal 25OHD concentration at P20. Comparing the results for mothers with 25OHD above and below 80 nmol/L did not alter this finding.


Maternal plasma 25-hydroxyvitamin D concentration and birthweight, growth and bone mineral accretion of Gambian infants.

Prentice A, Jarjou LM, Goldberg GR, Bennett J, Cole TJ, Schoenmakers I - Acta Paediatr. (2009)

Lack of a significant relationship between infant birthweight and maternal vitamin D status at 20 weeks of pregnancy (p = 0.8). Multiple regression model included season, maternal height, weight, weight gain, supplement group and sex of the infant.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2721965&req=5

fig01: Lack of a significant relationship between infant birthweight and maternal vitamin D status at 20 weeks of pregnancy (p = 0.8). Multiple regression model included season, maternal height, weight, weight gain, supplement group and sex of the infant.
Mentions: Mean ± SD 25OHD (range) was: P20 = 103 ± 25 (53–167) nmol/L; P36 = 111 ± 27 (51–189) nmol/L. No subject had a 25OHD value <50 nmol/L, 20% and 16% had 25OHD <80 nmol/L, at P20 and P36, respectively. There was a high degree of within-subject consistency in 25OHD at P20 and P36 (25OHDP36 = 33.2 + [0.79 ± 0.07]× 25OHDP20, p ≤ 0.001, R2 adjusted 51.5%, n = 121); 11% of women had 25OHD <80 nmol/L at both P20 and P36. The mean birthweight of the infants was 2.99 ± 0.36 kg. The infant anthropometric and bone measures during the first year are given in Table 1. No significant relationships or trends in the data were observed between maternal 25OHD concentration using the values at P20, P36 or the mean of the two and any of the following infant measures: birthweight, infant weight, length, head circumference, BMC, BW (or BA), BMD and size-adjusted BMC of the midshaft radius and whole body at any time postpartum. This is illustrated in Figure 1 for birthweight as a function of maternal 25OHD concentration at P20. Comparing the results for mothers with 25OHD above and below 80 nmol/L did not alter this finding.

View Article: PubMed Central - PubMed

Affiliation: MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK CB1 9NL. ann.prentice@mrc-hnr.cam.ac.uk

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Maternal vitamin D deficiency during pregnancy is a recognized risk factor for rickets and osteomalacia in infancy... The circulating plasma concentration of 25-hydroxyvitamin D (25OHD), a long-lived metabolite of vitamin D, is used to judge vitamin D status; values below 25 nmol/L are associated with an increased risk of rickets and osteomalacia... These relationships have been observed at concentrations of 25OHD higher than those associated with rickets and osteomalacia, and there are calls to raise the accepted lower threshold of vitamin D sufficiency for pregnant women, most recently to 80 nmol/L... Relationships between infant outcomes and maternal 25OHD concentration were explored using multiple linear regressions (DataDesk 6.2.1, Data Description Inc., Ithaca, NY, USA)... The following potential confounders were included in the full models: maternal weight, weight gain, height, parity, supplement group, sex of infant and season... This is illustrated in Figure 1 for birthweight as a function of maternal 25OHD concentration at P20... Comparing the results for mothers with 25OHD above and below 80 nmol/L did not alter this finding... Trends in the data were observed in a few instances for a supplement group × 25OHD interaction among the bone measures but no consistent picture emerged and they were considered to have arisen by chance... We conclude that there is no evidence for an influence of vitamin D status during pregnancy on infant growth and bone mineral accrual in the conditions prevailing in The Gambia... The children in this study, as is common in this region of The Gambia, were born small, grew well for the first months of life but experienced growth faltering during later infancy compared to Western children, as demonstrated by their weight and length SDS... The 25OHD concentrations of the women were >50 nmol/L in the second half of pregnancy, and no distinction could be drawn in infant outcomes between mothers with concentrations above or below 80 nmol/L... Thus, our study suggests that, for women with regular, adventitious UVB sunshine exposure and in situations where foetal and infant growth may be constrained by multiple factors, there would be no benefit for foetal and infant growth or bone mineral accrual in aiming to increase the vitamin D status of individual mothers during pregnancy above 50 or 80 nmol/L.

Show MeSH
Related in: MedlinePlus