Skip to main content
SpringerLink
Log in

Determinants of vitamin D status in pregnant women and neonates

  • Quantitative Research
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

OBJECTIVES: Evidence suggests a beneficial effect of vitamin D on perinatal health; however, low vitamin D status is prevalent in pregnant women and neonates. The objective was to determine factors that are associated with vitamin D status of mothers in early pregnancy and neonates.

METHODS: The study comprised 1,635 pregnant women from Quebec City and Halifax, Canada, 2002–2010. Vitamin D status was based on the concentration of 25-hydroxy-vitamin D [25(OH)D] determined with a chemiluminescence immunoassay in maternal sera collected at a median of 15 weeks’ gestation and in neonatal cord sera at delivery. A questionnaire with information on potential determinants was completed midpregnancy.

RESULTS: A total of 44.8% of mothers and 24.4% of neonates had 25(OH)D concentrations <50 nmol/L. Adjusted mean (95% confidence interval) maternal 25(OH)D levels were higher in summer than in winter by 16.1 nmol/L (13.6–18.7), and in those in the highest versus the lowest category of education by 6.1 nmol/L (0.5–11.8), in BMI <25 kg/m2 versus BMI ≥35 kg/m2 by 8.2 nmol/L (4.0–12.3), and in the highest versus the lowest physical activity category by up to 9.5 nmol/L (2.9–16.1). Determinants of neonatal 25(OH)D levels were similar but also included maternal age, dairy intake, supplement use and 25(OH)D level.

CONCLUSION: This study suggests that vitamin D status of pregnant women and/or neonates might be improved through supplementation, adequate dairy intake, a move towards a healthy pre-pregnancy body weight, and participation in physical activity. Controlled studies are needed to determine the effectiveness of interventions aimed at these factors.

Résumé

OBJECTIFS: Les données semblent indiquer que la vitamine D a un effet bénéfique sur la santé périnatale, mais un faible statut en vitamine D prévaut chez les femmes enceintes et les nouveau-nés. Nous avons voulu déterminer les facteurs associés au statut en vitamine D de mères en début de grossesse et de nouveau-nés.

MÉTHODE: L’étude a compris 1 635 femmes enceintes de Québec et de Halifax, au Canada, de 2002 à 2010. Le statut en vitamine D était fondé sur la concentration de 25-hydroxyvitamine D [25(OH)D], déterminée grâce à un immunoessai par chimiluminescence dans le sérum maternel prélevé à la durée médiane de 15 semaines de grossesse et dans le sérum du cordon ombilical des nouveau-nés à l’accouchement. Au milieu de leur grossesse, les femmes ont rempli un questionnaire donnant de l’information sur les déterminants potentiels.

RÉSULTATS: En tout, 44,8% des mères et 24,4% des nouveau-nés avaient des concentrations de 25(OH)D <50 nmol/L. Chez les mères, les concentrations moyennes ajustées (intervalle de confiance de 95%) de 25(OH)D étaient plus élevées de 16,1 nmol/L (13,6–18,7) l’été que l’hiver; plus élevées de 6,1 nmol/L (0,5–11,8) chez les femmes ayant le plus haut niveau d’instruction par rapport au plus bas; plus élevées de 8,2 nmol/L (4,0–12,3) chez les femmes ayant un IMC <25 kg/m2 contre un IMC ≥35 kg/m2; et pouvaient être plus élevées de 9,5 nmol/L (2,9–16,1) chez les femmes ayant le plus haut niveau d’activité physique par rapport au plus bas. Pour les concentrations de 25(OH)D chez les nouveau-nés, les déterminants étaient semblables aux déterminants maternels, mais incluaient aussi l’âge, l’apport en produits laitiers, l’utilisation de suppléments et la concentration de 25(OH)D des mères.

CONCLUSION: Notre étude indique que le statut en vitamine D des femmes enceintes et/ou des nouveau-nés pourrait être amélioré par la supplémentation, par un apport suffisant en produits laitiers, par un effort pour atteindre un poids-santé avant la grossesse et par la participation à l’activité physique. Il faudrait mener des études contrôlées pour déterminer l’efficacité des interventions ciblant ces facteurs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 2014;348:g2035. PMID: 24690624. doi: 10.1136/bmj.g2035.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: Systematic review and meta-analysis of observational studies. BMJ 2013;346:f1169. PMID: 23533188. doi: 10.1136/ bmj.f1169.

    Google Scholar 

  3. De Regil L, Palacios C, Lombardo L, Peña Rosas J. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2016;1:CD008873. PMID: 26765344.

    Google Scholar 

  4. Ross AC, Taylor CL, Yatkine AL, Del Valle HB, Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academies Press, 2011.

    Google Scholar 

  5. Canadian Paediatric Society. Vitamin D supplementation: Recommendations for Canadian mothers and infants. Paediatr Child Health 2007;12(7):583–89.

    Article  Google Scholar 

  6. Andersen LB, Abrahamsen B, Dalgard C, Kyhl HB, Beck-Nielsen SS, Frost-Nielsen M, et al. Parity and tanned white skin as novel predictors of vitamin D status in early pregnancy: A population-based cohort study. Clin Endocrinol 2013;79(3):333–41. doi: 10.1111/cen.12147.

    Article  CAS  Google Scholar 

  7. Bjorn Jensen C, Thorne-Lyman AL, Vadgard Hansen L, Strom M, Odgaard Nielsen N, Cohen A, et al. Development and validation of a vitamin D status prediction model in Danish pregnant women: A study of the Danish National Birth Cohort. PLoS ONE 2013;8(1):e53059. PMID: 23326380. doi: 10.1371/journal.pone.0053059.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol 2010;202(5):436.e1-e8. PMID: 20060512. doi: 10. 1016/j.ajog.2009.11.036.

    Google Scholar 

  9. Luque-Fernandez MA, Gelaye B, VanderWeele T, Ferre C, Siega-Riz AM, Holzman C, et al. Seasonal variation of 25-hydroxyvitamin D among non-Hispanic black and white pregnant women from three US pregnancy cohorts. Paediatr Perinat Epidemiol 2014;28(2):166–76. PMID: 24354847. doi: 10.1111/ppe.12103.

    Article  PubMed  Google Scholar 

  10. Vandevijvere S, Amsalkhir S, Van Oyen H, Moreno-Reyes R. High prevalence of vitamin D deficiency in pregnant women: A national cross-sectional survey. PLoS ONE 2012;7(8):e43868.

    Google Scholar 

  11. Rodriguez A, Santa Marina L, Jimenez AM, Esplugues A, Ballester F, Espada M, et al. Vitamin D status in pregnancy and determinants in a southern European cohort study. Paediatr Perinat Epidemiol 2016;30(3):217–28. PMID: 26849093. doi: 10.1111/ppe.12281.

    Article  PubMed  Google Scholar 

  12. Theriault S, Giguere Y, Masse J, Lavoie SB, Girouard J, Bujold E, et al. Absence of association between serum folate and preeclampsia in women exposed to food fortification. Obstet Gynecol 2013;122(2 Pt 1):345–51.

    Article  CAS  PubMed  Google Scholar 

  13. Dodds L, Fell DB, Dooley KC, Armson BA, Allen AC, Nassar BA, et al. Effect of homocysteine concentration in early pregnancy on gestational hypertensive disorders and other pregnancy outcomes. Clin Chem 2008;54(2):326–34. PMID: 18070815. doi: 10.1373/clinchem.2007.097469.

    Article  CAS  PubMed  Google Scholar 

  14. Schmidt MD, Freedson PS, Pekow P, Roberts D, Sternfeld B, Chasan-Taber L. Validation of the Kaiser Physical Activity Survey in pregnant women. Med Sci Sports Exerc 2006;38(1):42–50. PMID: 16394952. doi: 10.1249/01.mss. 0000181301.07516.d6.

    Article  PubMed  Google Scholar 

  15. Agborsangaya C, Toriola A, Grankvist K, Surcel H, Holl K, Parkkila S, et al. The effects of storage time and sampling season on the stability of serum 25-hydroxy vitamin D and androstenedione. Nutr Cancer 2010;62(1):51–57. PMID: 20043259. doi: 10.1080/01635580903191460.

    Article  CAS  PubMed  Google Scholar 

  16. Langlois K, Greene-Finestone L, Little J, Hidiroglou N, Whiting S. Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian Health Measures Survey. Health Rep 2010;21(1):47–55. PMID: 20426226.

    PubMed  Google Scholar 

  17. Li W, Green TJ, Innis SM, Barr SI, Whiting SJ, Shand A, et al. Suboptimal vitamin D levels in pregnant women despite supplement use. Can J Public Health 2011;102(4):308–12. PMID: 21913590.

    Article  PubMed  Google Scholar 

  18. Sloka S, Stokes J, Randell E, Newhook LA. Seasonal variation of maternal serum vitamin D in Newfoundland and Labrador. J Obstet Gynaecol Can 2009; 31(4):313–21. PMID: 19497150. doi: 10.1016/S1701-2163(16)34148-2.

    Article  PubMed  Google Scholar 

  19. Cooper C, Harvey NC, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I, et al. Maternal gestational vitamin D supplementation and offspring bone health (MAVIDOS): A multicentre, double-blind, randomised placebo-controlled trial. Lancet Diabetes Endocrinol 2016;4(5):393–402. PMID: 26944421. doi: 10.1016/S2213-8587(16)00044-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: Exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988;67(2):373–78. PMID: 2839537. doi: 10.1210/jcem-67-2-373.

    Article  CAS  PubMed  Google Scholar 

  21. Litonjua AA, Carey VJ, Laranjo N, Harshfield BJ, McElrath TF, O’Connor GT, et al. Effect of prenatal supplementation with vitamin D on asthma or recurrent wheezing in offspring by age 3 years: The VDAART randomized clinical trial. JAMA 2016;315(4):362–70.

    Article  CAS  PubMed  Google Scholar 

  22. Kramer C, Ye C, Swaminathan B, Hanley A, Connelly P, Sermer M, et al. The persistence of maternal vitamin D deficiency and insufficiency during pregnancy and lactation irrespective of season and supplementation. Clin Endocrinol (Oxf) 2016;84(4):680–86. doi: 10.1111/cen.12989.

    Article  CAS  Google Scholar 

  23. Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res 2011;26(10):2341–57. PMID: 21706518. doi: 10.1002/jbmr.v26.10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Liu NQ, Hewison M. Vitamin D, the placenta and pregnancy. Arch Biochem Biophys 2012;523(1):37–47. PMID: 22155151. doi: 10.1016/j.abb.2011.11. 018.

    Article  CAS  PubMed  Google Scholar 

  25. Bowyer L, Catling-Paull C, Diamond T, Homer C, Davis G, Craig ME. Vitamin D, PTH and calcium levels in pregnant women and their neonates. Clin Endocrinol 2009;70(3):372–77. doi: 10.1111/j.1365-2265.2008.03316.x.

    Article  CAS  Google Scholar 

  26. Dror DK, King JC, Durand DJ, Allen LH. Association of modifiable and nonmodifiable factors with vitamin D status in pregnant women and neonates in Oakland, CA. J Am Diet Assoc 2011;111(1):111–16. PMID: 21185972. doi: 10.1016/j.jada.2010.10.002.

    Article  CAS  PubMed  Google Scholar 

  27. Halicioglu O, Aksit S, Koc F, Akman SA, Albudak E, Yaprak I, et al. Vitamin D deficiency in pregnant women and their neonates in spring time in western Turkey. Paediatr Perinat Epidemiol 2012;26(1):53–60. PMID: 22150708. doi: 10. 1111/j.1365-3016.2011.01238.x.

    Article  PubMed  Google Scholar 

  28. Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 2007;137(2):447–52. PMID: 17237325.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Josefson JL, Reisetter A, Scholtens DM, Price HE, Metzger BE, Langman CB, et al. Maternal BMI associations with maternal and cord blood vitamin D levels in a North American Subset of Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study participants. PLoS ONE 2016;11(3):e0150221. doi: 10. 1371/journal.pone.0150221.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Merewood A, Mehta SD, Grossman X, Chen TC, Mathieu JS, Holick MF, et al. Widespread vitamin D deficiency in urban Massachusetts newborns and their mothers. Pediatrics 2010;125(4):640–47. PMID: 20308219. doi: 10.1542/peds. 2009–2158.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynaecology and Pediatrics, Dalhousie University and IWK Health Centre, 7th Floor, Women’s Site, Room G7108, IWK Health Centre, 5980 University Avenue, PO Box 9700, Halifax, NS, B3K 6R8, Canada

    Christy G. Woolcott PhD, Anne Spencer MSc & Linda Dodds PhD

  2. CHU de Québec Research Centre and Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Quebec City, QC, Canada

    Yves Giguère MD, PhD & Jean-Claude Forest MD, PhD

  3. School of Dietetics and Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, Canada

    Hope A. Weiler RD, PhD

  4. Department of Obstetrics & Gynaecology, Dalhousie University and IWK Health Centre, Halifax, NS, Canada

    B. Anthony Armson MD, MSc

Authors
  1. Christy G. Woolcott PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yves Giguère MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hope A. Weiler RD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne Spencer MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jean-Claude Forest MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Anthony Armson MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Linda Dodds PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christy G. Woolcott PhD.

Additional information

Conflict of Interest: None to declare

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Woolcott, C.G., Giguère, Y., Weiler, H.A. et al. Determinants of vitamin D status in pregnant women and neonates. Can J Public Health 107, e410–e416 (2016). https://doi.org/10.17269/CJPH.107.5629

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.17269/CJPH.107.5629

Key words

Mots clés

Search

Navigation