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.
Key words: Pregnancy, newborn, vitamin D, lifestyle, epidemiology, Canada
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.
Mots clés: grossesse, nouveau-né, vitamine D, style de vie, épidémiologie, Canada
Footnotes
Conflict of Interest: None to declare
References
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