Obstetrics & Gynecology

Skip Navigation LinksHome > January 2014 - Volume 123 - Issue 1 > Maternal Vitamin D Status and Small-for-Gestational-Age Offs...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000049
Contents: Original Research

Maternal Vitamin D Status and Small-for-Gestational-Age Offspring in Women at High Risk for Preeclampsia

Gernand, Alison D. PhD, MPH, RD; Simhan, Hyagriv N. MD, MS; Caritis, Steve MD; Bodnar, Lisa M. PhD, MPH, RD

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Abstract

OBJECTIVE: To examine the association between second-trimester maternal serum 25-hydroxyvitamin D concentrations and risk of small for gestational age (SGA) in singleton live births.

METHODS: We assayed serum samples at 12–26 weeks of gestation for 25-hydroxyvitamin D in a sample of participants in a multicenter clinical trial of low-dose aspirin for the prevention of preeclampsia in high-risk women (n=792). Multivariable log-binomial regression models were used to assess the association between 25-hydroxyvitamin D and risk of SGA (birth weight less than the 10th percentile for gestational age) after adjustment for confounders including maternal prepregnancy obesity, race, treatment allocation, and risk group.

RESULTS: Thirteen percent of neonates were SGA at birth. Mean (standard deviation) 25-hydroxyvitamin D concentrations were lower in women who delivered SGA (57.9 [29.9] nmol/L) compared with non-SGA neonates (64.8 [29.3] nmol/L, P=.028). In adjusted models, 25-hydroxyvitamin D concentrations of 50–74 nmol/L and 75 nmol/L or greater compared with less than 30 nmol/L were associated with 43% (95% confidence interval [CI] 0.33–0.99) and 54% (95% CI 0.24–0.87) reductions in risk of SGA, respectively. Race and maternal obesity each modified this association. White women with 25-hydroxyvitamin D 50 nmol/L or greater compared with less than 50 nmol/L had a 68% reduction in SGA risk (adjusted risk ratio 0.32, 95% CI 0.17–0.63) and nonobese women with 25-hydroxyvitamin D 50 nmol/L or greater compared with less than 50 nmol/L had a 50% reduction in SGA risk (adjusted risk ratio 0.50, 95% CI 0.31–0.82). There was no association between 25-hydroxyvitamin D and risk of SGA in black or obese mothers.

CONCLUSION: Maternal vitamin D status in the second trimester is associated with risk of SGA among all women and in the subgroups of white and nonobese women.

LEVEL OF EVIDENCE: II

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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