Skip to main content
×
×
Home

Prevalence and determinants of vitamin D deficiency in the third trimester of pregnancy: a multicentre study in Switzerland

  • Jean-Philippe Krieger (a1), Sophie Cabaset (a1), Claudia Canonica (a2), Ladina Christoffel (a3), Aline Richard (a1), Therese Schröder (a3), Begoña Lipp von Wattenwyl (a2), Sabine Rohrmann (a1) and Katharina Quack Lötscher (a4)...
Abstract

Vitamin D deficiency during pregnancy is associated with negative health consequences for mothers and their infants. Data on the vitamin D status of pregnant women in Switzerland are scarce. A three-centre study was conducted in the obstetric departments of Zurich, Bellinzona and Samedan (Switzerland) to investigate the prevalence and determinants of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D)<50 nmol/l) in 3rd-trimester pregnant women living in Switzerland (n 305), and the correlation between 25(OH)D in pregnant women and their offspring at birth (n 278). Demographic and questionnaire data were used to explore the determinants of vitamin D deficiency. Median concentration of serum 25(OH)D in the third trimester of pregnancy was 46·0 nmol/l (1st–3rd quartiles: 30·5–68·5), representing a 53·4 % prevalence of vitamin D deficiency. 25(OH)D levels in the umbilcal cord blood (median: 50·0 nmol/l; 1st–3rd quartiles: 31·0–76·6) strongly correlated with mothers’ serum 25(OH)D (Spearman’s correlation ρ=0·79, P<0·001). Multivariable logistic regression analysis showed that significant determinants of vitamin D deficiency in pregnant women were centre of study, country of origin, season of delivery and vitamin D supplement intake. Near-term BMI, skin colour, use of sunscreen and mothers’ education, although each not individually significant, collectively improved the ability of the model to explain vitamin D status. Low vitamin D levels were common in this sample of pregnant women and their newborns’ cord blood. Vitamin D supplement intake was the most actionable determinant of vitamin D status, suggesting that vitamin D supplementation during pregnancy should receive more attention in clinical practice.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Prevalence and determinants of vitamin D deficiency in the third trimester of pregnancy: a multicentre study in Switzerland
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Prevalence and determinants of vitamin D deficiency in the third trimester of pregnancy: a multicentre study in Switzerland
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Prevalence and determinants of vitamin D deficiency in the third trimester of pregnancy: a multicentre study in Switzerland
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Corresponding author: J.-P. Krieger, email jean-philippe.krieger2@uzh.ch
References
Hide All
1. Hilger, J, Friedel, A, Herr, R, et al. (2014) A systematic review of vitamin D status in populations worldwide. Br J Nutr 111, 2345.
2. Palacios, C & Gonzalez, L (2014) Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol 144, 138145.
3. Dror, DK & Allen, LH (2010) Vitamin D inadequacy in pregnancy: biology, outcomes, and interventions. Nutr Rev 68, 465477.
4. Moon, RJ, Harvey, NC & Cooper, C (2015) Endocrinology in pregnancy: Influence of maternal vitamin D status on obstetric outcomes and the fetal skeleton. Eur J Endocrinol 173, 6983.
5. Harvey, NC, Holroyd, C, Ntani, G, et al. (2014) Vitamin D supplementation in pregnancy: a systematic review. Health Technol Assess 18, 1190.
6. De-Regil, LM, Palacios, C, Lombardo, LK, et al. (2016) Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev, issue 1, CD008873.
7. Bodnar, LM, Catov, JM, Roberts, JM, et al. (2007) Prepregnancy obesity predicts poor vitamin D status in mothers and their neonates. J Nutr 137, 24372442.
8. Wegienka, G, Kaur, H, Sangha, R, et al. (2016) Maternal-cord blood vitamin D correlations vary by maternal levels. J Pregnancy 2016, 7474192.
9. Markestad, T, Aksnes, L, Ulstein, M, et al. (1984) 25-Hydroxyvitamin D and 1,25-dihydroxyvitamin D of D2 and D3 origin in maternal and umbilical cord serum after vitamin D2 supplementation in human pregnancy. Am J Clin Nutr 40, 10571063.
10. Maghbooli, Z, Hossein-Nezhad, A, Shafaei, AR, et al. (2007) Vitamin D status in mothers and their newborns in Iran. BMC Pregnancy Childbirth 7, 1.
11. Bassir, M, Laborie, S, Lapillonne, A, et al. (2001) Vitamin D deficiency in Iranian mothers and their neonates: a pilot study. Acta Paediatr 90, 577579.
12. Bodnar, LM, Simhan, HN, Powers, RW, et al. (2007) High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 137, 447452.
13. Holmes, VA, Barnes, MS, Alexander, HD, et al. (2009) Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study. Br J Nutr 102, 876881.
14. Molla, AM, Badawi, Al M, Hammoud, MS, et al. (2005) Vitamin D status of mothers and their neonates in Kuwait. Pediatr Int 47, 649652.
15. Ponsonby, A-L, Lucas, RM, Lewis, S, et al. (2010) Vitamin D status during pregnancy and aspects of offspring health. Nutrients 2, 389407.
16. Saraf, R, Morton, SMB, Camargo, CAJ, et al. (2016) Global summary of maternal and newborn vitamin D status - a systematic review. Matern Child Nutr 12, 647668.
17. Brembeck, P, Winkvist, A & Olausson, H (2013) Determinants of vitamin D status in pregnant fair-skinned women in Sweden. Br J Nutr 110, 856864.
18. Jensen, CB, Petersen, SB, Granstrom, C, et al. (2012) Sources and determinants of vitamin D intake in Danish pregnant women. Nutrients 4, 259272.
19. Richard, A, Rohrmann, S & Quack Lötscher, KC (2017) Prevalence of vitamin D deficiency and its associations with skin color in pregnant women in the first trimester in a sample from Switzerland. Nutrients 9, 260.
20. Karras, S, Paschou, SA, Kandaraki, E, et al. (2016) Hypovitaminosis D in pregnancy in the Mediterranean region: a systematic review. Eur J Clin Nutr 70, 979986.
21. Rodriguez, A, Santa Marina, L, Jimenez, AM, et al. (2016) Vitamin D status in pregnancy and determinants in a Southern European Cohort Study. Paediatr Perinat Epidemiol 30, 217228.
22. Dovnik, A, Mujezinović, F, Treiber, M, et al. (2017) Determinants of maternal vitamin D concentrations in Slovenia: a prospective observational study. Wien Klin Wochenschr 129, 2128.
23. Zgaga, L, Agakov, F, Theodoratou, E, et al. (2013) Model Selection Approach Suggests Causal Association between 25-Hydroxyvitamin D and Colorectal Cancer. PLOS ONE 8, e63475.
24. Sohl, E, Heymans, MW, de Jongh, RT, et al. (2014) Prediction of vitamin D deficiency by simple patient characteristics. Am J Clin Nutr 99, 10891095.
25. Federal Statistical Office (2017) Statistical Atlas of Switzerland., https://www.atlas.bfs.admin.ch (accessed October 2017).
26. Agresti, A (2007) An Introduction to Categorical Data Analysis, 2nd ed. Hoboken, NJ: John Wiley & Sons.
27. Holick, MF, Binkley, NC, Bischoff-Ferrari, HA, et al. (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96, 19111930.
28. Dawson-Hughes, B, Mithal, A, Bonjour, J-P, et al. (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 21, 11511154.
29. Hanley, DA, Cranney, A, Jones, G, et al. (2010) Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. CMAJ 182, E610E618.
30. Fitzpatrick, TB (1988) The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 124, 869871.
31. Buuren, SV & Groothuis-Oudshoorn, K (2011) mice: multivariate imputation by chained equations in R. J Stat Software 45, 167.
32. Wuertz, C, Gilbert, P, Baier, W, et al. (2013) Cross-sectional study of factors that influence the 25-hydroxyvitamin D status in pregnant women and in cord blood in Germany. Br J Nutr 110, 18951902.
33. Cadario, F, Savastio, S, Magnani, C, et al. (2015) High prevalence of vitamin D deficiency in native versus migrant mothers and newborns in the north of Italy: a call to act with a stronger prevention program. PLOS ONE 10, e0129586.
34. Ceccaldi, P-F, Pejoan, H, Breau, N, et al. (2017) French prenatal Vitamin D recommended supplementation: Enough or not? J Gynecol Obstet Biol Reprod 46, 3541.
35. Vandevijvere, S, Amsalkhir, S, Van Oyen, H, et al. (2012) High prevalence of vitamin D deficiency in pregnant women: a national cross-sectional survey. PLOS ONE 7, e43868.
36. Viljakainen, HT, Saarnio, E, Hytinantti, T, et al. (2010) Maternal vitamin D status determines bone variables in the newborn. J Clin Endocrinol Metab 95, 17491757.
37. Guessous, I, Dudler, V, Glatz, N, et al. (2012) Vitamin D levels and associated factors: a population-based study in Switzerland. Swiss Med Wkly 142, w13719.
38. Ritchie, LD, Fung, EB, Halloran, BP, et al. (1998) A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses. Am J Clin Nutr 67, 693701.
39. Ardawi, MS, Nasrat, HA & BA’Aqueel, HS (1997) Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study. Eur J Endocrinol 137, 402409.
40. Salle, BL, Delvin, EE, Lapillonne, A, et al. (2000) Perinatal metabolism of vitamin D. Am J Clin Nutr 71, 1317S1324SS.
41. Zhang, JY, Lucey, AJ, Horgan, R, et al. (2014) Impact of pregnancy on vitamin D status: a longitudinal study. Br J Nutr 112, 10811087.
42. Anderson, GD (2005) Pregnancy-induced changes in pharmacokinetics. Clin Pharmacokinet 44, 9891008.
43. Hollis, BW, Johnson, D, Hulsey, TC, et al. (2011) Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res 26, 23412357.
44. Wagner, CL, McNeil, RB, Johnson, DD, et al. (2013) Health characteristics and outcomes of two randomized vitamin D supplementation trials during pregnancy: a combined analysis. J Steroid Biochem Mol Biol 136, 313320.
45. Dawodu, A, Saadi, HF, Bekdache, G, et al. (2013) Randomized controlled trial (RCT) of vitamin D supplementation in pregnancy in a population with endemic vitamin D deficiency. J Clin Endocrinol Metab 98, 23372346.
46. Quack Lötscher, KC, l’Allemand, D, Bischoff-Ferrari, HA, et al. (2012) Vitamin D Deficiency: Evidence, Safety, and Recommendations for the Swiss Population. Switzerland: Federal Office of Public Health.
47. Fu, L, Yun, F, Oczak, M, et al. (2009) Common genetic variants of the vitamin D binding protein (DBP) predict differences in response of serum 25-hydroxyvitamin D [25(OH)D] to vitamin D supplementation. Clin Biochem 42, 11741177.
48. Didriksen, A, Grimnes, G, Hutchinson, MS, et al. (2013) The serum 25-hydroxyvitamin D response to vitamin D supplementation is related to genetic factors, BMI, and baseline levels. Eur J Endocrinol 169, 559567.
49. Moon, RJ, Harvey, NC, Cooper, C, et al. (2016) Determinants of the maternal 25-hydroxyvitamin D response to vitamin D supplementation during pregnancy. J Clin Endocrinol Metab 101, 50125020.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 54
Total number of PDF views: 458 *
Loading metrics...

Abstract views

Total abstract views: 672 *
Loading metrics...

* Views captured on Cambridge Core between 10th January 2018 - 20th July 2018. This data will be updated every 24 hours.