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Vitamin D in pregnancy at high latitude in Scotland

  • Paul Haggarty (a1), Doris M. Campbell (a2), Susan Knox (a3), Graham W. Horgan (a4), Gwen Hoad (a1), Emma Boulton (a3), Geraldine McNeill (a5) and Alan M. Wallace (a3)...

The aims of the present study were to determine compliance with current advice on vitamin D and to assess the influence of season, dietary intake, supplement use and deprivation on vitamin D status in pregnant mothers and newborns in the north of Scotland where sunlight exposure is low. Pregnant women (n 1205) and their singleton newborns were studied in the Aberdeen Maternity Hospital (latitude 57°N) between 2000 and 2006. Plasma 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 were measured at 19 weeks of gestation in mothers and at delivery in newborns. During pregnancy, 21·0 (95 % CI 18·5, 23·5) % of women took vitamin D supplements. The median intake was 5 μg/d and only 0·6 (95 % CI 0·1, 1·0) % took the recommended 10 μg/d. Supplement use, adjusted for season, dietary intake and deprivation, significantly increased maternal 25-hydroxyvitamin D (25(OH)D) by 10·5 (95 % CI 5·7, 15·2) nmol/l (P< 0·001); however, there was no significant effect on cord 25(OH)D (1·4 (95 % CI − 1·8, 4·5) nmol/l). The biggest influence on both maternal and cord 25(OH)D was season of birth (P< 0·001). Compared with the least deprived women (top three deciles), the most deprived pregnancies (bottom three deciles) were characterised by a significantly lower seasonally adjusted 25(OH)D ( − 11·6 (95 % CI − 7·5, − 15·7) nmol/l in the mother and − 5·8 (95 % CI − 2·3, − 9·4) nmol/l in the cord), and a lower level of supplement use (10 (95 % CI 4, 17) v. 23 (95 % CI 20, 26) %). More should be done to promote vitamin D supplement use in pregnancy but the critical importance of endogenous vitamin D synthesis, and known adaptations of fat metabolism specific to pregnancy, suggest that safe sun advice may be a useful additional strategy, even at high latitude.

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Corresponding author
*Corresponding author: Professor P. Haggarty, fax +44 1224 716622, E-mail:
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1Committee on Medical Aspects of Food and Nutrition Policy (1991) Dietary Reference Values for Food Energy and Nutritnets for the United Kingdom. Report no. 41. London: The Stationery Office.
2Committee on Medical Aspects of Food and Nutrition Policy (1998) Nutrition and Bone Health: With Particular Reference to Calcium and Vitamin D. Report no. 49. London: The Stationery Office.
3Scientific Advisory Committee on Nutrition (2007) Update on Vitamin D. London: TSO.
4Hollis, BW & Wagner, CL (2004) Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr 80, Suppl. 6, 1752S1758S.
5Hypponen, E & Boucher, BJ (2010) Avoidance of vitamin D deficiency in pregnancy in the United Kingdom: the case for a unified approach in National policy. Br J Nutr 104, 309314.
6National Institute for Health and Clinical Excellence (2008) Improving the Nutrition of Pregnant and Breastfeeding Mothers and Children in Low-income Households. Report no. 11. London: National Institute for Health and Clinical Excellence.
7Institute of Medicince (2011) Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academic Press.
8Hypponen, E, Berry, D, Cortina-Borja, M, et al. (2010) 25-Hydroxyvitamin D and pre-clinical alterations in inflammatory and hemostatic markers: a cross sectional analysis in the 1958 British Birth Cohort. PLoS One 5, e10801.
9Macdonald, HM, Mavroeidi, A, Fraser, WD, et al. (2011) Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern? Osteoporos Int 22, 24612472.
10Henderson, L, Irving, K, Gregory, J, et al. (2003) The National Diet & Nutrition Survey: Adults Aged 19 to 64 Years. Vitamin and Mineral Intake and Urinary Analytes. Report No. Vol 3. London: TSO.
11Ruston, D, Hoare, J, Henderson, L, et al. (2003) The National Diet & Nutrition Survey: Adults Aged 19 to 64 Years. Nutritional Status (Anthropometry and Blood Analytes), Blood Pressure and Physical Activity. Report No. Vol 4. London: TSO.
12Haggarty, P, Campbell, DM, Duthie, S, et al. (2009) Diet and deprivation in pregnancy. Br J Nutr 102, 14871497.
13Knox, S, Harris, J, Calton, L, et al. (2009) A simple automated solid-phase extraction procedure for measurement of 25-hydroxyvitamin D3 and D2 by liquid chromatography–tandem mass spectrometry. Ann Clin Biochem 46, 226230.
14Masson, LF, McNeill, G, Tomany, JO, et al. (2003) Statistical approaches for assessing the relative validity of a food-frequency questionnaire: use of correlation coefficients and the kappa statistic. Public Health Nutr 6, 313321.
15Campbell, D, Hall, M, Lemon, J, et al. (1993) Clinical birthweight standards for a total population in the 1980s. Br J Obstet Gynaecol 100, 436445.
16Scottish Executive Statistics (2007) SIMD: Scottish Index of Multiple Deprivation.
17Javaid, MK, Crozier, SR, Harvey, NC, et al. (2006) Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet 367, 3643.
18Ardawi, 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.
19Ritchie, 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.
20Cross, NA, Hillman, LS, Allen, SH, et al. (1995) Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 61, 514523.
21Mulligan, ML, Felton, SK, Riek, AE, et al. (2010) Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol 202, 429.
22Holmes, VA, Barnes, MS, Alexander, HD, et al. (2009) Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study. Br J Nutr 102, 876881.
23Haggarty, P (2010) Fatty acid supply to the human fetus. Annu Rev Nutr 30, 237255.
24Cockburn, F, Belton, NR, Purvis, RJ, et al. (1980) Maternal vitamin D intake and mineral metabolism in mothers and their newborn infants. Br Med J 281, 1114.
25Ashwell, M, Stone, EM, Stolte, H, et al. (2010) UK Food Standards Agency Workshop Report: an investigation of the relative contributions of diet and sunlight to vitamin D status. Br J Nutr 104, 603611.
26Thornton, A (2009) Public Attitudes and Behaviours Towards the Environment: A Report to the Department for Environment, Food and Rural Affairs. London: TNS.
27Fraser, DR (1983) The physiological economy of vitamin D. Lancet 322, 969972.
28Haddad, JG, Matsuoka, LY, Hollis, BW, et al. (1993) Human plasma transport of vitamin D after its endogenous synthesis. J Clin Invest 91, 25522555.
29Wortsman, J, Matsuoka, LY, Chen, TC, et al. (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72, 690693.
30Tzotzas, T, Papadopoulou, FG, Tziomalos, K, et al. (2010) Rising serum 25-hydroxy-vitamin D levels after weight loss in obese women correlate with improvement in insulin resistance. J Clin Endocrinol Metab 95, 42514257.
31Zittermann, A, Frisch, S, Berthold, HK, et al. (2009) Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers. Am J Clin Nutr 89, 13211327.
32Prentice, AM, Hennig, BJ & Fulford, AJ (2008) Evolutionary origins of the obesity epidemic: natural selection of thrifty genes or genetic drift following predation release? Int J Obes (Lond) 32, 16071610.
33Wells, JC (2006) The evolution of human fatness and susceptibility to obesity: an ethological approach. Biol Rev Camb Philos Soc 81, 183205.
34Specker, BL (1994) Do North American women need supplemental vitamin D during pregnancy or lactation? Am J Clin Nutr 59, 2 Suppl., 484S490S.
35Mitchell, R & Popham, F (2008) Effect of exposure to natural environment on health inequalities: an observational population study. Lancet 372, 16551660.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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