|DROR, DAPHNA - University Of California|
|KING, JANET - Children'S Hospital Oakland Research Institute|
|DURAND, DAVID - Children'S Hospital Oakland Research Institute|
|Allen, Lindsay - A|
Submitted to: Journal Of The American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/15/2010
Publication Date: 6/15/2010
Citation: Dror, D.K., King, J.C., Durand, D.J., Allen, L.H. 2010. Association of modifiable and nonmodifiable factors with vitamin D status in pregnant women and neonates in Oakland, CA. Journal Of The American Dietetic Association. 111:111-16.
Interpretive Summary: Vitamin D deficiency is common in the United States and occurs in pregnant women and their infants even in more temperate regions of the country including Oakland, CA. A study was designed to evaluate modifiable (maternal vitamin D intake from foods and supplements) and non-modifiable (skin pigmentation, season, pre-pregnancy body mass index) factors affecting maternal and neonatal vitamin D status. Over a 14-month period, 275 pregnant women and their infants were recruited from a multi- ethnic group in Oakland, CA. Maternal serum 25-hydroxy vitamin D (25OHD) was strongly and significantly predicted by season of delivery, vitamin D intake from food and supplements, skin pigmentation, and body mass index. The same factors were correlated with the concentration of 25OHD in cord blood (i.e. infant status). During the year 54% of mothers and 90% of neonates had serum 25OHD <30 ng/mL (<75 nmol/L). Even when women took daily prenatal vitamin supplements (which usually contained 400 IU of the vitamin/day), 51% had serum 25OHD <30 ng/mL. We conclude that poor vitamin D status is prevalent in these mothers and neonates and is associated with both modifiable and non-modifiable factors.
Technical Abstract: There is little information on the contribution of modifiable vs nonmodifiable factors to maternal and neonatal vitamin D status in temperate regions of the United States. The purpose of this cross-sectional observation study conducted between December 2006 and February 2008 was to identify associations between observed and measured maternal characteristics and vitamin D status at term in pregnant women and their infants in a multiethnic community in Oakland, CA. Two hundred seventyfive pregnant women aged 18 to 45 years and carrying a singleton fetus were recruited and data from 210 motherinfant pairs were included in analyses. Analysis of covariance identified predictors of maternal and cord serum 25-hydroxyvitamin D [25(OH)D] in a multivariate model considering vitamin D intake, lifestyle factors, and skin pigmentation. Maternal serum 25(OH)D was significantly associated with season of delivery (P=0.0002), average daily D intake (P=0.0008), right upper inner arm pigmentation (P=0.0035), and maternal pre- or early pregnancy body mass index (calculated as kg/m2)(P=0.0207). The same factors were significant for cord serum 25(OH)D, which was highly correlated with maternal serum 25(OH)D (r=0.79; P=0.0001). During the year, 54% of mothers and 90% of neonates had 25 OH)D <30 ng/mL (<75 nmol/L). Of women taking daily prenatal 50.7% had serum 25(OH)D <30 ng/mL (<75 nmol/L). In conclusion, 25(OH)D <30 ng/mL (<75 nmol/L) was prevalent in mothers and neonates across racial groups and seasons, and vitamin D status was associated with both modifiable and nonmodifiable risk factors.