Prevalence of Vitamin D Deficiency during Second Trimester of Pregnancy in Shanghai China, Risk Factors and Effects on Pregnancy Outcomes
AbstractAbstract Background: Vitamin D plays important roles in various physiological processes. Vitamin D deficiency is common among pregnant women in some regions, such as China. Our study aimed to determine the prevalence of Vitamin D deficiency during second trimester of pregnancy in Shanghai China, and explore its risk factors and effects on pregnant outcomes. Methods: Overall, 23100 pregnant women (2013 to 2017, Shanghai, China) were included and vitamin D concentrations were measured at 16 weeks of gestation. Correlations between vitamin D concentrations and participants’ general data and maternal and infant outcomes were analyzed by chi square test. Non-conditional multivariate logistic regression analysis was used to screen the independent risk factors for vitamin D deficiency. Results: Vitamin D deficiency was significantly correlated with aging, education level, smoking, dirking, BMI before pregnancy, body weight gain during pregnancy (P<0.01), the use of vitamin D supplement and milk consumption, and older than 30 years, drinking, smoking, BMI before pregnancy> 36, body weight gain during pregnancy< 40g per day, no daily milk consumption, no vitamin D supplement, and education lever below college were independent risk factors for vitamin D deficiency in second trimester of pregnancy. In addition, vitamin D deficiency in second trimester of pregnancy was closely correlated with the occurrence of a serious of adverse maternal and infant outcomes. Conclusion: Vitamin D deficiency was still common among women in second trimester of pregnancy in Shanghai China. Vitamin D deficiency was closely correlated with the occurrence of a serious of adverse maternal and infant outcomes.
Zhai F Y, Du S F, Wang Z H et al (2014). Dynamics of the Chinese diet and the role of urbanicity, 1991–2011. Obes Rev, 1: 16-26.
Xi B, He D, Hu Y et al (2013). Prevalence of metabolic syndrome and its influencing factors among the Chinese adults: the China Health and Nutrition Survey in 2009. Prev Med, 57(6): 867-871.
van der Meer I M, Karamali N S, Boeke A J P et al (2006). High prevalence of vitamin D deficiency in pregnant non-Western women in The Hague, Netherlands. Am J Clin Nutr, 84(2): 350-353.
Holmes V A, Barnes M S, Alexander H D et al (2009). Vitamin D deficiency and insuf-ficiency in pregnant women: a longitudi-nal study. Br J Nutr, 102(6): 876-881.
Holick M F (2006). Resurrection of vitamin D deficiency and rickets. J Clin Invest, 116(8): 20622072-.
Zhang W, Stoecklin E, Eggersdorfer M (2013). A glimpse of vitamin D status in Mainland China. Nutrition, 29(8-7): 953-957.
Lagunova Z, Porojnicu A C, Lindberg F et al (2009). The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res, 29(9): 3713-3720.
Wong E Y, Ray R, Gao D L et al (2010). Physical activity, physical exertion, and miscarriage risk in women textile workers in Shanghai, China. Am J Ind Med, 53(5): 497-505.
Tao M, Shao H, Gu J et al (2012). Vitamin D status of pregnant women in Shang-hai, China. J Matern Fetal Neonatal Med, 25(3): 237-239.
Ross AC, Manson JE, Abrams SA et al (2011). The 2011 report on dietary refer-ence intakes for calcium and vitamin D from the Institute of Medicine: what cli-nicians need to know. J Clin Endocrinol Metab, 96(1): 53-58.
McCullough M L, Bostick R M, Daniel C R et al (2009). Vitamin D status and impact of vitamin D3 and/or calcium supple-mentation in a randomized pilot study in the Southeastern United States. J Am Coll Nutr, 28(6): 678-686.
Webb A R, Kline L, Holick M F (1988). In-fluence of season and latitude on the cu-taneous synthesis of vitamin D3: expo-sure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab, 67(2): 373-378.
Yan X, Thomson J S, Zhao R et al (2017). Vitamin D Status of Residents in Taiyuan, China and Influencing Factors. Nutrients, 9(8).
Yun C, Chen J, He Y et al (2017). Vitamin D deficiency prevalence and risk factors among pregnant Chinese women. Public Health Nutr, 20(10): 1746-1754.
Forrest K Y, Stuhldreher W L (2011). Preva-lence and correlates of vitamin D defi-ciency in US adults. Nutr Res, 31(1): 48-54.
Mannion C A, Gray-Donald K, Koski K G (2006). Association of low intake of milk and vitamin D during pregnancy with de-creased birth weight. CMAJ, 174(9): 1273-1277.
Bodnar L M, Catov J M, Simhan H N et al (2007). Maternal vitamin D deficiency in-creases the risk of preeclampsia. J Clin Endocrinol Metab, 92(9): 3517-3522.
Gale C R, Robinson S M, Harvey N C et al (2008). Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr, 62(1): 68-77.
Wei S Q, Qi H P, Luo Z C et al (2013). Ma-ternal vitamin D status and adverse preg-nancy outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med, 26(9): 889-899.
Pfeifer M, Begerow B, Minne H W et al (2001). Effects of a short-term vitamin D3 and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab, 86(4): 1633-1637.
Oyelese Y, Ananth CV (2006). Placental ab-ruption. Obstet Gynecol, 108(4): 1005-1016.
Siddiqui F, Kean L (2009). Intrauterine fetal death. Obstet Gynaecol Reprod Med, 19(1): 1-6.
Shand A W, Nassar N, Von Dadelszen P et al (2010). Maternal vitamin D status in pregnancy and adverse pregnancy out-comes in a group at high risk for pre‐eclampsia. BJOG, 117(13): 1593-1598.