Full Papers

Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort

Abstract

Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and postnatal growth (weight and length), as well as the potential role of vitamin D status in explaining ethnic disparities in these outcomes. Data were derived from a large multi-ethnic cohort in The Netherlands (Amsterdam Born Children and their Development (ABCD) cohort), and included 3730 women with live-born singleton term deliveries. Maternal serum vitamin D was measured during early pregnancy (median 13 weeks, interquartile range: 12–14), and was labelled ‘deficient’ ( ≤ 29·9 nmol/l), ‘insufficient’ (30–49·9 nmol/l) or ‘adequate’ ( ≥ 50 nmol/l). Six ethnic groups were distinguished: Dutch, Surinamese, Turkish, Moroccan, other non-Western and other Western. Associations with neonatal outcomes were analysed using multivariate regression analyses. Results showed that compared with women with adequate vitamin D levels, women with deficient vitamin D levels had infants with lower birth weights ( − 114·4 g, 95 % CI − 151·2, − 77·6) and a higher risk of SGA (OR 2·4, 95 % CI 1·9, 3·2). Neonates born to mothers with a deficient vitamin D status showed accelerated growth in weight and length during the first year of life. Although a deficient vitamin D status influenced birth weight, SGA risk and neonatal growth, it played a limited role in explaining ethnic differences. Although vitamin D supplementation might be beneficial to those at risk of a deficient vitamin D status, more research is needed before a nationwide policy on the subject can be justified.

(Received September 11 2009)

(Revised January 06 2010)

(Accepted January 12 2010)

(Online publication March 02 2010)

Key Words:25-Hydroxyvitamin D; Ethnicity; Birth weight; Neonatal growth; ABCD Study

Correspondence:

^c1 Corresponding author: Dr Manon van Eijsden, fax +31 20 5555160, email mveijsden@ggd.amsterdam.nl

Footnotes

The work was performed at the Department of Epidemiology, Documentation and Health Promotion. Public Health Service of Amsterdam, PO Box 2200, 1000 CE Amsterdam, The Netherlands.

Abbreviations: 25(OH)D, 25-hydroxyvitamin D; ABCD, Amsterdam Born Children and their Development; SDS, standard deviation scores; SGA, small-for-gestational-age; YHC, youth health care