Figueiredo, Amanda C. Cunha, Cocate, Paula Guedes, Adegboye, Amanda R. Amorim ORCID: 0000-0003-2780-0350, Franco-Sena, Ana Beatriz, Farias, Dayana R., de Castro, Maria Beatriz Trindade, Brito, Alex, Allen, Lindsay H., Mokhtar, Rana R., Holick, Michael F. and Kac, Gilberto (2017) Changes in plasma concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort. European Journal of Nutrition, 57 (3). pp. 1059-1072. ISSN 1436-6207 (Print), 1436-6215 (Online) (doi:https://doi.org/10.1007/s00394-017-1389-z)

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Abstract

PURPOSE:
To characterize the physiological changes in 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] throughout pregnancy.

METHODS:
Prospective cohort of 229 apparently healthy pregnant women followed at 5th-13th, 20th-26th, and 30th-36th gestational weeks. 25(OH)D and 1,25(OH)2D concentrations were measured by LC-MS/MS. Statistical analyses included longitudinal linear mixed-effects models adjusted for parity, season, education, self-reported skin color, and pre-pregnancy BMI. Vitamin D status was defined based on 25(OH)D concentrations according to the Endocrine Society Practice Guideline and Institute of Medicine (IOM) for adults.

RESULTS:
The prevalence of 25(OH)D <75 nmol/L was 70.4, 41.0, and 33.9%; the prevalence of 25(OH)D <50 nmol/L was 16.1, 11.2, and 10.2%; and the prevalence of 25(OH)D <30 nmol/L was 2, 0, and 0.6%, at the first, second, and third trimesters, respectively. Unadjusted analysis showed an increase in 25(OH)D (β = 0.869; 95% CI 0.723-1.014; P < 0.001) and 1,25(OH)2D (β = 3.878; 95% CI 3.136-4.620; P < 0.001) throughout pregnancy. Multiple adjusted analyses showed that women who started the study in winter (P < 0.001), spring (P < 0.001), or autumn (P = 0.028) presented a longitudinal increase in 25(OH)D concentrations, while women that started during summer did not. Increase of 1,25(OH)2D concentrations over time in women with insufficient vitamin D (50-75 nmol/L) at baseline was higher compared to women with sufficient vitamin D (≥75 nmol/L) (P = 0.006).

CONCLUSIONS:
The prevalence of vitamin D inadequacy varied significantly according to the adopted criteria. There was a seasonal variation of 25(OH)D during pregnancy. The women with insufficient vitamin D status present greater longitudinal increases in the concentrations of 1,25(OH)2D in comparison to women with sufficiency.

Item Type:	Article
Uncontrolled Keywords:	Vitamin D, Pregnancy, Micronutrients, Cohort, Tropical country, Seasons
Subjects:	R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM) Faculty of Education, Health & Human Sciences > Health & Society Research Group
Last Modified:	28 Apr 2020 17:57
URI:	http://gala.gre.ac.uk/id/eprint/22125

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