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Unplanned c-section birth 40 percent less often if sufficient vitamin D – Sept 2014

Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes.

BJOG. 2014 Sep 11. doi: 10.1111/1471-0528.13074. [Epub ahead of print]
Rodriguez A1, García-Esteban R, Basterretxea M, Lertxundi A, Rodríguez-Bernal C, Iñiguez C, Rodriguez-Dehli C, Tardón A, Espada M, Sunyer J, Morales E.

OBJECTIVE:
To investigate the association of maternal circulating 25-hydroxyvitamin D3 [25(OH)D3] concentration with pregnancy and birth outcomes.
DESIGN:
Prospective cohort study.
SETTING:
Four geographical areas of Spain, 2003-2008.
POPULATION:
Of 2382 mother-child pairs participating in the INfancia y Medio Ambiente (INMA) Project.
METHODS:
Maternal circulating 25(OH)D3 concentration was measured in pregnancy (mean [SD] 13.5 2.2 weeks of gestation). We tested associations of maternal 25(OH)D3 concentration with pregnancy and birth outcomes.
MAIN OUTCOME MEASURES:
Gestational diabetes mellitus (GDM), preterm delivery, caesarean section, fetal growth restriction (FGR) and small-for-gestational age (SGA), anthropometric birth outcomes including weight, length and head circumference (HC).
RESULTS:
Overall, 31.8% and 19.7% of women had vitamin D insufficiency [25(OH)D3 20-29.99 ng/ml] and deficiency [25(OH)D3 < 20 ng/ml], respectively. After adjustment, there was no association between maternal 25(OH)D3 concentration and risk of GDM or preterm delivery. Women with sufficient vitamin D [25(OH)D3 ≥ 30 ng/ml] had a decreased risk of caesarean section by obstructed labour compared with women with vitamin D deficiency [relative risk (RR) = 0.60, 95% CI 0.37, 0.97). Offspring of mothers with higher circulating 25(OH)D3 concentration tended to have smaller HC [coefficient (SE) per doubling concentration of 25(OH)D3, -0.10 (0.05), P = 0.038]. No significant associations were found for other birth outcomes.
CONCLUSION:
This study did not find any evidence of an association between vitamin D status in pregnancy and GDM, preterm delivery, FGR, SGA and anthropometric birth outcomes. Results suggest that sufficient circulating vitamin D concentration [25(OH)D3 ≥ 30 ng/ml] in pregnancy may reduce the risk of caesarean section by obstructed labour.

© 2014 Royal College of Obstetricians and Gynaecologists.
KEYWORDS:
Birthweight; caesarean section; gestational diabetes; pregnancy; preterm delivery; vitamin D
PMID: 25208685

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