Vitamin D status during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study in a multiracial cohort

Jin Xia, Yiqing Song, Shristi Rawal, Jing Wu, Stefanie N. Hinkle, Michael Y. Tsai, Cuilin Zhang

Research output: Contribution to journalArticle

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Abstract

Aim: To prospectively and longitudinally investigate vitamin D status during early to mid-pregnancy in relation to gestational diabetes mellitus (GDM) risk. Methods: In a nested case-control study of 107 GDM cases and 214 controls within the Fetal Growth Studies-Singleton Cohort, plasma levels of 25-hydroxyvitamin D2 and D3 (25(OH)D) and vitamin D binding protein were measured at gestational weeks 10 to 14, 15 to 26, 23 to 31, and 33 to 39; we further calculated total, free, and bioavailable 25(OH)D. Conditional logistic regression models and linear mixed-effects models were used. Results: We observed a threshold effect for the relation of vitamin D biomarkers with GDM risk. Vitamin D deficiency (<50 nmol/L) at 10 to 14 gestational weeks was associated with a 2.82-fold increased risk for GDM [odds ratio (OR) = 2.82, 95% confidence interval (CI): 1.15-6.93]. Women with persistent vitamin D deficiency at 10 to 14 and 15 to 26 weeks of gestation had a 4.46-fold elevated risk for GDM compared with women persistently non-deficient (OR = 4.46, 95% CI: 1.15-17.3). Conclusions: Maternal vitamin D deficiency as early as the first trimester of pregnancy was associated with an elevated risk of GDM. The association was stronger for women who were persistently deficient through the second trimester. Assessment of vitamin D status in early pregnancy may be clinically important and valuable for improving risk stratification and developing effective interventions for the primary prevention of GDM.

Original languageEnglish (US)
JournalDiabetes, Obesity and Metabolism
DOIs
StatePublished - Jan 1 2019

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Gestational Diabetes
Vitamin D
Longitudinal Studies
Pregnancy
Vitamin D Deficiency
25-Hydroxyvitamin D 2
Logistic Models
Odds Ratio
Vitamin D-Binding Protein
Confidence Intervals
Calcifediol
Second Pregnancy Trimester
First Pregnancy Trimester
Primary Prevention
Fetal Development
Case-Control Studies
Cohort Studies
Biomarkers
Mothers

Keywords

  • observational study
  • population study

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Vitamin D status during pregnancy and the risk of gestational diabetes mellitus : A longitudinal study in a multiracial cohort. / Xia, Jin; Song, Yiqing; Rawal, Shristi; Wu, Jing; Hinkle, Stefanie N.; Tsai, Michael Y.; Zhang, Cuilin.

In: Diabetes, Obesity and Metabolism, 01.01.2019.

Research output: Contribution to journalArticle

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