Exploring the concept of functional vitamin D deficiency in pregnancy: impact of the interaction between 25-hydroxyvitamin D and parathyroid hormone on perinatal outcomes

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dc.contributor.author Hemmingway, Andrea
dc.contributor.author Kenny, Louise C.
dc.contributor.author Malvisi, Lucio
dc.contributor.author Kiely, Mairead E.
dc.date.accessioned 2019-01-15T12:07:39Z
dc.date.available 2019-01-15T12:07:39Z
dc.date.issued 2018
dc.identifier.citation Hemmingway, A., Kenny, L. C., Malvisi, L. and Kiely, M. E. (2018) 'Exploring the concept of functional vitamin D deficiency in pregnancy: impact of the interaction between 25-hydroxyvitamin D and parathyroid hormone on perinatal outcomes', The American Journal of Clinical Nutrition, 108(4), pp. 821-829. doi: 10.1093/ajcn/nqy150 en
dc.identifier.volume 108 en
dc.identifier.issued 4 en
dc.identifier.startpage 821 en
dc.identifier.endpage 829 en
dc.identifier.issn 0002-9165
dc.identifier.uri http://hdl.handle.net/10468/7296
dc.identifier.doi 10.1093/ajcn/nqy150
dc.description.abstract Background: Associations of vitamin D with perinatal outcomes are inconsistent and few studies have considered the wider calcium metabolic system. Objectives: We aimed to explore functional vitamin D deficiency in pregnancy by investigating associations between vitamin D status, parathyroid hormone (PTH), and perinatal outcomes. Design: SCOPE (Screening for Pregnancy Endpoints) Ireland is a prospective cohort study of low-risk, nulliparous pregnant women. We measured serum 25-hydroxyvitamin D [25(OH)D] and PTH at 15 wk of gestation in 1754 participants. Results: Mean ± SD 25(OH)D was 56.6 ± 25.8 nmol/L (22.7 ± 10.3 ng/mL) and geometric mean (95% CI) PTH was 7.84 pg/mL (7.7, 8.0 pg/mL) [0.86 pmol/L (0.85, 0.88 pmol/L)]. PTH was elevated in 34.3% of women who had 25(OH)D <30 nmol/L and in 13.9% of those with 25(OH)D ≥75 nmol/L. Whereas 17% had 25(OH)D <30 nmol/L, 5.5% had functional vitamin D deficiency, defined as 25(OH)D <30 nmol/L with elevated PTH. Elevated mean arterial pressure (MAP), gestational hypertension, pre-eclampsia, and small-for-gestational-age (SGA) birth were confirmed in 9.2%, 11.9%, 3.8%, and 10.6% of participants, respectively. In fully adjusted regression models, neither low 25(OH)D nor elevated PTH alone increased the risk of any individual outcome. The prevalence of elevated MAP (19.1% compared with 9.7%) and SGA (16.0% compared with 6.7%) were highest (P < 0.05) in those with functional vitamin D deficiency compared with the reference group [25(OH)D ≥75 nmol/L and normal PTH]. The adjusted prevalence ratio (PR) and RR (95% CIs) for elevated MAP and SGA were 1.83 (1.02, 3.27) and 1.53 (0.80, 2.93), respectively. There was no effect of functional vitamin D deficiency on the risk of gestational hypertension (adjusted RR: 1.00; 95% CI: 0.60, 1.67) or pre-eclampsia (adjusted RR: 1.17; 95% CI: 0.32, 4.20). Conclusion: The concept of functional vitamin D deficiency, reflecting calcium metabolic stress, should be considered in studies of vitamin D in pregnancy. The SCOPE pregnancy cohort is registered at http://www.anzctr.org.au as ACTRN12607000551493. en
dc.description.sponsorship Health Research Board (SCOPE Ireland pregnancy cohort study, grant (CSA 02/2007)); en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Oxford University Press en
dc.relation.uri http://dx.doi.org/10.1093/ajcn/nqy150
dc.rights © 2018 American Society for Nutrition. Published by Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in American Journal of Clinical Nutrition following peer review. The version of record, 108, Issue 4, 1 October 2018, Pages 821–829, is available online at: https://doi.org/10.1093/ajcn/nqy150 en
dc.subject Vitamin D en
dc.subject 25-hydroxyvitamin D en
dc.subject Parathyroid hormone en
dc.subject Pregnancy en
dc.subject Perinatal en
dc.subject Mean arterial pressure en
dc.subject Gestational hypertension en
dc.subject Preeclampsia en
dc.subject Small-for-gestational-age en
dc.title Exploring the concept of functional vitamin D deficiency in pregnancy: impact of the interaction between 25-hydroxyvitamin D and parathyroid hormone on perinatal outcomes en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Andrea Hemmingway, Obstetrics & Gynaecology, University College Cork, Cork, Ireland. +353-21-490-3000 Email: m.kiely@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication at the request of the publisher en
dc.check.date 2019-08-28
dc.date.updated 2019-01-15T11:51:45Z
dc.description.version Accepted Version en
dc.internal.rssid 469618754
dc.contributor.funder Seventh Framework Programme en
dc.contributor.funder Health Research Board en
dc.contributor.funder Science Foundation Ireland en
dc.contributor.funder European Regional Development Fund en
dc.description.status Peer reviewed en
dc.identifier.journaltitle The American Journal of Clinical Nutrition en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress m.kiely@ucc.ie en
dc.internal.IRISemailaddress andrea.hemmingway@ucc.ie en
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::KBBE/613977/EU/Food-based solutions for Optimal vitamin D Nutrition and health through the life cycle/ODIN en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Spokes Programme/14/SP APC INFANT/B3067/IE/The Cork Nutrition and Microbiome Maternal-Infant Cohort Study (COMBINE)/ en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/ en


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