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Avoiding maternal vitamin D deficiency may lower blood glucose in pregnancy

Journal article
Authors Meabh Walsh
Linnea Bärebring
Hanna Augustin Olausson
Published in Journal of Steroid Biochemistry and Molecular Biology
Volume 186
Pages 117-121
ISSN 0960-0760
Publication year 2019
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 117-121
Language en
Links dx.doi.org/10.1016/j.jsbmb.2018.10....
Keywords Hyperglycaemia, Large for gestational age, 25-hydroxyvitamin D, gestational diabetes-mellitus, serum 25-hydroxyvitamin d, insulin-resistance, glycemic control, 1st trimester, risk, outcomes, women, hyperglycemia, association, Biochemistry & Molecular Biology, Endocrinology & Metabolism
Subject categories Obstetrics and women's diseases

Abstract

Background: Vitamin D status is hypothesised to play a role in gestational glucose control. No studies to date have examined vitamin D in relation to changes in blood glucose in pregnancy. Thus, the aim was to examine if vitamin D in early pregnancy and vitamin D trajectory associate with blood glucose trajectory over pregnancy in a Swedish cohort. We also investigated the relation between maternal vitamin D status and excessive fetal growth. Methods: In 2013-2014, pregnant women were recruited to the GraviD cohort study when registering at the antenatal clinics in south-west Sweden. In the present analysis, 1928 women were included. Women with preexisting diabetes and multifetal pregnancy were excluded. Random blood glucose was assessed according to routine practice, in first trimester (T1, gestational week 4-16), second trimester (T2, gestational week 17-27), early (T3a, gestational week 28-35) and late third trimester (T3b, gestational week 36-41). In Ti and T3a, serum 25-hydroxyvitamim D (25OHD) was analyzed by liquid chromatography tandem mass spectrometry. Large for gestational age (LGA), as a proxy of excessive fetal growth, was defined as body weight at birth above 2 standard deviations of the gender specific population mean. Adjusted linear regression, linear mixed models analysis and logistic regression analysis were used to study 25OHD in relation to Ti blood glucose, glucose trajectory and LGA, respectively. Results: Mean blood glucose increased during pregnancy (5.21 mmol/L in Tl, 5.27 mmol/L in T2, 5.31 mmol/L in T3a and 5.34 mmol/L in T3b; p = 0.003). In T1, 25OHD was negatively associated with blood glucose, i.e. 25OHD > 30 nmol/L was associated with 0.25-0.35 mmol/L lower glucose. Ti 25OHD was also negatively associated with blood glucose trajectory. Higher T3 25OHD was associated with higher odds of LGA (p = 0.032). Conclusion: Avoiding maternal vitamin D deficiency in early pregnancy is associated with lower blood glucose in early pregnancy and throughout pregnancy. Higher 25OHD in late pregnancy was associated with higher odds of LGA at birth.

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