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  • Pediatric Original Article
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Deficit of vitamin D in pregnancy and growth and overweight in the offspring

Abstract

Background:

Maternal vitamin D status during fetal development may influence offspring growth and risk of obesity; however, evidence in humans is limited.

Objective:

To investigate whether maternal circulating 25-hydroxyvitamin D3 (25(OH)D3) concentration in pregnancy is associated with offspring prenatal and postnatal growth and overweight.

Methods:

Plasma 25(OH)D3 concentration was measured in pregnant women (median weeks of gestation 14.0, range 13.0–15.0) from the INMA (INfancia y Medio Ambiente) cohort (Spain, 2003–2008) (n=2358). Offspring femur length (FL), biparietal diameter (BPD), abdominal circumference (AC) and estimated fetal weight (EFW) were evaluated at 12, 20 and 34 weeks of gestation by ultrasound examinations. Fetal overweight was defined either as AC or as EFW 90th percentile. Child’s anthropometry was recorded at ages 1 and 4 years. Rapid growth was defined as a weight gain z-score of >0.67 from birth to ages 6 months and 1 year. Age- and sex-specific z-scores for body mass index (BMI) were calculated at ages 1 and 4 years (World Health Organization referent); infant’s overweight was defined as a BMI z-score 85th percentile.

Results:

We found no association of maternal 25(OH)D3 concentration with FL and a weak inverse association with BPD at 34 weeks. Maternal deficit of 25(OH)D3 (<20 ng ml−1) was associated with increased risk of fetal overweight defined as AC 90th percentile (odds ratio (OR)=1.50, 95% confidence interval (CI): 1.01–2.21; P=0.041) or either as EFW 90th percentile (OR=1.47, 95% CI: 1.00–2.16; P=0.046). No significant associations were found with rapid growth. Deficit of 25(OH)D3 in pregnancy was associated with an increased risk of overweight in offspring at age 1 year (OR=1.42, 95% CI: 1.02–1.97; P=0.039); however, the association was attenuated at age 4 years (OR=1.19, 95% CI: 0.83–1.72; P=0.341).

Conclusions:

Vitamin D deficiency in pregnancy may increase the risk of prenatal and early postnatal overweight in offspring. Clinical trials are warranted to determine the role of vitamin D in the early origins of obesity.

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Acknowledgements

We particularly thank all the participants for their generous collaboration. A full roster of the INMA Project Investigators can be found at http://www.proyectoinma.org/presentacion-inma/listado-investigadores/en_listado-investigadores.html. This study was funded by Grants from Instituto de Salud Carlos III and Spanish Ministry of Health (Red INMA G03/176; CB06/02/0041; FIS 97/0588; 00/0021-2, PI061756; PS0901958; FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314 and 09/02647; FIS-PI041436, FIS- PI081151, FIS-PI06/0867, FIS-PS09/00090 and FIS-FEDER PI11/010007), FISS-PI042018, FISS-PI0902311, Universidad de Oviedo, Conselleria de Sanitat Generalitat Valenciana, Generalitat de Catalunya-CIRIT 1999SGR 00241, Department of Health of the Basque Government (2005111093 and 2009111069), the Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001) and Fundación Roger Torné. The funding organizations and sponsors had no role in the design and conduct of the study; the collection, management, analysis and interpretation of the data; the preparation, review or approval of the manuscript; and the decision to submit the manuscript for publication.

Author Contributions

Dr Sunyer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study conception and design: Morales, Iñiguez, Santa Marina, Rodriguez Dehli and Sunyer. Acquisition of data: Iñiguez, Valvi, Santa Marina, Espada, Rodriguez Dehli and Sunyer. Analysis and interpretation of data: Morales, Valvi and Vrijheid. Drafting of the manuscript: Morales, Valvi and Vrijheid. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: Morales and Iñiguez. Obtained funding: Iñiguez, Santa Marina, Vrijheid and Sunyer.

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Correspondence to E Morales.

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Morales, E., Rodriguez, A., Valvi, D. et al. Deficit of vitamin D in pregnancy and growth and overweight in the offspring. Int J Obes 39, 61–68 (2015). https://doi.org/10.1038/ijo.2014.165

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