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Minerals, trace elements, Vit. D and bone health

Vitamin D status during fetal life and childhood kidney outcomes

European Journal of Clinical Nutrition volume 70, pages 629–634 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

Maternal vitamin D deficiency during pregnancy may influence offspring kidney health. We aimed to examine the associations of 25-hydroxyvitamin D (25(OH)D) blood levels during fetal life with kidney outcomes at school age.

Subjects/Methods:

This study was embedded in a population-based prospective cohort study among 4212 mother–child pairs. We measured maternal second trimester (18–25 weeks) and fetal cord blood (at birth) 25(OH)D levels. At a median age of 6.0 years, we measured children’s combined kidney volume, glomerular filtration rate (eGFR) from creatinine and cystatin C serum levels, and microalbuminuria from albumin and creatinine urine levels.

Results:

Of all mothers, 21.9% had severely deficient levels (25(OH)D <25.0 nmol/l), 25.7% had deficient levels (25.0–49.9 nmol/l), 25% had sufficient levels (50.0–74.9 nmol/l) and 27.4% had optimal levels (⩾75.0 nmol/l). Maternal 25(OH)D levels were not consistently associated with childhood combined kidney volume. Higher maternal 25(OH)D levels were associated with lower childhood eGFR (difference −0.94 ml/min per 1.73 m2 (95% confidence interval, −1.73; −0.15) per 1 standard deviation (s.d.) increase in 25(OH)D). Maternal 25(OH)D levels were not associated with microalbuminuria. Cord blood 25(OH)D levels were not associated with childhood kidney outcomes. The associations of maternal 25(OH)D levels with childhood eGFR were partly explained by childhood vitamin D status.

Conclusions:

Our findings suggest that maternal 25(OH)D levels during pregnancy may influence childhood kidney outcomes. These results should be considered hypothesis generating. Further studies are needed to replicate the observations, to examine the underlying mechanisms and to identify the long-term clinical consequences.

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Acknowledgements

The Generation R Study is conducted by the Erasmus University Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond, Rotterdam. We gratefully acknowledge the contribution of participating mothers, general practitioners, hospitals, midwives and pharmacies in Rotterdam. The general design of the Generation R Study was made possible by financial support from the following: Erasmus Medical Center, Rotterdam; Erasmus University, Rotterdam; the Dutch Ministry of Health, Welfare and Sport; and the Netherlands Organization for Health Research and Development (ZonMw). K Miliku has been financially supported through Erasmus Mundus Western Balkans (ERAWEB), a project funded by the European Commission. T Voortman and O Franco work in ErasmusAGE, a research center funded by Nestlé Nutrition (Nestec Ltd), Metagenics Inc. and AXA. The vitamin D assay was supported by the Australian National Health and Medical Research Council (NHMRC APP1062846). Dr John McGrath received a NHMRC John Cade Fellowship (APP1056929). VWV Jaddoe received an additional grant from the Netherlands Organization for Health Research and Development (VIDI 016.136.361) and an European Research Council Consolidator Grant (ERC-2014-CoG-648916).

Author contributions

KM, TV and VWVJ designed the research and wrote the paper; AH, HT, OHF and VWVJ were involved in the design and planning of the study and data collection; JM, DE and TB performed the vitamin D assays on maternal and cord blood. KM and TV analyzed the data; JM, DE, TB, AH, HT, OHF and VWVJ provided comments and consultation regarding the analyses and manuscript; KM and VWVJ had primary responsibility for the final content. All authors critically reviewed and gave final approval of the version to be published.

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Authors and Affiliations

  1. The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    K Miliku, T Voortman & V W V Jaddoe

  2. Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    K Miliku, T Voortman, O H Franco, A Hofman, H Tiemeier & V W V Jaddoe

  3. Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    K Miliku & V W V Jaddoe

  4. Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia

    J J McGrath, D W Eyles & T H Burne

  5. Queensland Centre for Mental Health Research, Park Centre for Mental Health, Brisbane, Queensland, Australia

    J J McGrath, D W Eyles & T H Burne

  6. Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

    H Tiemeier

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Correspondence to V W V Jaddoe.

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Miliku, K., Voortman, T., Franco, O. et al. Vitamin D status during fetal life and childhood kidney outcomes. Eur J Clin Nutr 70, 629–634 (2016). https://doi.org/10.1038/ejcn.2015.216

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