Agueda Rodriguez1,2, Loreto Santa Marina3,4,5, Ana María Jimenez4,5, Ana Esplugues3,6,7, Ferran Ballester3,6,7, Mercedes Espada8, Jordi Sunyer3,9,10,11, Eva Morales3,12. 1. Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Spain. 2. Universitat Autònoma de Barcelona, Campus d'Excelència Internacional, Bellaterra, Spain. 3. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. 4. Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain. 5. BIODONOSTIA Health Research Institute, San Sebastian, Spain. 6. University of Valencia, Valencia, Spain. 7. Centre for Public Health Research (CSISP-FISABIO), Valencia, Spain. 8. Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Euskadi, Spain. 9. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. 10. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain. 11. Universitat Pompeu Fabra (UPF), Barcelona, Spain. 12. IMIB-Arrixaca Biomedical Research Institute, Virgen de la Arrixaca University Hospital, Murcia, Spain.
Abstract
BACKGROUND: Population-based data on vitamin D status in pregnancy in southern European countries are scarce. We assessed the prevalence and determinants of vitamin D insufficiency and deficiency in pregnancy in Spain. METHODS: Plasma 25-hydroxyvitamin D3 (25(OH)D3) concentration was measured at the first trimester of gestation in 2,036 pregnant women from several geographical areas of Spain (latitude 39-42°N). Uni- and multivariable regression models were conducted to identify predictors of circulating 25(OH)D3 concentration and vitamin D insufficiency (20-30 ng/mL) and deficiency (<20 ng/mL). RESULTS: Thirty-one per cent and 18% of women were vitamin D insufficient and deficient, respectively. Season at blood collection, latitude, age, social class, tobacco smoking, physical activity and use of vitamin D supplements were identified as independent determinants of 25(OH)D3 concentration. Lower risk of vitamin D insufficiency and deficiency was associated with summer season at blood collection (RR for insufficiency = 0.34, confidence intervals (CI) 0.25, 0.48; and RR for deficiency = 0.07, 95% CI 0.04, 0.12), southern latitude (RR for insufficiency = 0.71, 95% CI 0.50, 1.02; RR for deficiency = 0.60, 95% CI 0.38, 0.94); use of vitamin D supplements (RR for insufficiency = 0.50, 95% CI 0.35, 0.71; RR for deficiency = 0.24, 95% CI 0.14, 0.41); and strong physical activity (RR for insufficiency = 0.80, 95% CI 0.58, 1.09; and RR for deficiency = 0.67, 95% CI 0.46, 1.03). Higher risk of vitamin D deficiency was related to lower social class (RR = 1.94, 95% CI 1.19, 3.16) and smoking (RR = 1.76, 95% CI 1.23, 2.54). CONCLUSIONS: Vitamin D insufficiency and deficiency are highly prevalent in pregnancy. Recommendations and policies to detect and prevent hypovitaminosis D during pregnancy should be developed taking into account the associated factors.
BACKGROUND: Population-based data on vitamin D status in pregnancy in southern European countries are scarce. We assessed the prevalence and determinants of vitamin Dinsufficiency and deficiency in pregnancy in Spain. METHODS: Plasma 25-hydroxyvitamin D3 (25(OH)D3) concentration was measured at the first trimester of gestation in 2,036 pregnant women from several geographical areas of Spain (latitude 39-42°N). Uni- and multivariable regression models were conducted to identify predictors of circulating 25(OH)D3 concentration and vitamin Dinsufficiency (20-30 ng/mL) and deficiency (<20 ng/mL). RESULTS: Thirty-one per cent and 18% of women were vitamin Dinsufficient and deficient, respectively. Season at blood collection, latitude, age, social class, tobacco smoking, physical activity and use of vitamin D supplements were identified as independent determinants of 25(OH)D3 concentration. Lower risk of vitamin Dinsufficiency and deficiency was associated with summer season at blood collection (RR for insufficiency = 0.34, confidence intervals (CI) 0.25, 0.48; and RR for deficiency = 0.07, 95% CI 0.04, 0.12), southern latitude (RR for insufficiency = 0.71, 95% CI 0.50, 1.02; RR for deficiency = 0.60, 95% CI 0.38, 0.94); use of vitamin D supplements (RR for insufficiency = 0.50, 95% CI 0.35, 0.71; RR for deficiency = 0.24, 95% CI 0.14, 0.41); and strong physical activity (RR for insufficiency = 0.80, 95% CI 0.58, 1.09; and RR for deficiency = 0.67, 95% CI 0.46, 1.03). Higher risk of vitamin D deficiency was related to lower social class (RR = 1.94, 95% CI 1.19, 3.16) and smoking (RR = 1.76, 95% CI 1.23, 2.54). CONCLUSIONS:Vitamin Dinsufficiency and deficiency are highly prevalent in pregnancy. Recommendations and policies to detect and prevent hypovitaminosis D during pregnancy should be developed taking into account the associated factors.
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Authors: Cristina Palacios; Maria Angelica Trak-Fellermeier; Ricardo X Martinez; Lucero Lopez-Perez; Paul Lips; James A Salisi; Jessica C John; Juan Pablo Peña-Rosas Journal: Cochrane Database Syst Rev Date: 2019-10-03