Maternal Vitamin D Status Related to Triacylglycerol in Early Pregnancy and Subsequent Risk for Adverse Pregnancy Outcomes
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Issue Date
2011-04-25Author
Chan, Ka Ian
Publisher
University of Kansas
Format
54 pages
Type
Thesis
Degree Level
M.S.
Discipline
Dietetics & Nutrition
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This item is protected by copyright and unless otherwise specified the copyright of this thesis/dissertation is held by the author.
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Research has suggested roles of vitamin D in health beyond its action on calcium homeostasis and bone health. Recent studies revealed a high proportion of pregnant women having low vitamin D status. This may lead to increased risks for preeclampsia, gestational diabetes (GDM), and cesarean delivery. Findings on the effects of vitamin D on these adverse pregnancy outcomes have been inconsistent. To our knowledge, no studies have examined maternal vitamin D status with circulating triacylglycerol (TAG) concentrations. This study was conducted to assess the effects of maternal vitamin D status on subsequent risk for pregnancy complications and to determine the effectiveness of 25-hydroxyvitamin D [25(OH)D] to TAG ratio to indicate vitamin D status. We measured the plasma 25(OH)D and TAG concentrations of 299 pregnant women in their 8th to 20th week of gestation, and examined the association between 25(OH)D concentrations, 25(OH)D/TAG ratios and the risk of preeclampsia, GDM, and cesarean delivery. Of the 299 subjects, five developed preeclampsia, 15 developed GDM, and 89 delivered their infants by cesarean section. Women diagnosed with preeclampsia or GDM had significantly lower 25(OH)D/TAG ratios than women without these complications. Women with 25(OH)D concentrations and 25(OH)D/TAG below medians had increased odds of preeclampsia (OR, 4.05; 95% CI, 0.45-36.71 and OR, 4.05; 95% CI, 0.45-36.71 respectively) and GDM (OR, 2.12; 95% CI, 0.71-6.38 and OR, 2.96, 95% CI, 0.92-9.55 respectively). These results were not statistically significant because of the small number of affected women, but the association between 25(OH)D/TAG and GDM risk was close to significant (P = 0.07). Women with 25(OH)D concentrations and 25(OH)D/TAG below medians also had reduced odds for cesarean delivery (OR, 0.54; 95% CI, 0.32-0.89 and OR, 0.74; 95% CI, 0.45-1.22 respectively), but only the association between 25(OH)D concentration and risk of cesarean delivery was statistically significant. This study suggested increased preeclampsia and GDM risks in women with low vitamin D status. Few cases of these events compromised the statistical significance of results. The increased risk of cesarean delivery in women with higher vitamin D status shown has to be reevaluated because reasons for cesarean delivery were not included in the analysis.
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