Maternal vitamin D status during pregnancy and body composition and cardiovascular risk markers in Indian children: The Mysore Parthenon Study

Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 03/2011; 93(3):628-35. DOI: 10.3945/ajcn.110.003921
Source: PubMed


Metabolic consequences of vitamin D deficiency have become a recent research focus. Maternal vitamin D status is thought to influence musculoskeletal health in children, but its relation with offspring metabolic risk is not known.
We aimed to examine the association between maternal vitamin D status and anthropometric variables, body composition, and cardiovascular risk markers in Indian children.
Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured at 28-32 wk gestation in 568 women who delivered at Holdsworth Memorial Hospital, Mysore, India. Anthropometric variables, glucose and insulin concentrations, blood pressure, and fasting lipid concentrations were measured in the offspring at 5 and 9.5 y of age. Muscle-grip strength was measured by using a hand-held dynamometer at age 9.5 y. Arm-muscle area was calculated as a measure of muscle mass. Fasting insulin resistance was calculated by using the homeostasis model assessment equation.
Sixty-seven percent of women had vitamin D deficiency [serum 25(OH)D concentration <50 nmol/L]. At ages 5 and 9.5 y, children born to vitamin D-deficient mothers had smaller arm-muscle area in comparison with children born to mothers without deficiency (P < 0.05). There was no difference in grip strength between offspring of women with and without vitamin D deficiency. At 9.5 y, children of vitamin D-deficient mothers had higher fasting insulin resistance than did children of nondeficient women (P = 0.04). There were no associations between maternal vitamin D status and other offspring risk factors at either age.
Intrauterine exposure to low 25(OH)D concentrations is associated with less muscle mass and higher insulin resistance in children.

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    • "The median serum 25(OH)D level observed in the present study for affluent pregnant women was only slightly higher (11.0 versus 10.4 ng/mL) than the value reported by Agarwal and Arya for a comparable group [3]. The mean/median (9.8/9.3 ng/mL) values observed for serum 25(OH)D for nonaffluent pregnant women in the present study were lower in comparison to most of the previous researches (median: 14.0–15.1 ng/mL) [7, 17, 18] except for the values (mean: 9.2–8.8 ng/mL) reported by Goswami et al. [2] and Marwaha et al. [19]. "
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    ABSTRACT: Objectives: This cross-sectional study primarily aimed to assess vitamin D adequacy in the third trimester of pregnancy using 25-hydroxyvitamin D (25(OH)D) and explore lifestyle characteristics (sun exposure index, diet, and economic indicators) associated with serum 25(OH)D. The secondary aim was to examine the relationship of serum 25(OH)D with birth weight and gestational age. Methods: Serum 25(OH)D was measured by chemiluminescent immunoassay in 150 pregnant women from Mumbai. Sun exposure index was computed. Dietary calcium, phytate : calcium ratio, and dietary phosphorus was calculated using the 24-hour diet recall method. Results: All women had 25(OH)D levels < 30.00 ng/ml. Multivariable linear regression showed that nonaffluent women had poorer 25(OH)D status than their affluent counterparts (β = -0.20; P = 0.03). Higher sun exposure index was associated with higher 25(OH)D concentrations (β = 0.31; P < 0.001), which remained significant after controlling for covariates. At the bivariate level, mothers of infants weighing <2500 g had lower serum 25(OH)D concentrations compared to mothers whose infants weighed ≥ 2500 g (P = 0.02). This association became non-significant after controlling for covariates. Conclusions: Vitamin D deficiency was universally prevalent in the cohort studied. There is a need to develop culturally sensitive strategies for improving the 25(OH)D status.
    Full-text · Article · Jun 2014 · BioMed Research International
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    • "Recent evidence from primate animal models suggest that even moderate maternal undernutrition may lead to major disturbances in the architecture and maturation of the developing cortical neuronal network with a potential impact on brain function over the lifespan [28]. Moreover, data supporting a relation between maternal undernutrition during pregnancy and cognitive impairment in children have been also reported [29]. In agreement with this report, IUGR was proven to be a major determinant of severity and poor outcome of GDD in our study. "
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    ABSTRACT: Although several determinants of global developmental delay (GDD) have been recognized, a significant number of children remain without definitive etiologic diagnosis. The objective of this study was to assess the effect of various prenatal and perinatal factors on the severity and outcome of developmental delay without definitive etiologic yield. From March 2008 to February 2010, 142 children with developmental quotient (DQ) <70 and without definitive etiologic diagnosis, were included. Prenatal and perinatal risk factors known to be associated with disordered neonatal brain function were identified. Participants underwent a thorough investigation, an individualized habilitation plan was recommended, and the children were followed-up regularly for a period of 2 years. The effect of prenatal and perinatal risk factors on the severity and outcome of GDD was assessed by regression analysis. The mean age at enrolment was 31 +/- 12 months, and the mean DQ 52.2 +/- 11.4. Prematurity and intrauterine growth restriction (IUGR) were found to be independently associated with lower DQ values. The mean DQ after the 2-year follow-up was 62.5 +/- 12.7, and the DQ difference from the enrollment 10.4 +/- 8.9 (median 10; range-10 to 42). DQ improvement (defined as a DQ difference >= median) was noted in 52.8% of the children. IUGR, low socio-economic status, and poor compliance to habilitation plan were found to be independently associated with poorer developmental outcomes. Prematurity and IUGR were found to be significantly and independently related to the severity of GDD in cases without definitive etiologic yield. Poorer 2-year developmental outcome was associated with IUGR, low socioeconomic status and non compliance to habilitation plan. Prematurity was a significant determinant of the outcome only in association with the above mentioned factors.
    Full-text · Article · Feb 2014 · BMC Pediatrics
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    • "A few studies suggest that low fetal vitamin D may reduce bone mineral content, consequently leading to fragility fractures [14]. Possibly it also affects metabolic functioning and consequently leads to obesity [15]. Some studies have found that adult obesity varies as a function of month of birth and that subjects born from winter to spring become more obese, possibly due to low vitamin D levels from restricted maternal sun exposure during the third trimester of pregnancy [16]. "
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    ABSTRACT: Background Vitamin D deficiency is common among otherwise healthy pregnant women and may have consequences for them as well as the early development and long-term health of their children. However, the importance of maternal vitamin D status on offspring health later in life has not been widely studied. The present study includes an in-depth examination of the influence of exposure to vitamin D early in life for development of fractures of the wrist, arm and clavicle; obesity, and type 1 diabetes (T1D) during child- and adulthood. Methods/design The study is based on the fact that in 1961 fortifying margarine with vitamin D became mandatory in Denmark and in 1972 low fat milk fortification was allowed. Apart from determining the influences of exposure prior to conception and during prenatal life, we will examine the importance of vitamin D exposure during specific seasons and trimesters, by comparing disease incidence among individuals born before and after fortification. The Danish National databases assure that there are a sufficient number of individuals to verify any vitamin D effects during different gestation phases. Additionally, a validated method will be used to determine neonatal vitamin D status using stored dried blood spots (DBS) from individuals who developed the aforementioned disease entities as adults and their time and gender-matched controls. Discussion The results of the study will contribute to our current understanding of the significance of supplementation with vitamin D. More specifically, they will enable new research in related fields, including interventional research designed to assess supplementation needs for different subgroups of pregnant women. Also, other health outcomes can subsequently be studied to generate multiple health research opportunities involving vitamin D. Finally, the results of the study will justify the debate of Danish health authorities whether to resume vitamin D supplementation policies.
    Full-text · Article · May 2013 · BMC Public Health
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