Analysis of maternal serum vitamin D concentrations at birth in women presenting with spontaneous preterm birth: A case-control study

Grace Chiudzu, Alfred Maluwa, Augustine Choko, Jon Odland


Vitamin D is a potent immune system modulator; its deficiency correlates with increased susceptibility to infections. We evaluated the status of maternal serum vitamin D in women with spontaneous preterm birth. In this case-control study, the maternal serum concentration of vitamin D (25OH D) was measured in 95 women delivering preterm and 92 women having a term birth. Vitamin D sufficiency was found in 79% of the mothers who delivered preterm and 80.4% of the mothers who had term birth (p=0.822). There was a negative correlation between maternal serum concentration of 25 Hydroxyvitamin D and maternal age in the preterm birth group (p=0.043). In conclusion, there was no difference in maternal serum concentrations of 25 Hydroxyvitamin D between women delivering preterm compared to those having term birth. Maternal serum concentration of 25 Hydroxyvitamin D is not associated with occurrence of preterm birth. (Afr J Reprod Health 2021; 25[2]: 103-109).

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Holick MF. Sunlight and vitamin D for bone health and

prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6):1678S-1688S. doi:10.1093/ajcn/80.6.1678S

Tsoukas C, Provvedini D and Manolagas S. 1,25-

dihydroxyvitamin D3: a novel immunoregulatory hormone. Science. 1984;224(4656):1438-1440. doi:10.1126/science.6427926

Bhalla AshokK, Amento EP, Clemens TL, Holick MF and

Krane SM. Specific high-affinity receptors for 1,25-dihydroxyvitamin D 3 in human peripheral blood mononuclear cells: presence in monocytes and induction in T lymphocytes following activation. J Clin Endocrinol Metab. 1983;57(6):1308-1310. doi:10.1210/jcem-57-6-1308

Lee S. 1,25-Dihydroxyvitamin D3 and pancreatic beta-

cell function: vitamin D receptors, gene expression, and insulin secretion. Endocrinology. 1994;134(4):1602-1610. doi:10.1210/en.134.4.1602

Weishaar RE and Simpson RU. The Involvement of the

Endocrine System in Regulating Cardiovascular Function: Emphasis on Vitamin D 3 *. Endocr Rev. 1989;10(3):351-365. doi:10.1210/edrv-10-3-351

Weishaar RE, Kim SN, Saunders DE and Simpson RU.

Involvement of vitamin D3 with cardiovascular function. III. Effects on physical and morphological properties. Am J Physiol-Endocrinol Metab. 1990;258(1):E134-E142. doi:10.1152/ajpendo.1990.258.1.E134

Holick MF. Vitamin D: importance in the prevention of

cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79(3):362-371. doi:10.1093/ajcn/79.3.362

Holick MF. McCollum Award Lecture, 1994: Vitamin

D—new horizons for the 21st century. Am J Clin Nutr. 1994;60(4):619-630. doi:10.1093/ajcn/60.4.619

Holick MF. Vitamin D: A millenium perspective: Vitamin

D. J Cell Biochem. 2003;88(2):296-307. doi:10.1002/jcb.10338

Cantorna MT, Munsick C, Bemiss C and Mahon BD.

,25-Dihydroxycholecalciferol Prevents and Ameliorates Symptoms of Experimental Murine Inflammatory Bowel Disease. J Nutr. 2000;130(11):2648-2652. doi:10.1093/jn/130.11.2648

Jones G. Pharmacokinetics of vitamin D toxicity. Am J

Clin Nutr. 2008;88(2):582S-586S. doi:10.1093/ajcn/88.2.582S

Holick M, MacLaughlin J, Clark M, Holick SA, Potts JT,

Anderson RR, Blank IH, Parrish JA and Elias P. Photosynthesis of previtamin D3 in human skin and the physiologic consequences. Science. 1980;210(4466):203-205. doi:10.1126/science.6251551

Holick MF, Chen TC, Lu Z and Sauter E. Vitamin D and

Skin Physiology: A D-Lightful Story. J Bone Miner Res. 2007;22(S2):V28-V33. doi:10.1359/jbmr.07s211

Calvo MS, Whiting SJ and Barton CN. Vitamin D Intake:

A Global Perspective of Current Status. J Nutr. 2005;135(2):310-316. doi:10.1093/jn/135.2.310

Weisman Y, Harell A, Edelstein S, David M, Spirer Z and

Golander A. Alpha, 25-Dihydroxyvitamin D3 and 24, 25-Dihydroxyvitamin D3 in Vitro Synthesis by Human Decidua and Placenta Nature 1979 281. N; 1.

Kovacs CS and Kronenberg HM. Maternal-fetal calcium

and bone metabolism during pregnancy, puerperium, and lactation. Endocr Rev. 1997;18(6):832-872. doi:10.1210/er.18.6.832

Mithal A, Wahl DA, Bonjour J-P, P Burckhardt, B

Dawson-Hughes, Eisman JA, El-Hajj Fuleihan, RG Josse, P Lips and J Morales-Torres. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20(11):1807-1820.

Nair R and Maseeh A. Vitamin D: The “sunshine”

vitamin. J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506

Toko EN, Sumba OP, Daud II, Ogolo S, Majiwa M,

Krisher JT, Ouma C, Dent AE, Rochford R and Mehta S. Maternal Vitamin D Status and Adverse Birth Outcomes in Children from Rural Western Kenya. Nutrients. 2016;8(12):794. doi:10.3390/nu8120794

Nimitphong H and Holick MF. Vitamin D status and sun

exposure in southeast Asia. Dermatoendocrinol. 2013;5(1):34-37. doi:10.4161/derm.24054

Mehta S, Spiegelman D, Aboud S, Aboud S, Glovannucci

EL, Msamanga GI, Hertzmark E, Mugusi FM, Hunter DJ and Fawzi WW. Lipid-soluble vitamins A, D and E in HIV-infected pregnant women in Tanzania. Eur J Clin Nutr. 2010;64(8):808-817. doi:10.1038/ejcn.2010.76

Lips P, Schoor NM van and Jongh RT de. Diet, sun, and

lifestyle as determinants of vitamin D status. Ann N Y Acad Sci. 2014;1317(1):92-98. doi:10.1111/nyas.12443

Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers

RW and Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92(9):3517-3522.

Poel YHM, Hummel P, Lips P, Stam F, Van Der Ploeg T

and Simsek S. Vitamin D and gestational diabetes: a systematic review and meta-analysis. Eur J Intern Med. 2012;23(5):465-469.

Bodnar LM, Platt RW and Simhan HN. Early-Pregnancy

Vitamin D Deficiency and Risk of Preterm Birth Subtypes: Obstet Gynecol. 2015;125(2):439-447. doi:10.1097/AOG.0000000000000621

van der Pligt P, Willcox J, Szymlek-Gay E, Murray E,

Worsley A and Daly R. Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review. Nutrients. 2018;10(5):640. doi:10.3390/nu10050640

Blencowe H, Cousens S, Oestergaard MZ, Chou D,

Moller A, Narwal R, Adler A, Garcia CV, Rohde S, Say L and Lawn JE. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet. 2012;379(9832):2162-2172. doi:10.1016/S0140-6736(12)60820-4

Romero R, Espinoza J, Kusanovic J, Gotsch F, Hassan S,

Erez O, Chaiworapongsa T and Mazor M. The preterm parturition syndrome. BJOG Int J Obstet Gynaecol. 2006;113:17-42. doi:10.1111/j.1471-0528.2006.01120.x

Gonçalves LF, Chaiworapongsa T and Romero R.

Intrauterine infection and prematurity. Ment Retard Dev Disabil Res Rev. 2002;8(1):3-13. doi:10.1002/mrdd.10008

Adams JS and Hewison M. Unexpected actions of vitamin

D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab. 2008;4(2):80-90. doi:10.1038/ncpendmet0716

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon

CM, Hanley DA, Heaney RP, Murad MH and Weaver CM. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930. doi:10.1210/jc.2011-0385

Kassai MS, Cafeo FR, Affonso-Kaufman FA, Suano-

Souza FI and Sarni ROS. Vitamin D plasma concentrations in pregnant women and their preterm newborns. BMC Pregnancy Childbirth. 2018;18(1):412. doi:10.1186/s12884-018-2045-1

Shibata M, Suzuki A, Sekiya T, Sekiguchi S, Asano S,

Udagawa Y, and Itoh M. High prevalence of hypovitaminosis D in pregnant Japanese women with threatened premature delivery. J Bone Miner Metab. 2011;29(5):615-620. doi:10.1007/s00774-011- 0264-x

Zhou S-S, Tao Y-H, Huang K, Zhu B-B and Tao F-B.

Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies. J Obstet Gynaecol Res. 2017;43(2):247-256. doi:10.1111/jog.13239

Yin K and Agrawal DK. Vitamin D and inflammatory

diseases. J Inflamm Res. 2014;7:69.

Baker MR, Peacock M and Nordin BEC. The decline in

vitamin d status with age. Age Ageing. 1980;9(4):249-252. doi:10.1093/ageing/9.4.249

Lips P. Vitamin D physiology. Prog Biophys Mol Biol.

;92(1):4-8. doi:10.1016/j.pbiomolbio.2006.02.016

Konradsen S, Ag H, Lindberg F, Hexeberg S and Jorde R.

Serum 1, 25-dihydroxy vitamin D is inversely associated with body mass index. Eur J Nutr. 2008;47(2):87-91.


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