The individual and joint effects of maternal 25(OH)D deficiency and gestational diabetes on infant birth size |
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| Institution: | 1. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China;2. Tongzhou Maternal and Child Health Hospital of Beijing, 101101, China;3. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China;1. Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, Avenida Carlos Chagas Filho 373, Bloco J, 2º Andar, Rio de Janeiro, RJ, 21941-902, Brazil;2. Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, FIOCRUZ/RJ, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil;3. Departamento de Investigación en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria, (IECS-CONICET), Ravignani 2024, (1414), Buenos Aires, Argentina;1. Nutrition–Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France;2. Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France;1. Macarthur Clinical School, Western Sydney University, Sydney, Australia;2. Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England, UK;3. Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria;4. Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain;5. Institut de Recerca de ĺHospital de la Santa Creu i Sant Pau, Barcelona, Spain;6. CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain;7. KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Belgium;8. Gynaecology and Obstetrics, University Hospitals Leuven, Belgium;9. Universita Degli Studi di Padova, Padua, Italy;10. Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy;11. Department of Medicine III, Division of Endocrinology, Gender Medicine Unit Medical University of Vienna, Vienna, Austria;12. Department of Reproduction, Poznan University of Medical Sciences, Poland;13. National University of Ireland, Galway, Ireland;14. Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark;15. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;p. Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark;q. Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark;r. Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark;s. Recherche en Santé Lawson SA, St. Gallen, Switzerland;t. Lawson Health Research Institute, London, Ontario, Canada;u. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands;v. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands;w. Medical University of Graz, Clinical Inst Medical and Chemical Laboratory Diagnostics, Graz, Austria;x. Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands;y. Gender Institute Gars am Kamp, Vienna, Austria;z. Institute of Sport Science, University of Graz, Graz, Austria;1. Paris 13 university, Sorbonne Paris Cité, AP–HP, Jean-Verdier hospital, department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, 93143 Bondy, France;2. Paris 13 university, Sorbonne Paris Cité, UMR U557 Inserm/U11125 INRA/CNAM/université Paris 13, unité de recherche epidémiologique nutritionnelle, Bobigny, France;3. Université Denis Diderot, AP–HP unité de recherche clinique St-Louis-Lariboisière, Paris, France;4. Paris 13 university, Sorbonne Paris Cité, AP–HP, Jean-Verdier hospital, department of obstetrics and gynecology, Bondy, France |
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| Abstract: | Background and aimsTo examine the independent effect of maternal serum 25-hydroxyvitamin D 25(OH)D] deficiency and its joint effect with gestational diabetes mellitus (GDM) on infant birth size.Methods and resultsThis retrospective cohort study was conducted in 15,724 mother-offspring dyads in Beijing, China between 2016 and 2017. Outcomes included infant birth weight Z-score (adjusted for gestational age and sex) and large for gestational age (LGA). Exposures were maternal 25(OH)D concentrations. Linear and logistic regression models were used to assess the associations of exposures with continuous and binary outcomes, respectively. Exposure-outcome associations were not observed when analyzing 25(OH)D concentrations continuously or in quartiles (P > 0.05); however, mothers with severely deficient 25(OH)D concentrations (n = 307) had a decreased risk of LGA compared with those with sufficient 25(OH)D concentrations (≥30.0 ng/mL; n = 5400) (adjusted odds ratio (OR): 0.63; 95% confidence interval (CI): 0.42, 0.93). Compared to mothers with no 25(OH)D deficiency (≥20.0 ng/mL) and no GDM (n = 7975), those with both 25(OH)D deficiency and GDM (n = 1090) had 0.15 (95% CI: 0.09, 0.21) higher infant birth weight Z-score and a higher risk of LGA (OR: 1.29; 95% CI: 1.09, 1.52). Maternal 25(OH)D deficiency and GDM had additive interaction on the risk of LGA (relative risk due to interaction: 0.18).ConclusionMothers with severely deficient 25(OH)D might have a decreased risk of LGA. However, the joint effect of maternal 25(OH)D deficiency and GDM might increase the risk of LGA. Our findings have clinical and public health implications and provide potential directions for future studies. |
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| Keywords: | Pregnancy 25(OH)D deficiency Gestational diabetes mellitus Birth weight Large for gestational age |
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