Factors affecting newborn bone mineral content: in utero effects on newborn bone mineralization

Several factors have been found recently to have a significant impact on newborn bone mineral content (BMC) and developing fetal bone. Recently we showed that maternal vitamin D deficiency may affect fetal bone mineralization. Korean winter-born newborn infants had extremely low serum 25-hydroxyvitamin D (25-OHD), high serum cross-linked carboxy-terminal telopeptide of type I collagen (ICTP; a bone resorption marker), and markedly lower (8 %) total body BMC than summer-born newborn infants. Infant total body BMC was positively correlated with cord serum 25-OHD and inversely correlated with ICTP, which was also negatively correlated with vitamin D status. In three separate studies on North American neonates we found markedly lower (8-12 %) BMC in summer newborn infants compared with winter newborn infants, the opposite of the findings for Korean neonates. The major reason for the conflicting BMC results might be the markedly different maternal vitamin D status of the North American and Korean subjects. Recently, we found evidence of decreased bone formation rates in infants who were small-for-gestational age (SGA) compared with infants who were appropriate-for-gestational age; we reported reduced BMC, cord serum osteocalcin (a marker of bone formation) and 1,25-dihydroxyvitamin D (the active metabolite of vitamin D), but no alterations in indices of fetal bone collagen metabolism. In theory, reduced utero-placental blood flow in SGA infants may result in reduced transplacental mineral supply and reduced fetal bone formation. Infants of diabetic mothers (IDM) have low BMC at birth, and infant BMC correlated inversely with poor control of diabetes in the mother, specifically first trimester maternal mean capillary blood glucose concentration, implying that factors early in pregnancy might have an effect on fetal BMC. The low BMC in IDM may be related to the decreased transplacental mineral transfer. Cord serum ICTP concentrations were higher in IDM than in control subjects, implying increased intrauterine bone resorption. BMC is consistently increased with increasing body weight and length in infants. Race and gender differences in BMC appear in early life, but not at birth. Ethanol consumption and smoking by the mother during pregnancy affect fetal skeletal development.     

25-Hydroxyvitamin D and 1,25-dihydroxyvitamin D of D2 and D3 origin in maternal and umbilical cord serum after vitamin D2 supplementation in human pregnancy

Serum concentrations of 25-hydroxyvitamin D (25-OHD) and 1,25-dihydroxyvitamin D [1,25-(OH)2D] of vitamin D2 and D3 origin were determined separately in 10 women before vitamin intake in early pregnancy, and repeated in maternal and cord serum obtained at delivery after 20 to 30 wk of vitamin D2 supplementation in a dose of 400 IU/day. Before supplementation 25-OHD2 and 1,25-(OH)D2D2 were present in just traceable or nondetectable concentrations, but the levels increased in all to a mean +/- 1 SD of 7.3 +/- 3.7 ng/ml and 37.2 +/- 18.1 pg/ml, respectively (p less than 0.0025), by the time of delivery. At delivery the total 25-OHD and 1,25-(OH)2D levels were always lower in the cord than in the maternal serum (30.7 +/- 14.2 versus 20.1 +/- 9.1 ng/ml, and 90.1 +/- 31.2 versus 37.3 +/- 11.6 pg/ml, p less than 0.0025). The paired concentrations of 25-OHD were closely related (r = 0.89, p less than 0.0005), while the association for 1,25-(OH)2D was not statistically significant (r = 0.53, p less than .01). The 25-OHD of D2 and D3 origin accounted for a similar proportion of the total 25-OHD in the maternal and cord serum (ratio of 25-OHD2 to 25-OHD3: 0.40 +/- 0.28 versus 0.45 +/- 0.29, p = NS), as did the respective 1,25-(OH)2D metabolites [ratio of 1,25-(OH)2D2 to 1,25-(OH)2D3: 0.73 +/- 0.35 versus 0.90 +/- 0.50, p = NS].(ABSTRACT TRUNCATED AT 250 WORDS)     

Prenatal Vitamin D Levels in Maternal Sera and Offspring Specific Learning Disorders

Recent evidence has suggested potential harmful effects of vitamin D deficiency during pregnancy on offspring brain development, for example, elevated risks for neuropsychiatric disorders. Findings on general cognition and academic achievement are mixed, and no studies have examined the effect of prenatal 25-hydroxyvitamin D (25(OH)D) levels on diagnosed specific learning disorders, which was the aim of this study. We examined a nested case–control sample from the source cohort of all singleton-born children in Finland between 1996 and 1997 (n = 115,730). A total of 1607 cases with specific learning disorders (mean age at diagnosis: 9.9 years) and 1607 matched controls were identified from Finnish nationwide registers. Maternal 25(OH)D levels were analyzed from serum samples collected during the first trimester of pregnancy and stored in a national biobank. Conditional logistic regression was used to test the association between maternal 25(OH)D and offspring specific learning disorders. There were no significant associations between maternal 25(OH)D levels and specific learning disorders when vitamin D was examined as a log-transformed continuous variable (adjusted OR 0.98, 95% CI 0.82–1.18, p = 0.84) or as a categorical variable (25(OH)D < 30 nmol/L: adjusted OR 1.03, 95% CI 0.83–1.28, p = 0.77 compared to levels of >50 nmol/L), nor when it was divided into quintiles (adjusted OR for the lowest quintile 1.00, 95% CI 0.78–1.28, p = 0.99 compared to the highest quintile). This study found no association between low maternal 25(OH)D in early pregnancy and offspring specific learning disorders.     

Does vitamin D during pregnancy impact offspring growth and bone?

During pregnancy, maternal and fetal Ca demands are met through increased intestinal Ca absorption. Increased Ca absorption may be more dependent on oestrogen's up-regulation of Ca transport genes than on vitamin D status. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to abnormal Ca homoeostasis in the neonate. Some, but not all, studies of maternal vitamin D supplementation during pregnancy find a greater birth weight among infants of mothers with adequate vitamin D status. Observational studies find a higher incidence of small-for-gestational age (SGA) infants among mothers who are vitamin D deficient, but this effect may be modified by genetics. In addition, the effect of vitamin D status on SGA may not be linear, with increased occurrence of SGA at high maternal 25-hydroxyvitamin D (25-OHD) concentrations. Some studies, but not all, also have found that maternal vitamin D status is associated with growth trajectory during the first year of life, although the findings are contradictory. There are recent studies that suggest maternal 25-OHD, or surrogates of vitamin D status, are associated with growth and bone mass later in childhood. These results are not consistent, and blinded randomised trials of vitamin D supplementation during pregnancy with long-term follow-up are needed to determine the benefits, and possible risks, of maternal vitamin D status on offspring growth and bone development. The possibility of adverse outcomes with higher maternal 25-OHD concentrations should be considered and investigated in all ongoing and future studies.     

乌市水区新生儿脐血与孕母血维生素D水平的相关性及其影响因素

目的了解新生儿脐带血与孕母妊娠末期血维生素D水平的相关性,探讨影响新生儿脐血维生素D水平的相关因素。方法对自2015年11月-2016年3月冬季收住的112例新生儿脐血及其中40例的孕母产前静脉血采用化学发光法测定维生素D值,进行相关性分析。结果 112例新生儿脐血25(OH)D平均水平为(6.75±3.59)ng/ml,新生儿维生素D均处于缺乏状态,中、重度维生素D缺乏新生儿占85.7%。40例孕母血25(OH)D平均水平与新生儿血25(OH)D水平呈显著正相关(r=0.86,P0.001);孕妇的民族、孕期补钙时间、海产品摄入次数与孕妇文化程度等对新生儿维生素D水平的影响有统计学意义;孕妇不同孕周、工作类型、户外活动时间、孕期是否抽筋及新生儿胎产次、胎儿性别、出生方式等对新生儿维生素D水平的影响无统计学意义(P0.05)。结论冬季出生的新生儿维生素D缺乏严重,与孕妇妊娠末期静脉血维生素D水平显著相关。冬季应给予孕晚期孕妇补充足量维生素D,以提高新生儿维生素D水平。     

Maternal Acrylamide Intake during Pregnancy and Sex Hormone Levels in Maternal and Umbilical Cord Blood and Birth Size of Offspring

Exposure to acrylamide during pregnancy may disturb pregnancy hormones and the growth of the fetus. The present study aimed to examine the association of maternal acrylamide intake with maternal and cord sex hormone levels during pregnancy and at birth and birth size of offspring. The study subjects were 204 pregnant Japanese women and their newborn girls. Intake of acrylamide was assessed based on 5-day diet records at approximately the 29th week of pregnancy. The concentrations of estradiol, estriol, and testosterone were measured in maternal serum at the 29th weeks of pregnancy and at delivery and umbilical cord blood at delivery. Birth weight, length, and head circumference were measured at the delivery. After controlling for covariates, higher intake of acrylamide was significantly positively associated with higher level of umbilical cord estradiol at the delivery (p for trend?=?.01), but not with any hormone levels measured in maternal blood. A positive association between acrylamide intake and head circumference was of borderline significance (p for trend?=?.06). Overall, there were no consistent associations between maternal acrylamide intake and sex hormone levels during pregnancy. However, as this is the first study to examine these associations, additional studies are needed.     

Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case–Control Study

Several meta-analyses found an association between low maternal serum 25-hydroxyvitamin D (25(OH)D) level and gestational diabetes mellitus (GDM). However, some of them reported significant heterogeneity. We examined the association of serum 25(OH)D concentration measured in the first and in the second halves of pregnancy with the development of GDM in Russian women surveyed in the periods of 2012–2014 and 2018–2021. We conducted a case–control study (including 318 pregnant women) nested on two previous studies. In 2012–2014, a total of 214 women (83 GDM and 131 controls) were enrolled before 15 weeks of gestation and maternal serum 25(OH)D concentrations were measured twice: at 8th–14th week of gestation and simultaneously with two-hour 75 g oral glucose tolerance test (OGTT) at 24th–32nd week of gestation. In the period of 2018–2021, 104 women (56 GDM and 48 controls) were included after OGTT and 25(OH)D concentrations were measured at 24th–32nd week of gestation. Median 25(OH)D levels were 20.0 [15.1–25.7] vs. 20.5 [14.5–27.5] ng/mL (p = 0.565) in GDM and control group in the first half of pregnancy and 25.3 [19.8–33.0] vs. 26.7 [20.8–36.8] ng/mL (p = 0.471) in the second half of pregnancy, respectively. The prevalence rates for vitamin D deficiency (25(OH)D levels < 20 ng/mL) were 49.4% and 45.8% (p = 0.608) in the first half of pregnancy and 26.2% vs. 22.1% (p = 0.516) in the second half of pregnancy in women who developed GDM and in women without GDM, respectively. The frequency of vitamin D supplements intake during pregnancy increased in 2018–2021 compared to 2012–2014 (p = 0.001). However, the third trimester 25(OH)D levels and prevalence of vitamin D deficiency (25.5 vs. 23.1, p = 0.744) did not differ in women examined in the periods of 2012–2014 and 2018–2021. To conclude, there was no association between gestational diabetes risk and maternal 25(OH)D measured both in the first and in the second halves of pregnancy. The increased prevalence of vitamin D supplements intake during pregnancy by 2018–2021 did not lead to higher levels of 25(OH)D.     

Vitamin D Intake and Risk of Type 1 Diabetes: A Meta-Analysis of Observational Studies

Vitamin D is suggested to have protective effects against type 1 diabetes. However, the results from observational studies have been inconsistent. We aimed to examine their association by conducting a meta-analysis of observational studies. Multiple databases were searched in June 2013 to identify relevant studies including both case-control and cohort studies. Either a fixed- or random-effects model was used to calculate the pooled risk estimate. We identified eight studies (two cohort studies and six case-control studies) on vitamin D intake during early life and three studies (two cohort studies and one case-control study) on maternal vitamin D intake during pregnancy. The pooled odds ratio for type 1 diabetes comparing vitamin D supplementation with non-supplementation during early life was 0.71 (95% confidence interval [CI], 0.51–0.98). Similar results were observed in the case-control subgroup analysis but not in the cohort subgroup analysis. The pooled odds ratio with maternal intake of vitamin D during pregnancy was 0.95 (95% CI, 0.66–1.36). In conclusion, vitamin D intake during early life may be associated with a reduced risk of type 1 diabetes. However, there was not enough evidence for an association between maternal intake of vitamin D and risk of type 1 diabetes in the offspring.     

Associations between Maternal Selenium Status and Cord Serum Vitamin D Levels: A Birth Cohort Study in Wuhan,China

Serum selenium (Se) has been reported to be associated with serum 25-hydroxyvitamin D [25(OH)D], but epidemiological findings are limited in pregnant women. We aimed to assess the associations between maternal urinary Se concentrations and cord serum 25(OH)D levels. We measured urinary concentrations of Se in the first, second, and third trimesters and cord serum 25(OH)D of 1695 mother-infant pairs from a prospective cohort study in Wuhan, China. The results showed that each doubling of urinary Se concentrations in the first, second, third trimester, and whole pregnancy (average SG-adjusted concentrations across three trimesters) were associated with 8.76% (95% confidence interval (CI): 4.30%, 13.41%), 15.44% (95% CI: 9.18%, 22.06%), 11.84% (95% CI: 6.09%, 17.89%), and 21.14% (95% CI: 8.69%, 35.02%) increases in 25(OH)D levels. Newborns whose mothers with low (<10 μg/L) or medium (10.92–14.34 μg/L) tertiles of urinary Se concentrations in whole pregnancy were more likely to be vitamin D deficient (<20 ng/mL) compared with those with the highest tertile (>14.34 μg/L). Our study provides evidence that maternal Se levels were positively associated with cord serum vitamin D status.     

Total Duration of Breastfeeding,Vitamin D Supplementation,and Serum Levels of 25-Hydroxyvitamin D

Objectives. To determine the association between total breastfeeding duration and serum 25-hydroxyvitamin D (25-OHD) and to explore whether vitamin D supplementation influences this association.Methods. We conducted a cross-sectional study of healthy children between September 2011 and August 2013 through the TARGet Kids! primary health care research network. Of the 4533 eligible children, we included only the 2508 who had 25-OHD measured. We assessed adjusted associations of total breastfeeding duration (in months) with serum 25-OHD and in supplemented versus nonsupplemented children, with the odds of 25-OHD less than 20 nanograms per milliliter.Results. Each 1-month increase in total breastfeeding duration was associated with a 0.12 nanograms per milliliter lower median serum 25-OHD (95% confidence interval [CI] = –0.21 ng/mL, –0.02 ng/mL) among children who were not supplemented. The odds of serum 25-OHD less than 20 nanograms per milliliter increased by 6% (odds ratio [OR] = 1.06; 95% CI = 1.03, 1.10) for every 1-month increase in total breastfeeding duration among nonsupplemented children. The interaction between vitamin D supplementation, duration of breastfeeding, and median serum 25-OHD was statistically significant (P = .04).Conclusions. Breastfed children who were not supplemented, particularly those breastfed more than 1 year, appear to have lower vitamin D status. Vitamin D supplementation may mitigate this risk. These findings support recommendations for supplementation during breastfeeding of any duration.Vitamin D is a fat-soluble steroid that has numerous biological actions that affect health.1–4 In infants and young children, very low vitamin D intake can lead to rickets.5–8 Exclusively breastfed infants who are not supplemented with vitamin D are at increased risk for developing rickets because of the limited transfer of vitamin D in breast milk.9,10 Although previous research supports the association between exclusive breastfeeding and low serum vitamin D levels in children,11,12 little is known about the effect of total duration of breastfeeding, including the period of nonexclusive breastfeeding, on vitamin D status.Guidelines for vitamin D supplementation during breastfeeding beyond the first year of life vary throughout the world. The American Academy of Pediatrics recommends, “Any breastfeeding infant, regardless of whether he or she is being supplemented with formula, should be supplemented with 400 IU of vitamin D.”10^(p1146) The Committee on Nutrition of the French Society of Pediatrics also suggests continuous vitamin D supplementation beyond the first year of life,13 irrespective of breastfeeding status, and the Canadian Pediatric Society recommends, “400 IU/day for all infants during the first year.”14 An improved understanding of the relationship between breastfeeding beyond the first year of life, vitamin D supplementation, and vitamin D stores may assist with reducing variation in professional recommendations, current practice, and optimizing vitamin D status during breastfeeding beyond the first year.We examined whether total duration of breastfeeding is associated with infant serum 25-hydroxyvitamin D (25-OHD) concentration in a cohort of healthy urban North American children. Our secondary objective was to explore how vitamin D supplementation influences the relationship between total duration of breastfeeding and 25-OHD.     

Vitamin D status during pregnancy and aspects of offspring health

Low maternal vitamin D levels during pregnancy have been linked to various health outcomes in the offspring, ranging from periconceptional effects to diseases of adult onset. Maternal and infant cord 25(OH)D levels are highly correlated. Here, we review the available evidence for these adverse health effects. Most of the evidence has arisen from observational epidemiological studies, but randomized controlled trials are now underway. The evidence to date supports that women should be monitored and treated for vitamin D deficiency during pregnancy but optimal and upper limit serum 25(OH)D levels during pregnancy are not known.     

Diet and Maternal Obesity Are Associated with Increased Oxidative Stress in Newborns: A Cross-Sectional Study

Overweight and obesity have become a world-health public problem, mainly for developing countries. Both health conditions have a higher prevalence among women of childbearing age. Physiopathology, overweight and obesity are characterized by a chronic oxidative stress status, which has deleterious effects on mothers and children. Hence, we determine whether the qualities of diet during pregnancy and maternal pregestational body mass index (BMI) are associated with increased oxidative stress markers in mothers and newborns. Two hundred forty-two (242) mother-newborn pairs were classified according to their pregestational BMI. Information on food intake was collected using a food frequency questionnaire in the third trimester of pregnancy. Levels of Malondialdehyde (MDA) and Nitric Oxide (NO) were measured in plasma from mothers at the end of the third trimester of pregnancy and from cord blood at birth. MDA and NO levels in mother–newborn pairs with maternal pregestational overweight or obesity were higher than in mother–newborn pairs with pregestational normal weight. For women (and newborns) who had a higher intake of fruit and vegetables, the levels of NO and MDA were lower. Lastly, women with pregestational obesity had lower fruit and vegetable intake during pregnancy and higher levels of oxidative stress and in their newborns.     

Time spent outdoors and seasonal variation in serum concentrations of 25-hydroxyvitamin D in Korean women

The vitamin D status of 179 Korean women between the ages of 20 and 75 were measured by the use of high performance liquid chromatography (HPLC). Related biochemical indices such as iPTH, alkaline, phosphatase, creatinine, albumin, Ca, Mg, and P were also measured. Factors such as demographic characteristics, intake of foods containing vitamin D, and proxy measure of sunlight exposure (time spent outdoors) were assessed to determine their effect on vitamin D status and used in the analysis. The purpose of this study was twofold. The first was to define reference data for the distribution of vitamin D status and to explore the relationship between vitamin D and the variables that affect the vitamin D status in Korean women. The second was to analyze the risk factors of the vitamin D status and the relation between the factors. The results of this study will provide valuable information regarding the role of vitamin D in Korean women. The mean serum 25-hydroxyvitamin D (25-OHD) level was 25.8 ng/ml. Of the total subjects, 16.5% showed vitamin D deficiency (i.e. s-25-OHD < 10 ng/ml). Serum 25-OHD was inversely related to iPTH and alkaline phophatase. There were significant changes in serum 25-OHD level from the pre- to the post-menopausal women with a positive correlation between vitamin D intake and serum at the 25-OHD level. Significant seasonal variation of serum 25-OHD and PTH were noted in 26 of the subjects and the serum 25-OHD level also correlated with sunlight exposure especially at 12.00 p.m. to 2.00 p.m. as assessed by the time spent outdoors. The relative importance of the two sources of vitamin D such as dietary intake (33.6% explained) and endogenous production of the time spent outdoors (19.7% explained) in serum 25-OHD were also evaluated. Multiple regression analysis revealed that the effects of aging on serum 25-OHD could largely be accounted for. Both the decline in dietary vitamin D intake and the time spent outdoors were closely related to the decreasing serum 25-OHD level. Among the determinants of low serum 25-OHD were age, dietary vitamin D intake, serum calcium level and dietary calcium intake, and serum alkaline phosphatase.     

Time spent outdoors and seasonal variation in serum concentrations of 25-hydroxyvitamin D in Korean women

The vitamin D status of 179 Korean women between the ages of 20 and 75 were measured by the use of high performance liquid chromatography (HPLC). Related biochemical indices such as iPTH, alkaline, phosphatase, creatinine, albumin, Ca, Mg, and P were also measured. Factors such as demographic characteristics, intake of foods containing vitamin D, and proxy measure of sunlight exposure (time spent outdoors) were assessed to determine their effect on vitamin D status and used in the analysis. The purpose of this study was twofold. The first was to define reference data for the distribution of vitamin D status and to explore the relationship between vitamin D and the variables that affect the vitamin D status in Korean women. The second was to analyze the risk factors of the vitamin D status and the relation between the factors. The results of this study will provide valuable information regarding the role of vitamin D in Korean women. The mean serum 25-hydroxyvitamin D (25-OHD) level was 25.8 ng/ml. Of the total subjects, 16.5% showed vitamin D deficiency (i.e. s-25-OHD < 10 ng/ml). Serum 25-OHD was inversely related to iPTH and alkaline phosphatase. There were significant changes in serum 25-OHD level from the pre- to the post-menopausal women with a positive correlation between vitamin D intake and serum at the 25-OHD level. Significant seasonal variation of serum 25-OHD and PTH were noted in 26 of the subjects and the serum 25-OHD level also correlated with sunlight exposure especially at 12.00 p.m. to 2.00 p.m. as assessed by the time spent outdoors. The relative importance of the two sources of vitamin D such as dietary intake (33.6% explained) and endogenous production of the time spent outdoors (19.7% explained) in serum 25-OHD were also evaluated. Multiple regression analysis revealed that the effects of aging on serum 25-OHD could largely be accounted for. Both the decline in dietary vitamin D intake and the time spent outdoors were closely related to the decreasing serum 25-OHD level. Among the determinants of low serum 25-OHD were age, dietary vitamin D intake, serum calcium level and dietary calcium intake, and serum alkaline phosphatase.     

Vitamin D Status and Factors Associated with Vitamin D Deficiency during the First Year of Life in Preterm Infants

We aimed to investigate the changes in vitamin D levels and factors associated with vitamin D deficiency (VDD) during the first year of life in Korean preterm infants. We enrolled 333 preterm infants who were born at Kyungpook National University Children’s Hospital between March 2013 and December 2019. 25-hydroxyvitamin D (25-OHD) levels and medical records were collected at birth, 6 months, and 12 months of age. The mean gestational age was 33.4 ± 2.3 weeks and mean 25-OHD levels at birth were 18.2 ± 13.5 ng/mL. The incidence of VDD was 82.8%, 30.6%, and 27.0% at birth, 6 months, and 12 months, respectively. The incidence of severe VDD (25-OHD < 10 ng/mL) was 31.5%, 1.5%, and 0%, at birth, 6 months, and 12 months, respectively. Among infants with severe VDD, the deficiency persisted in 49.6% at 6 months, and 35.3% at 12 months. The strongest predictor of VDD during follow-up was 25-OHD concentration at birth. Vitamin D supplementation at 400 IU/day did not affect vitamin D levels during the first year of life. Therefore, it is important to prevent neonatal VDD through maternal vitamin D supplementation during pregnancy. Further research is needed to determine the optimal vitamin D supplementation dose for Korean preterm infants.     

孕期补充维生素D对先天性佝偻病的预防作用

将妊娠28周的受试孕妇随机分为4组,分别1次性口服维生素D(VD)10万IU或肌注VD10万IU或20万IU,对照组口服空白胶囊.结果3个补充组产妇血和脐血25-(OH)D水平以及产妇血钙水平显著高于对照组(P<0.05),而产妇血和脐血25-(OH)D小于27.3nmol/L(11ng/ml)的发生率以及孕后期腿抽筋的发生率显著低于对照组,补充组产妇血25-(OH)D水平高于其妊娠28周时的水平.补充组未发现先天性佝偻病,而对照组先天性佝偻病和可疑先天性佝偻病的发生率显著高于补充组。结果提示孕后期补充VD可明显改善孕妇和胎儿的VD和钙的营养状况.预防先天性佝偻病,品服与肌泣10万IU与20万IU效果相同.     

High Maternal Omega-3 Supplementation Dysregulates Body Weight and Leptin in Newborn Male and Female Rats: Implications for Hypothalamic Developmental Programming

Maternal diet is critical for offspring development and long-term health. Here we investigated the effects of a poor maternal diet pre-conception and during pregnancy on metabolic outcomes and the developing hypothalamus in male and female offspring at birth. We hypothesised that offspring born to dams fed a diet high in fat and sugar (HFSD) peri-pregnancy will have disrupted metabolic outcomes. We also determined if these HFSD-related effects could be reversed by a shift to a healthier diet post-conception, in particular to a diet high in omega-3 polyunsaturated fatty acids (ω3 PUFAs), since ω3 PUFAs are considered essential for normal neurodevelopment. Unexpectedly, our data show that there are minimal negative effects of maternal HFSD on newborn pups. On the other hand, consumption of an ω3-replete diet during pregnancy altered several developmental parameters. As such, pups born to high-ω3-fed dams weighed less for their length, had reduced circulating leptin, and also displayed sex-specific disruption in the expression of hypothalamic neuropeptides. Collectively, our study shows that maternal intake of a diet rich in ω3 PUFAs during pregnancy may be detrimental for some metabolic developmental outcomes in the offspring. These data indicate the importance of a balanced dietary intake in pregnancy and highlight the need for further research into the impact of maternal ω3 intake on offspring development and long-term health.     

Maternal Dietary Carbohydrate Intake and Newborn Aortic Wall Thickness

Evidence from animal models indicates that maternal diet during pregnancy affects offspring cardiometabolic health. Improving carbohydrate quality during high-risk pregnancies reduces aortic intima-medial thickness; a marker for early atherosclerosis; in the infant offspring. We sought to determine whether maternal carbohydrate quantity and quality are associated with newborn aortic intima-medial thickness in healthy pregnancies. Maternal diet throughout pregnancy was evaluated in 139 mother–child dyads using a validated food frequency questionnaire. Carbohydrate intake was expressed as quantity (% total energy), quality (fibre, glycaemic index), and glycaemic burden (glycaemic load). Aortic intima-medial thickness was measured by high-frequency ultrasound of the neonatal abdominal aorta. Neither quantity nor quality of maternal carbohydrate intake during pregnancy was associated with meaningful differences in offspring maximum aortic intima-medial thickness with the exception of fibre intake in women with overweight or obesity which was inversely associated (−8 μm [95% CI −14, −1] per g fibre, p = 0.04). In healthy pregnancy, the quantity and quality of maternal carbohydrate intake is likely not a meaningful modifiable lifestyle factor for influencing offspring vascular health. The effect of carbohydrate quality may only be evident in high-risk pregnancies, consistent with previous findings. These findings may be confirmed in prospective dietary trials in pregnancy.     

妊娠期大气二氧化氮暴露与孕妇维生素D缺乏症的关联

目的 孕妇维生素D缺乏症与妊娠期糖尿病、妊娠期高血压、孕妇贫血以及胎儿生长受限和早产等不良妊娠结局密切相关。本研究旨在探讨妊娠期大气二氧化氮（nitrogen dioxide,NO2）暴露与孕妇维生素D缺乏症的关联。方法 选取2013年5月-至2014年５月,在某市妇幼保健院建卡的孕妇作为初始研究对象。按照入选和排除标准最终纳入3244名孕妇进入本研究。通过问卷调查收集孕妇的一般人口学信息;利用环境监测站点的数据模拟孕妇在妊娠期间大气NO2的暴露水平;采用酶联免疫吸附法检测孕晚期孕妇血清中25（OH）D的浓度。结果 孕妇在孕早期、中期、晚期以及整个孕期NO2暴露水平的中位数分别为:39.52、36.84、28.09以及31.90μg/m3。孕晚期血清中25(OH)D浓度的平均值为42.09nmol/L。多元线性回归分析的结果显示,孕中期、孕晚期以及整个孕期NO2的暴露水平每增加10μg / m3,孕妇血清中25（OH）D的水平分别降低2.224nmol/L（95%CI:-2.777,-1.671）,2.240nmol/L（95%CI:-2.665,-1.816）以及5.299 nmol/L（95%CI:-6.481,-4.177）。多元logistic回归分析的结果显示,随着孕中期、孕晚期以及整个孕期NO2的暴露水平的增加,孕妇VD缺乏症发生的风险增加,其OR值分别为1.338（95%CI:1.225,1.461）,1.347（95%CI:1.259,1.442）以及2.049（95%CI:1.709～2.456）。结论 孕期NO2暴露是孕妇维生素D缺乏症发生的一个危险因素。在制订维生素D缺乏症的防控措施时需要考虑孕期NO2的暴露。     

High Prevalence of Vitamin D Deficiency among Pregnant Saudi Women

Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OH)D) was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OH)D < 50 nmol/L) and insufficiency (25(OH)D = 50–74 nmol/L) were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OH)D concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day) was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements.