Maternal obesity,gestational hypertension,and preterm delivery

Objective.?To study maternal obesity as a risk factor for preterm delivery.

Methods.?Maine State Birth Records Database from 1996 through 2006 was evaluated to investigate obese pregnant women compared with normal weight women regarding risk for preterm delivery. Multiple risk factors and outcomes were studied in univariable and multivariable models.

Results.?Among 58,112 pregnant women, 8% (n?=?4653) gave birth to preterm infants. Univariable analyses revealed a relationship between obesity and increased risk of prematurity. In multivariable regressions, the most important intermediate variable appears to be gestational hypertension/preeclampsia.

Conclusions.?As maternal body mass index increases in pregnancy, the risk of preterm delivery and other maternal complications increases. The obesity–prematurity relationship is complex, with hypertensive disorders of pregnancy playing a crucial role. More detailed analyses of causal pathways are warranted.     

Fetal heart rate response to cordocentesis and pregnancy outcome: A prospective cohort

Objective.?To evaluate fetal cardiac response to cordocentesis and whether such changes may affect pregnancy outcome.

Methods.?117 singleton pregnant women requiring percutaneous trans-abdominal cordocentesis were prospectively included. Fetal heart rate was continuously evaluated by ultrasound for 1?min after completion of cordocentesis and intermittently for 20?min more. Fetal and pregnancy outcomes were analyzed by grouping fetal cardiac response to cordocentesis into bradycardia, normal heart rate and tachycardia groups.

Results.?Women included in the study were 30.5?±?4.0 years old and had a gestational age of 23.7?±?2.0 weeks. Fetal blood sample obtained by cordocentesis was 3.1?±?0.8?ml. Fetal heart rate before cordocentesis was 149?±?8 beats per minute (bpm), ranging from 130 to 169 bpm. Fetal heart rate post-cordocentesis was 145?±?30 bpm (from 32 to 175 bpm). The incidence of bradycardia and tachycardia was 10.3% (n?= 12) and 6.0% (n?= 7), respectively. Fetal heart rate returned to normal levels in all cases at ??5 minutes post-cordocentesis. In the tachycardia group, 6 cases had normal pregnancy outcome and one patient was lost to follow-up. In the bradycardia group, we observed two pregnancy terminations, one patient was lost to follow-up and nine were normal outcomes. In the group with normal heart rate (n?=?98), we observed one intrauterine fetal death, nine adverse fetal outcomes, eight pregnancy terminations and nine patients were lost to follow-up.

Conclusions.?Transient fetal tachycardia and bradycardia were uncommon and were not associated with adverse fetal or pregnancy outcomes.     

Pregnancy complications and delivery outcomes of pregnant women with influenza

Objectives.?In a previous study, we showed that maternal influenza in pregnancy gives rise to an increase in some congenital abnormality groups. The aim of this study was to ascertain the relationship between influenza during pregnancy and pregnancy complications, and in addition, delivery outcomes particularly preterm birth and low birth weight in newborns.

Methods.?The population-based large control (without any defects) data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities, in which pregnancy complications, gestational age and birth weight are medically recorded, was evaluated.

Results.?Of 38 151 newborn infants, 1838 (4.8%) had mothers with influenza during pregnancy. The prevalence of pregnancy complications showed no difference between mothers with or without influenza during the study pregnancy. Mothers with influenza in pregnancy had a somewhat higher gestational age (0.1 week) and a lower proportion of preterm births (8.0% vs. 9.2%). These findings were reflected in the mean birth weight (+37 g) and lower proportion of low birth weight newborns (4.7% vs. 5.1%); these differences were explained by confounders.

Conclusion.?Maternal influenza during pregnancy does not increase the prevalence of pregnancy complications and unsuccessful delivery outcomes.     

Outcome of preterm and term neonates of mothers with malignant diseases diagnosed during pregnancy

Objective.?To investigate the outcome of preterm and term neonates born to mothers with malignant diseases diagnosed during pregnancy.

Methods.?A retrospective analysis with a matched-paired control group in a third level obstetric department and third level neonatal department of the University Hospital Frankfurt. Patients were preterm and term neonates from mothers with oncologic diseases diagnosed during pregnancy and matched-paired preterm and term neonates from healthy mothers.

Measurements and results.?Nineteen preterm and three term (1 × twins) neonates from 21 mothers with oncologic diseases and matched-paired neonates from 21 healthy mothers were included. With the exception of one case, pregnancy was terminated because of the necessity for maternal oncological treatment. Children from mothers with malignant diseases had a significantly lower birth weight and a tendency towards a higher incidence of high-grade respiratory distress syndrome. No significant differences concerning Apgar scores, red blood cell (RBC), white blood cell (WBC), and platelet (PLT) counts postpartum, and duration of hospital days between the two groups of neonates were observed.

Conclusion.?Direct perinatal outcome of preterm or term neonates from mothers with malignant diseases diagnosed during ongoing intact pregnancy does not differ from the outcome of a comparable group of neonates from healthy mothers. This might be in contrast to the long-term outcome of this special patient group. In our study we could find no elevated mortality in neonates where pregnancy was terminated because of the need for maternal chemotherapeutic therapy.     

Preterm premature rupture of membranes in the presence of cerclage: is the risk for intra-uterine infection and adverse neonatal outcome increased?

Abstract

Objective.?To determine whether preterm premature rupture of membranes (PPROM) in the presence of a cerclage is associated with an increased incidence of intrauterine infection and/or adverse neonatal outcome compared to PPROM in the absence of cerclage.

Study design.?Patients diagnosed with PPROM with a cerclage (cases) between 24–34 weeks were matched (1:2.6) for gestational age at PPROM, gestational number, and chorionicity with patients diagnosed with PPROM without a cerclage (controls).

Results.?Pregnancy latency period was not different but the rates of chorioamnionitis [clinical (26.6% versus 13.5%) and histological (92.6% versus 65.4%)] and the rates of adverse perinatal outcome were higher following PPROM in the presence of a cerclage compared with no cerclage.

Conclusion.?The presence of a cerclage in patients with PPROM appears to increase the risk of intra-uterine infection and affect neonatal outcome; it may not be justified to leave a cerclage in place in patients with PPROM.     

Possible association between maternal recurrent orofacial herpes in pregnancy and a lower rate of preterm birth

Objective.?To study the possible association between orofacial herpes during pregnancy and pregnancy complications including preterm birth and low birth weight, since the results of previous studies are inconsistent.

Method.?The population-based large data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities was used; pregnancies in mothers with and without recurrent orofacial herpes were compared.

Results.?Of 38 151 newborn infants, 572 (1.5%) had mothers with recurrent orofacial herpes during pregnancy, while 37 577 had mothers with no orofacial herpes. Pregnant women with recurrent orofacial herpes had a higher prevalence of severe nausea and vomiting, threatened preterm delivery, and placental disorders but a lower prevalence of preeclampsia. Mothers with recurrent orofacial herpes during pregnancy also had a somewhat longer (0.4 weeks) gestation (adjusted t = 2.7; p = 0.006) and an obviously lower proportion of preterm births (3.5% vs. 9.3%; adjusted POR with 95% CI = 0.42, 0.27–0.65). However, there was no significant difference in the mean birth weight and rate of low birth weight infants between the two study groups.

Conclusion.?Recurrent orofacial herpes during pregnancy is associated with a smaller proportion of preterm births.     

Adverse effects of thyroid dysfunction on pregnancy and pregnancy outcome: Epidemiologic study in Slovenia

Objective.?To evaluate the consequences of maternal thyroid dysfunction for pregnancy outcome.

Methods.?A retrospective analysis involving all pregnant women who delivered in Slovenia in the 1997–1999 triennium; those having a medical history of thyroid dysfunction and/or taking thyroid medications were allotted to the study group (n = 748) and the remaining ones to the control group (n = 52 253).

Results.?Significantly higher incidences of infertility (5.5% vs. 3.7%, p < 0.05), menstrual cycle irregularities (3.2% vs. 1.9%, p < 0.05), hypertensive disorders (7.0% vs. 4.2%, p < 0.05), threatened preterm delivery (9.1% vs. 5.6%, p < 0.001), and delivery before 32 weeks (2.7% vs. 1.5%, p < 0.05) were found in the study than in the control group. There were no significant differences in the incidences of miscarriage, non-gestational diabetes mellitus, proteinuria, hyperemesis, intrahepatic cholestasis of pregnancy, intrauterine growth restriction, placental abruption, preterm delivery, small for gestational age newborns (SGA), and stillbirths.

Conclusions.?This is the first study to evaluate the incidence of thyroid dysfunction for the whole population of pregnant women in Slovenia using a retrospective analysis. Thyroid dysfunction adversely affects pregnancy and pregnancy outcome but to a lesser extent than presented in previous studies. An evaluation of thyroid function in the women who experience menstrual cycle irregularities, infertility, and complications during pregnancy, labor and delivery would be advisable.     

Differences in amniotic fluid patterns and fetal biometric parameters in third trimester pregnancies with and without diabetes

Objective.?The amniotic fluid index (AFI) has been increasingly used in the assessment of fetal well-being. We conducted the study to evaluate and compare the amniotic fluid index in third trimester normal and diabetic human pregnancy and to assess the correlation between the AFI and the fetal biometric parameters.

Methods.?Real-time ultrasound was performed to evaluate the AFI (four-quadrant technique), and to measure the biparietal diameter, head circumference, abdominal circumference, and femur length in 225 normal and 120 diabetic pregnant women from 27 to 42 weeks of gestation. Each patient was studied only once.

Results.?AFI in normal pregnancies was less than that in diabetic pregnancies throughout the gestational ages studied (27–42 weeks). In normal pregnancy, the mean AFI was 14.0 cm at 27 weeks and decreased to 11.4 cm at 42 weeks (r = 0.25, p = 0.0005), whereas in diabetic pregnancies, the values remained stable throughout the gestational ages studied. There exist significant differences in AFI, estimated fetal weight, estimated fetal weight %, abdominal circumference, abdominal circumference %, and head circumference to abdominal circumference ratio between the two groups. In both normal and diabetic pregnancies, there is a positive correlation between the AFI and the percentile of abdominal circumference (p < 0.0001), and between the AFI and the percentile of estimated fetal weight (p < 0.0001).

Conclusion.?This study provides gestational age-specific values of the AFI in normal and diabetic pregnancies. Diabetic pregnancy has greater AFI values than normal pregnancy between 27 and 42 weeks. The AFI correlates to the percentile of the estimated fetal weight and the abdominal circumference in both groups, suggesting that there may be a relationship between increased AFI and large for gestational age fetus independent of diabetes.     

Serological markers of autoimmunity in pregnant women with polycystic ovary syndrome: a pilot study

Background.?Gestational diabetes mellitus (GDM) is highly prevalent in women with polycystic ovary syndrome (PCOS). Women with GDM have considerable risk for developing both type 1 and type 2 diabetes.

Aim.?To evaluate the prevalence of anti-GAD65 and anti-IA2 auto-antibodies in Chilean pregnant women with GDM, normal pregnancy (NP) and with PCOS (PPCOS) to establish whether in PCOS women GDM is partially induced by auto-antibodies.

Methods.?Women with singleton pregnancies matched by age and gestational age were included: 50 GDM, 59 NP and 50 PPCOS. During gestational weeks 22–28, a 2-h, 75?g oral glucose tolerance test was performed, with measurement of glucose, insulin, lipids and auto-antibodies.

Results.?A highly prevalence of anti-GAD65 antibodies (12%) was observed in women with GDM. PPCOS and NP women showed a similar distribution of anti-GAD65 antibodies (2.0% and 1.7%, respectively). Anti-IA2 antibodies were present in 4.0% of women with GDM, in 1.7% of NP women and 2.0% PPCOS women.

Conclusion.?A highly prevalence of anti-GAD65 was observed in women with GDM which is in agreement with previous studies. Nevertheless, the frequency of these auto-antibodies was very low in NP and PPCOS women.     

Maternal overweight and pregnancy outcome in women with Type-1 diabetes mellitus and different degrees of nephropathy

Objective.?We aimed to assess the parameters associated with complicated pregnancy in women with Type 1 diabetes mellitus (DM) and nephropathy.

Study design.?A cohort study of 46 consecutive women diagnosed with Type 1 DM with nephropathy prior to pregnancy was included during the years 2000–2007. Complicated pregnancy was defined as one or more of the following: first trimester abortion, superimposed pre-eclampsia, pre-term delivery?<34 weeks, small and large for gestational age neonate, macrosomia, admission to the neonatal intensive care unit and foetal loss (after 22 weeks' gestation).

Results.?Overall, 31/46 (67%) had at least one pregnancy complication. Body mass index (BMI) was the only parameter with a significant difference between the groups, being higher in the women with complicated pregnancy vs. uncomplicated pregnancy (27?±?9 vs. 24?±?3, p?=?0.027). On Multiple logistic regression model in which composite outcome (pregnancy complication) as the dependent variable, pre-pregnancy BMI was the only statistically significant parameter with a difference between the groups (p?=?0.044). No statistical difference was found between the groups in the rate of pre-pregnancy counselling (60% vs. 67%), glycaemic control prior to pregnancy (Hba1c 7.5 vs. 7.1%), the prevalence of patients achieving desired level of glycaemic control (44% vs. 42%), weight gain during pregnancy (12.4 vs. 10.6?kg), duration of DM (18.0 vs. 19.7 years) and proportion of patients treated with angiotensin converting enzyme inhibitors prior to pregnancy (26 vs. 33%).

Conclusion.?Overweight is associated with poor pregnancy outcome in patients with Type-1 DM and different degrees of nephropathy.     

Expectant management of preeclampsia superimposed on chronic hypertension

Objective.?Women with chronic hypertension (CHTN) are at an increased risk for pregnancy complications including preeclampsia. The objective of this study was to review pregnancy outcomes for women with expectant management of preeclampsia superimposed on CHTN prior to 37 weeks'.

Methods.?We reviewed the inpatient charts of all women admitted to Magee-Womens Hospital (1995–2005) with the diagnosis of both CHTN and preeclampsia prior to term.

Results.?Sixty-eight women diagnosed with both CHTN and preeclampsia prior to 37 weeks' were identified. Of these, 42 women were expectantly managed; one subject was excluded from analysis for pregestational diabetes. For the remaining 41 women, the median gestational age at diagnosis was 31.6 weeks (range 23.6–36.4). The mean time from diagnosis to delivery was 9.7 days (range 2–34 days). Adverse perinatal outcomes included one case of HELLP syndrome, two cases of placental abruptions, three cases of pulmonary edema, and five postpartum hemorrhages. There were no fetal/neonatal or maternal deaths. Average NICU stay was 17.9 days.

Conclusions.?Expectant management of preterm superimposed preeclampsia among women with CHTN is a reasonable management strategy, but associated with some maternal morbidity. Prospective studies are needed to definitively quantify the risks and benefits of this approach.     

Matching risk and resources in high-risk pregnancies

Objective.?To evaluate the joint impact of pregnancy risk and the timing of referral of high-risk pregnancies from obstetricians to maternal fetal medicine (MFM) sub-specialists on gestational age (GA) at delivery.

Methods.?For the period 1992–2002, 2567 consecutive deliveries from pregnancies of at least 23 weeks gestational age (GA) from a community-level sub-specialty perinatal center were studied. A multiple regression model was developed specifying the impact of various risk factors and referral timing.

Results.?Prior pregnancy risk was inversely related to GA at birth. Referral timing, operationalized as a continuous variable, did not have a significant additive impact on GA at birth, but several dummy-variable interaction effects combining risk factors and referral before 20 weeks as a dichotomy were significant.

Conclusion.?There are identifiable risks that occur either before the pregnancy or early into it that should lead to early referral to a sub-specialist because of their impact on GA at birth. Early referral is an important tactic in a larger preterm prevention strategy, but it needs to be embedded in a broader maternal-fetal health initiative in which both generalists and sub-specialists play important roles.     

Factors affecting the duration of the latency period in preterm premature rupture of membranes

Objective.?To investigate the natural course of preterm premature rupture of membranes (PPROM) at <34 + 0 weeks and to identify factors that affect the duration of the latency period.

Design.?A retrospective cohort study of all women diagnosed with PPROM prior to 34 + 0 weeks during 1998–2006. Latency period was defined as the time between onset of PPROM to either spontaneous delivery, labor induction at 34 + 0 weeks, or indicated delivery prior to 34 + 0 weeks because of suspected chorioamnionitis or nonreassuring fetal heart rate.

Results.?The overall rate of PPROM was 1.4% (905/66,775), of which 46% (417/905) occurred at <34 + 0 weeks. Overall, the latency period exceeded 48 h in about 73.4% of cases (306/471). Women with short latency periods (<48 h) were characterised by higher degree of cervical dilatation and higher gestational age at admission and were more likely to be nulliparous. The duration of the latency period ranged between 0 and 59 days and was inversely related to gestational age at admission (r = ?0.63, P < 0.001). Using Cox proportional hazards model, gestational age at admission (HR = 1.29, 95% CI = 1.22–1.37), oligohydroamnios (HR = 1.49, 95% CI = 1.18–1.87), cervical dilatation >1 cm (HR = 0.65, 95% CI = 0.52–0.83), fetal growth restriction (HR = 2.94, 95% CI = 1.24–6.94) and nulliparity (HR = 1.28, 95% CI = 1.12–1.63) were significantly associated with shorter duration of the latency period.

Conclusion.?In this study, we have identified several predictive factors for the duration of the latency period in cases of PPROM. This information may assist clinicians in risk stratification and in providing consultation for women presenting with PPROM prior to 34 weeks of gestation.     

The association between follicular size on human chorionic gonadotropin day and pregnancy rate in clomiphene citrate treated polycystic ovary syndrome patients

Objective.?To examine leading follicle size on human chorionic gonadotropin (hCG) day and pregnancy rate in anovulatory polycystic ovary syndrome (PCOS) patients treated with clomiphene citrate (CC).

Design.?Retrospective cohort study.

Setting.?Fertility clinics in women's health centers.

Patients.?Data on 291 infertile women with PCOS and irregular cycles who underwent 685 CC treatment cycles were used. Only cycles with one or two follicles >14?mm were included. hCG was administered once the leading follicle reached the size of 17–24?mm.

Main outcome measure(s).?Pregnancy rates in relation to leading follicle size.

Results.?Mono/bi-follicular response was observed in 418 cycles. Pregnancy rates were highest (13.6–18.6%) when hCG was administered in the presence of an 18–22?mm follicle, lowest with 17?mm, 23?mm and 24?mm (8.8%, 8.8% and 5.7%, respectively). No differences were observed in pregnancy rates between mono and bi-follicular cycles.

Conclusions.?In CC treatment, hCG should be administered when follicular size is at the range of 18–22?mm.     

Outcomes of multiple gestations with advanced maternal age

Objective.?To investigate outcomes of twin gestations with advanced maternal age (AMA).

Study design.?Historical cohort of twin gestations cared for by a maternal–fetal medicine faculty practice. Outcomes of patients with AMA (70) and non-AMA (75) were compared. AMA was defined as age ≥35. Analysis including mode of delivery, gestational age at delivery and overall complications was performed. Significance was determined using the chi-square test or the Student's t-test.

Results.?The Cesarean rate for AMA was significantly greater compared to non-AMA (80.0% vs. 54.7%; p = 0.001). The main reason for the increased rate was uterine dysfunction. The mean gestational age at delivery for AMA was significantly greater than for non-AMA (36.7 weeks vs. 35.4 weeks; p = 0.02). There were no differences in rates of other adverse outcomes including gestational hypertension, pre-eclampsia, gestational diabetes, suspected fetal growth restriction, preterm birth, low birth weight or low birth weight percentiles. This remained true when we compared the 32 women ages ≥40 years to 118 women ages <40 years.

Conclusion.?Among twin pregnancies, AMA women are not at an increased risk of adverse pregnancy outcomes, aside from an increased rate of cesarean delivery.     

Respiratory outcome in preterm small for gestational age fetuses with or without abnormal umbilical artery Doppler and/or maternal hypertension

Objective.?To study respiratory outcome in preterm small for gestational age (SGA) fetuses with or without signs of intrauterine growth restriction due to placental insufficiency, and with or without maternal hypertension.

Methods.?This was a retrospective study of 187 neonates with birth weight <10^th percentile and gestational age <34 weeks. Results from umbilical artery Doppler velocimetry were used to identify the abnormal Doppler subgroup.

Results.?No significant difference in respiratory outcome between SGA fetuses with normal (SGA-N) or abnormal (SGA-A) umbilical artery Doppler examination was found. Within the SGA-A group, the respiratory distress syndrome (RDS) incidence (OR 5.6, 95% CI 1.7–18.3), RDS grade (OR 6.7, 95% CI 1.2–38.5), and need for surfactant (OR 5.3, 95% CI 1.1–24.4) were higher in infants of women with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome as compared to those of normotensive mothers.

Conclusions.?Lung maturation is not accelerated with placental insufficiency. SGA-A fetuses of mothers with HELLP syndrome have a significantly poorer respiratory outcome than those with healthy mothers. Possibly, fetuses of mothers with HELLP syndrome are subjected to ‘oxidative stress’ causing lung damage rather than lung maturation.     

Cervical funneling after cerclage in cervical incompetence as a predictor of pregnancy outcome

Objectives.?To evaluate whether cervical funneling influences pregnancy outcome in women with short cervical length (CL) after cerclage, and to identify funneling parameters associated with pregnancy outcome.

Methods.?Medical records of women identified to have a short CL with or without funneling after cerclage were reviewed. Women with short CL as well as funneling were defined as cases (Funneling group), and those with short CL but no funneling were the controls (No Funneling group). We compared perinatal outcome between the two groups and analyzed the relationships between funneling parameters and pregnancy outcome.

Results.?Seventy-two patients were included in this study; 39 women with short CL and funneling and 33 with short CL and no funneling. The mean gestational age at delivery of the Funneling group was 33.7 weeks, as compared to 36.5 weeks for the NoFunneling group (p < 0.001). We found a significant inverse association of funneling depth as well as volume with pregnancy outcome (p < 0.001, and p?=?0.005, respectively). However, funneling width was not associated with pregnancy outcome (p?=?0.49).

Conclusions.?Funneling depth and volume may be useful predictors of pregnancy outcome after cerclage.     

Maternal leptin and body composition in the first trimester of pregnancy

Background.?Leptin is produced mainly by adipocytes. Levels are increased in women with obesity and during pregnancy. Increased levels are also associated with pregnancy complications such as, pre-eclampsia and gestational diabetes mellitus.

Objective.?We studied what component of body composition correlated best with maternal leptin in the first trimester of pregnancy and, whether maternal leptin correlated better with visceral fat rather than fat distributed elsewhere.

Subjects and methods.?Women were recruited in the first trimester. Maternal adiposity was measured using body mass index and advanced bioelectrical impedance analysis. Maternal leptin was measured using an enzyme-linked immunosorbent assay technique.

Results.?Of the 100 subjects studied, the mean leptin concentration was 37.7?ng/ml (range: 2.1–132.8). Leptin levels did not correlate with gestational age in the first trimester, maternal age, parity or birth weight. Serum leptin correlated positively with maternal weight and body mass index, and with the different parameters of body composition. On multiple regression analysis, serum leptin correlated with visceral fat but not fat distributed elsewhere.

Conclusions.?Visceral fat is the main determinant of circulating maternal leptin in the first trimester of pregnancy. This raises the possibility that maternal leptin in early pregnancy may be a marker for the development of metabolic syndrome, including diabetes mellitus.     

The interval to spontaneous delivery following discontinuation of maintenance tocolysis

Objective.?To determine the interval to spontaneous delivery following discontinuation of continuous subcutaneous terbutaline (SQT).

Methods.?Singleton and twin gestations receiving outpatient preterm labor management services with SQT were identified from a database. Patients having SQT discontinued at 33.0–35.9 weeks (in a stable condition, not hospitalized and with known cervical status at discontinuation) with subsequent spontaneous labor and delivery were included (n = 1420). Data were compared by gestation type, week of SQT discontinuation and cervical dilatation using Kruskal–Wallis and Fisher's exact test analyses ( p < 0.05 statistically significant).

Results.?Spontaneous preterm delivery occurred in 63.0% of singletons and 87.9% of twins. Although stable at SQT discontinuation, 32.5% of singletons and 59.9% of twins delivered within three days. The interval from discontinuation of SQT to delivery was less for twin than singleton gestations (5.1 ± 6.5 vs. 11.0 ± 10.5 days, respectively, p < 0.001).

Conclusions.?Preterm discontinuation of SQT should be avoided if additional pregnancy prolongation is desired.     

Vitamin D status of pregnant women in Shanghai,China

Objective.?The aims of this study were to identify the prevalence of vitamin D insufficiency in pregnant women in Shanghai, China and to determine the correlations between 25-hydroxyvitamin D (25(OH)D) and age, serum lipids, renal function, BMI, gestational weeks, and season of sampling.

Methods.?A total of 1695 pregnant women who visited the outpatient clinic for their first prenatal examination were included in the study.

Results.?Over 90.5% of these women had less than optimal levels of 25(OH)D. Of the 1695 women, 1162 were deficient, 372 were insufficient, only 372 were sufficient, and 5 had possible hypervitaminosis. 25(OH)D levels were negatively correlated with age, total cholesterol, low-density lipoprotein (LDL), gestational age, body weight, and BMI. They were positively correlated with urea levels. Neither parity nor season was a significant factor.

Conclusions.?Vitamin D deficiency and insufficiency were common in pregnant Chinese women and routine screening as well as prophylactic measures should be considered.