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Maternal serum vitamin D at 11-13 weeks in pregnancies delivering small for gestational age neonates

Rebecca Ertl1, Christina K H Yu, Robert Samaha

  • 1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.

Fetal Diagnosis and Therapy
|January 21, 2012
PubMed

Insights

Maternal vitamin D (25(OH)D) levels are lower in pregnancies resulting in small for gestational age (SGA) neonates, particularly in Caucasian women. This decrease is not linked to placental function.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Nutritional Science

Background:

  • Small for gestational age (SGA) neonates are a significant concern in prenatal care.
  • Maternal vitamin D (25(OH)D) status is crucial for fetal development.
  • Pregnancy-associated plasma protein-A (PAPP-A) is a marker of placental function.

Purpose of the Study:

  • To investigate if maternal serum 25(OH)D levels at 11-13 weeks gestation differ in pregnancies delivering SGA neonates.
  • To assess the relationship between 25(OH)D levels and placental function (indicated by PAPP-A) in SGA pregnancies.

Main Methods:

  • Serum 25(OH)D and PAPP-A levels were measured in 150 SGA pregnancies and 1,000 appropriate for gestational age (AGA) controls at 11-13 weeks.
  • Median multiples of the unaffected median (MoM) were compared between outcome groups.

Main Results:

  • Significantly lower median serum 25(OH)D and PAPP-A MoM were observed in the SGA group compared to AGA controls (0.78 vs. 1.00 MoM, p < 0.0001 for both).
  • The incidence of low 25(OH)D levels (<10th percentile) was higher in SGA pregnancies of Caucasian women (p = 0.002) but not in those of African racial origin (p = 0.183).
  • No significant association was found between 25(OH)D MoM and PAPP-A MoM in either group.

Conclusions:

  • Maternal serum 25(OH)D levels are decreased in Caucasian pregnancies that result in SGA neonates.
  • The observed decrease in 25(OH)D is independent of placental function as assessed by PAPP-A.
  • Findings suggest a potential role for vitamin D monitoring in specific maternal populations at risk for SGA.
Abstract

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