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Published on: May 4, 2018
Higher serum alkaline phosphatase activity in infants born to vitamin D-deficient mothers
Ibrahim Al Alwan1,2,3, Maryam Al Badi4,5, Motasim Badri4,6
1King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Po Box 3600, Riyadh, 11481, Saudi Arabia. alwani@ksau-hs.edu.sa.
Insights
Maternal vitamin D deficiency is common and linked to higher newborn alkaline phosphatase (ALP) activity, suggesting increased bone turnover and potential impacts on fetal skeletal development.
Area of Science:
- Biochemistry
- Pediatrics
- Endocrinology
Background:
- Low maternal 25-hydroxy vitamin D (25(OH)D) during pregnancy can lead to infant vitamin D deficiency at birth.
- This deficiency poses risks to fetal skeletal mineralization and growth.
- Alkaline phosphatase (ALP) activity is a marker of bone turnover.
Purpose of the Study:
- To investigate the relationship between maternal serum 25(OH)D levels and newborn serum ALP activity at term.
- To assess the impact of maternal vitamin D status on fetal bone metabolism.
Main Methods:
- Prospective cross-sectional study involving 150 healthy pregnant mothers and their newborns.
- Maternal serum 25(OH)D levels measured within 6 hours of delivery.
- Newborn cord blood analyzed for calcium, phosphorus, and ALP activity.
Main Results:
- 72% of mothers were vitamin D-deficient (25(OH)D < 25 nmol/l).
- Newborns of vitamin D-deficient mothers exhibited significantly higher ALP activity (p=0.04).
- A significant inverse correlation was found between maternal 25(OH)D levels and infant ALP activity (p=0.03).
Conclusions:
- Newborns of vitamin D-deficient mothers show elevated ALP activity, indicative of increased bone turnover.
- This finding suggests a potential negative impact on fetal bone development and skeletal growth.
- Maternal vitamin D status is a critical factor in fetal skeletal health.
Abstract:
Our research shows that the newborns of vitamin D-deficient mothers have higher serum alkaline phosphatase (ALP) activity compared with those of vitamin D-non-deficient mothers, which is likely related to increased bone turnover rather than just being a marker for bone formation. This has a potential negative impact on fetal bone development and subsequent skeletal growth.
Purpose/Introduction:
Low maternal serum 25-hydroxy vitamin D (25(OH)D) level during pregnancy contributes to vitamin D deficiency in infants at birth, which is associated with multiple potential adverse effects on fetal skeletal mineralization and growth. We studied the relationship between maternal 25(OH)D level and newborn serum alkaline phosphatase activity (ALP) at term.
Methods:
In this prospective cross-sectional hospital-based study, venous blood samples of healthy pregnant mothers were drawn to measure 25(OH)D levels within 6 h of delivery. Cord blood samples were examined for calcium, phosphorus levels, and ALP activity immediately after birth. In addition, we also recorded the newborns' anthropometric measurements.
Results:
Seventy-two percent (n = 108/150) of mothers in our study were vitamin D-deficient (serum 25(OH)2D < 25 nmol/l). In a multivariate logistic regression model, young maternal age (odds ratio (OR) = 0.94, 95% CI 0.88-0.99, p = 0.04) and increased weight (OR = 1.03, 95% CI 1.01-1.07, p = 0.02) as well as decreased milk intake (OR = 0.31, 95% CI 0.13-0.74, p = 0.009) were all significantly associated with maternal vitamin D deficiency. ALP activity was significantly higher in newborns of vitamin D-deficient compared with vitamin D-non-deficient mothers (median = 176 (IQR = 139-221) and 156 (IQR = 132-182), respectively, p = 0.04). A significant inverse correlation (Pearson's coefficient = - 0.18, p = 0.03) was observed between maternal 25(OH)D levels and babies' ALP activities. This association persisted in a multivariate logistic regression model (OR = 3.46, 95% CI 1.18-10.18, p = 0.024).
Conclusions:
Our findings indicate that newborns of vitamin D-deficient mothers have higher serum ALP activity than those of non-deficient mothers, which might be related to increased bone turnover rather than just being a marker for bone formation. This could have a potential negative impact on fetal bone development and subsequent skeletal growth.
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