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Determinants and Measurement of Neonatal Vitamin D: Overestimation of 25(OH)D in Cord Blood Using CLIA Assay

Mengdi Lu1,2, Bruce W Hollis3, Vincent J Carey1

  • 1Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

The Journal of Clinical Endocrinology and Metabolism
|December 25, 2019
PubMed

Insights

Chemiluminescence immunoassays overestimate vitamin D (VD) in cord blood, making them invalid for neonatal measurements. Maternal VD levels in the third trimester, not the first, influence neonatal VD status.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Nutritional Science

Background:

  • Maternal vitamin D (VD) deficiency impacts childhood outcomes.
  • Maternal VD sufficiency is critical for neonatal sufficiency.
  • The influence of early vs. late pregnancy VD levels on neonatal VD is unclear.

Purpose of the Study:

  • Validate chemiluminescence immunoassays (CLIAs) for cord blood 25-hydroxy-vitamin D (25(OH)D) measurement.
  • Identify maternal determinants of neonatal 25(OH)D, including timing of VD levels during pregnancy.

Main Methods:

  • Ancillary analysis of the Vitamin D Antenatal Asthma Reduction Trial (VDAART).
  • 881 high-risk pregnant women received VD or placebo.
  • Assayed 25(OH)D in maternal and cord blood using CLIA and LC-MS/MS.

Main Results:

  • CLIA significantly overestimated cord blood 25(OH)D compared to LC-MS/MS (bias: 13.54 ng/mL).
  • This overestimation was specific to cord blood, not maternal samples.
  • Third-trimester maternal 25(OH)D levels positively correlated with neonatal levels.

Conclusions:

  • CLIAs are not valid for measuring 25(OH)D in neonatal cord blood.
  • Maternal 25(OH)D levels in the third trimester are a key determinant of neonatal status.
  • First-trimester maternal VD levels do not significantly predict neonatal VD status.
Abstract

Keywords:
25-hydroxy-vitamin Dneonatalpregnancyvitamin D

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