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Updated: Jun 16, 2025
Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
The association between preterm birth and the supplementation with vitamin D and calcium during pregnancy
Jiatao Zhang1, Shuoxin Bai2, Shaoqian Lin3
1Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
Background And Aim:
Although vitamin D (VD) supplementation or calcium supplementation during pregnancy has become publicly accepted and part of health care behavior, the effect of co-supplementation on preterm birth remains unclear.
Objective:
To explore whether the supplementation with vitamin D and calcium during pregnancy is associated with preterm birth.
Methods:
The study was the baseline survey from the birth cohort in Jinan, which was built at one month after the baby birth. Preterm birth and monthly VD and calcium supplementation during pregnancy were obtained by the questionnaire. The logistic model was conducted to exam the association. The distributed lag nonlinear model was applied to explore the critical window for the supplements.
Results:
Preterm birth occurred in 4.4 % (285/6501) of the study subjects with single live births and the rates were 39.7% and 82.6% for single VD supplementation or calcium supplementation in pregnancy. The adjusted OR (95% CI) for preterm birth was 1.428 (1.115-1.829) related to VD and 0.883 (0.652-1.216) related to calcium. It is interesting to note that the increased risk of preterm birth with VD supplementation during pregnancy was only seen in pregnant women who supplemented with calcium (OR was 1.600) and had a significant increase in preterm birth weight (P = 0.040). Besides, supplementation VD with calcium during pregnancy from the 3rd to 6th month during pregnancy was associated with preterm birth (OR3rd = 1.216, 95% CI: 1.119-1.320; OR4th = 1.275, 95% CI: 1.152-1.411; OR5th = 1.279, 95% CI: 1.130-1.446; OR6th = 1.208, 95% CI: 1.076-1.356). Moreover, birth weight mediated 10.8% of the total effect of supplementation on preterm birth.
Conclusion:
Women who supplemented with VD among taking calcium during pregnancy were more likely to experience preterm birth, and birth weight partly mediates the effect. The critical window for association between supplements and preterm birth may be from the 3rd to 6th weeks of pregnancy.
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