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Torn\u00e9"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the association of maternal circulating 25\u2010hydroxyvitamin D3 [25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3] concentration with pregnancy and birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Four geographical areas of Spain, 2003\u20132008.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Of 2382 mother\u2013child pairs participating in the <jats:styled-content style=\"fixed-case\">IN<\/jats:styled-content>fancia y Medio Ambiente (<jats:styled-content style=\"fixed-case\">INMA<\/jats:styled-content>) Project.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Maternal circulating 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3 concentration was measured in pregnancy (mean [<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>] 13.5 [2.2] weeks of gestation). We tested associations of maternal 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3 concentration with pregnancy and birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Gestational diabetes mellitus (<jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>), preterm delivery, caesarean section, fetal growth restriction (<jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>) and small\u2010for\u2010gestational age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>), anthropometric birth outcomes including weight, length and head circumference (<jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 31.8% and 19.7% of women had vitamin D insufficiency [25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3 20\u201329.99\u00a0ng\/ml] and deficiency [25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3\u00a0&lt;\u00a020\u00a0ng\/ml], respectively. After adjustment, there was no association between maternal 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3 concentration and risk of <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> or preterm delivery. Women with sufficient vitamin D [25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3\u00a0\u2265\u00a030\u00a0ng\/ml] had a decreased risk of caesarean section by obstructed labour compared with women with vitamin D deficiency [relative risk (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>)\u00a0=\u00a00.60, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.37, 0.97). Offspring of mothers with higher circulating 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3 concentration tended to have smaller <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content> [coefficient (<jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content>) per doubling concentration of 25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3, \u22120.10 (0.05), <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.038]. No significant associations were found for other birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study did not find any evidence of an association between vitamin D status in pregnancy and <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>, preterm delivery, <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> SGA<\/jats:styled-content> and anthropometric birth outcomes. Results suggest that sufficient circulating vitamin D concentration [25(<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>)D3\u00a0\u2265\u00a030\u00a0ng\/ml] in pregnancy may reduce the risk of caesarean section by obstructed labour.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13074","type":"journal-article","created":{"date-parts":[[2014,9,11]],"date-time":"2014-09-11T02:19:48Z","timestamp":1410401988000},"page":"1695-1704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":97,"title":["Associations of maternal circulating 25\u2010hydroxyvitamin D3 concentration with pregnancy and birth outcomes"],"prefix":"10.1111","volume":"122","author":[{"given":"A","family":"Rodriguez","sequence":"first","affiliation":[{"name":"Hospital de Sabadell Corporaci\u00f3 Sanit\u00e0ria Parc Taul\u00ed Institut Universitari ParcTaul\u00ed\u2010UAB Sabadell Catalonia Spain"},{"name":"Universitat Aut\u00f2noma de Barcelona 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