{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T09:43:23Z","timestamp":1789897403705,"version":"4.0.1"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"The Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CPHS\/20\/1\/505278"],"award-info":[{"award-number":["IA\/CPHS\/20\/1\/505278"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>India has a high prevalence of Vitamin D insufficiency among women of childbearing age. In this study, we aimed to evaluate the potential relationship between Vitamin D deficiency and gestational diabetes mellitus (GDM) and low birth weight (LBW) of newborns in the \u201cMaternal antecedents of adiposity and studying the transgenerational role of hyperglycaemia and insulin\u201d (MAASTHI) birth cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study involving 230 participants was conducted in public hospitals located in urban Bengaluru, India. Healthy pregnant women who visited these hospitals for antenatal care (ANC) and who were between 14 and 36 weeks of gestational age were recruited after obtaining their informed consent. An oral glucose tolerance test (OGTT) was administered between 24 and 36 weeks of pregnancy and blood samples were preserved at \u221280\u00b0C for Vitamin D analysis. Follow-up at birth included recording the child's birth weight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that 178 (77.4%) of the study participants were vitamin D deficient, 44 (19.1%) were diagnosed with GDM, and 64 (27.8%) gave birth to LBW babies. Women in the lowest quartile of serum Vitamin D levels had three times higher odds of developing GDM than women in the higher quartiles [OR = 3.22 (95% CI: 1.03, 10.07),\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04] after adjusting for age, parity, socioeconomic status, season, and adiposity. For every one-unit increase in Vitamin D levels, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) decreased by nearly 18%. Furthermore, causal mediation analysis showed that a decrease in one unit of Vitamin D is associated with a decrease of 0.015 units of fasting blood sugar (FBS) and 0.019 units of postprandial blood sugar (PPBS) as it flows through the mediator variable insulin resistance. Vitamin D-deficient women were twice at risk of giving birth to LBW babies (OR 2.04, 95% CI 0.99, 4.19,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussions<\/jats:title>\n                    <jats:p>Low levels of Vitamin D during pregnancy are associated with a greater risk of pregnant women developing GDM and giving birth to LBW babies in urban Bengaluru.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2024.1352617","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:34:58Z","timestamp":1717374898000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Low levels of Vitamin D during pregnancy associated with gestational diabetes mellitus and low birth weight: results from the MAASTHI birth cohort"],"prefix":"10.3389","volume":"11","author":[{"given":"R.","family":"Deepa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onno C. P. Van","family":"Schayck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giridhara R.","family":"Babu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3602","DOI":"10.1080\/10408398.2021.1990850","article-title":"High prevalence of vitamin D deficiency in Asia: a systematic review and meta-analysis","volume":"63","author":"Jiang","year":"2023","journal-title":"Crit Rev Food Sci Nutr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s41043-021-00253-y","article-title":"Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis","volume":"40","author":"Jeyakumar","year":"2021","journal-title":"J Health Popul Nutr."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2884","DOI":"10.4103\/jfmpc.jfmpc_1819_21","article-title":"Prevalence of vitamin D deficiency among South Indian pregnant women","volume":"11","author":"Sheela Ravinder","year":"2022","journal-title":"J Family Med Prim Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"116","DOI":"10.3389\/fnut.2019.00116","article-title":"Relationship of early vitamin D concentrations and gestational diabetes mellitus in Indian pregnant women","volume":"6","author":"Dwarkanath","year":"2019","journal-title":"Front Nutr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/j.placenta.2010.08.015","article-title":"Vitamin D effects on pregnancy and the placenta","volume":"31","author":"Shin","year":"2010","journal-title":"Placenta"},{"key":"B6","doi-asserted-by":"publisher","first-page":"84","DOI":"10.18203\/2320-1770.ijrcog20164637","article-title":"A study of vitamin D levels and associated deficiency in pregnancy and its effect on maternal and fetal outcome","volume":"6","author":"Dave","year":"2016","journal-title":"Int J Reprod Contracept Obstet Gynecol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"8366","DOI":"10.3390\/nu7105398","article-title":"Vitamin D deficiency increases the risk of gestational diabetes mellitus: a meta-analysis of observational studies","volume":"7","author":"Zhang","year":"2015","journal-title":"Nutrients."},{"key":"B8","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.tjog.2018.02.013","article-title":"Association of vitamin D level and vitamin D deficiency with risk of preeclampsia: a systematic review and updated meta-analysis","volume":"57","author":"Akbari","year":"2018","journal-title":"Taiwan J Obstet Gynecol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1097\/AOG.0000000000000621","article-title":"Early-pregnancy vitamin D deficiency and risk of preterm birth subtypes","volume":"125","author":"Bodnar","year":"2015","journal-title":"Obstet Gynecol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1002\/(SICI)1520-6661(199811\/12)7:6<292::AID-MFM7>3.0.CO;2-A","article-title":"Anthropometric differences in macrosomic infants of diabetic and nondiabetic mothers","volume":"7","author":"McFarland","year":"1998","journal-title":"J Matern Fetal Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1177\/1933719112459222","article-title":"The relationship between maternal and fetal vitamin d, insulin resistance, and fetal growth","volume":"20","author":"Walsh","year":"2013","journal-title":"Reprod Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jsbmb.2016.09.017","article-title":"Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome","volume":"175","author":"Wimalawansa","year":"2018","journal-title":"J Steroid Biochem Mol Biol."},{"key":"B13","first-page":"853","article-title":"Serum vitamin-D predicts insulin resistance in individuals with prediabetes","volume":"138","author":"Dutta","year":"2013","journal-title":"Indian J Med Res."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.2337\/dc09-2321","article-title":"Association of vitamin D with insulin resistance and \u03b2-cell dysfunction in subjects at risk for type 2 diabetes","volume":"33","author":"Kayaniyil","year":"2010","journal-title":"Diabetes Care."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e3739","DOI":"10.1210\/clinem\/dgab213","article-title":"Sex-dependent association of vitamin D with insulin resistance in humans","volume":"106","author":"Chen","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"B16","doi-asserted-by":"publisher","first-page":"105733","DOI":"10.1016\/j.jsbmb.2020.105733","article-title":"Gestational vitamin D deficiency causes placental insufficiency and fetal intrauterine growth restriction partially through inducing placental inflammation","volume":"203","author":"Chen","year":"2020","journal-title":"J Steroid Biochem Mol Biol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"3473","DOI":"10.1007\/s00394-021-02528-w","article-title":"Associations between maternal vitamin D status during three trimesters and cord blood 25(OH)D concentrations in newborns: a prospective Shanghai birth cohort study","volume":"60","author":"Wang","year":"2021","journal-title":"Eur J Nutr."},{"key":"B18","first-page":"2","article-title":"Kuppuswamy's socio-economic status scale\u2013a revision of economic parameter for 2012","volume":"1","author":"Kumar","year":"2013","journal-title":"Int J Res Dev Health."},{"key":"B19","doi-asserted-by":"publisher","first-page":"4","DOI":"10.2174\/138945011793591635","article-title":"Vitamin D: evolutionary, physiological and health perspectives","volume":"12","author":"F Holick","year":"2011","journal-title":"Curr Drug Targets"},{"key":"B20","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/S0140-6736(95)92143-5","article-title":"A simple measure of insulin resistance","volume":"346","author":"Duncan","year":"1995","journal-title":"Lancet."},{"key":"B21","volume-title":"Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity","year":"2011"},{"key":"B22","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.pbiomolbio.2006.02.016","article-title":"Vitamin D physiology","volume":"92","author":"Lips","year":"2006","journal-title":"Prog Biophys Mol Biol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1111\/cen.12147","article-title":"Parity and tanned white skin as novel predictors of vitamin D status in early pregnancy: a population-based cohort study","volume":"79","author":"Andersen","year":"2013","journal-title":"Clin Endocrinol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"22","DOI":"10.4103\/injms.injms_107_20","article-title":"Estimating serum vitamin D levels and assessing its influencing factors among antenatal women in a South Indian town-Kumbakonam urban rural epidemiological study: KURES-5","volume":"12","author":"Suchitra","year":"2021","journal-title":"Ind J Med Spec"},{"key":"B25","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1093\/jn\/135.2.218","article-title":"Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing","volume":"135","author":"Hatun","year":"2005","journal-title":"J Nutr."},{"key":"B26","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s13224-014-0658-5","article-title":"Current scenario of vitamin D status during pregnancy in north Indian population","volume":"66","author":"Sharma","year":"2016","journal-title":"J Obstet Gynaecol India"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2437","DOI":"10.1093\/jn\/137.11.2437","article-title":"Prepregnancy obesity predicts poor vitamin D status in mothers and their neonates","volume":"137","author":"Bodnar","year":"2007","journal-title":"J Nutr."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v059.i05","article-title":"Mediation: R package for causal mediation analysis","volume":"59","author":"Tingley","year":"2014","journal-title":"J. Stat Softw."},{"key":"B29","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1177\/1536867X1101100407","article-title":"Causal mediation analysis","volume":"11","author":"Hicks","year":"2011","journal-title":"Stata J"},{"key":"B30","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1037\/a0020761","article-title":"A general approach to causal mediation analysis","volume":"15","author":"Imai","year":"2010","journal-title":"Psychol Methods"},{"key":"B31","doi-asserted-by":"publisher","first-page":"130","DOI":"10.4161\/derm.23873","article-title":"Vitamin D status and sun exposure in India","volume":"5","author":"Harinarayan","year":"2013","journal-title":"Dermatoendocrinol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1007\/s00198-015-3427-0","article-title":"Regional and seasonal variations in ultraviolet B irradiation and vitamin D synthesis in India","volume":"27","author":"Marwaha","year":"2016","journal-title":"Osteoporos Int."},{"key":"B33","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1017\/S0007114512002103","article-title":"Low fish intake is associated with low blood concentrations of vitamin D, choline and n-3 DHA in pregnant women","volume":"109","author":"Wu","year":"2013","journal-title":"Br J Nutr"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2230","DOI":"10.1016\/j.clnu.2017.10.024","article-title":"Vitamin D pathway gene polymorphisms influenced vitamin D level among pregnant women","volume":"37","author":"Shao","year":"2018","journal-title":"Clin Nutr"},{"key":"B35","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1210\/en.2004-1116","article-title":"Altered pharmacokinetics of 1\u03b1, 25-dihydroxyvitamin D3 and 25-hydroxyvitamin D3 in the blood and tissues of the 25-hydroxyvitamin D-24-hydroxylase (Cyp24a1) null mouse","volume":"146","author":"Masuda","year":"2005","journal-title":"Endocrinology"},{"key":"B36","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.ejim.2012.01.007","article-title":"Vitamin D and gestational diabetes: a systematic review and meta-analysis","volume":"23","author":"Poel","year":"2012","journal-title":"Eur J Intern Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1007\/s00404-016-4010-4","article-title":"Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis","volume":"293","author":"Lu","year":"2016","journal-title":"Arch Gynecol Obstet."},{"key":"B38","doi-asserted-by":"publisher","first-page":"2576","DOI":"10.1016\/j.clnu.2021.03.037","article-title":"Maternal vitamin D status and risk of gestational diabetes mellitus: a systematic review and meta-analysis of prospective cohort studies","volume":"40","author":"Milajerdi","year":"2021","journal-title":"Clin Nutr."},{"key":"B39","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3389\/fendo.2018.00007","article-title":"Effects of vitamin D deficiency on incidence risk of gestational diabetes mellitus: a systematic review and meta-analysis","volume":"9","author":"Amraei","year":"2018","journal-title":"Front Endocrinol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"108779","DOI":"10.1016\/j.diabres.2021.108779","article-title":"Second-trimester maternal serum vitamin D and pregnancy outcome: the Western Australian Raine cohort study","volume":"175","author":"Mosavat","year":"2021","journal-title":"Diabetes Res Clin Pract."},{"key":"B41","doi-asserted-by":"publisher","first-page":"616","DOI":"10.4103\/2230-8210.163175","article-title":"Vitamin D status and gestational diabetes mellitus","volume":"19","author":"Muthukrishnan","year":"2015","journal-title":"Indian J Endocrinol Metab."},{"key":"B42","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1038\/ejcn.2008.14","article-title":"Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size","volume":"63","author":"Farrant","year":"2009","journal-title":"Eur J Clin Nutr."},{"key":"B43","doi-asserted-by":"publisher","first-page":"17","DOI":"10.5897\/JDE2017.0111","article-title":"Vitamin D and insulin resistance in gestational diabetes mellitus","volume":"8","author":"Gashlan","year":"2017","journal-title":"J Diabetes Endocrinol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1002\/jcp.24371","article-title":"Induction of STEAP 4 correlates with 1, 25-dihydroxyvitamin D3 stimulation of adipogenesis in mesenchymal progenitor cells derived from human adipose tissue","volume":"228","author":"Narvaez","year":"2013","journal-title":"J Cell Physiol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3390\/ijerph18010205","article-title":"Association between gene polymorphisms of vitamin D receptor and gestational diabetes mellitus: a systematic review and meta-analysis","volume":"18","author":"Zhou","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B46","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1124\/pr.55.1.7","article-title":"Pharmacological agents that directly modulate insulin secretion","volume":"55","author":"Doyle","year":"2003","journal-title":"Pharmacol Rev"},{"key":"B47","doi-asserted-by":"publisher","first-page":"3148","DOI":"10.1016\/j.clnu.2020.12.016","article-title":"The effects of vitamin D supplementation on glycemic control and maternal-neonatal outcomes in women with established gestational diabetes mellitus: a systematic review and meta-analysis","volume":"40","author":"Wang","year":"2021","journal-title":"Clin Nutr."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1716","DOI":"10.3390\/ijerph16101716","article-title":"The effect of vitamin D supplementation on glycaemic control in women with gestational diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials","volume":"16","author":"Ojo","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"B49","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1111\/1471-0528.15060","article-title":"Vitamin D and gestational diabetes mellitus: a systematic review based on data free of Hawthorne effect","volume":"125","author":"Zhang","year":"2018","journal-title":"BJOG"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1080\/14767058.2019.1623780","article-title":"Maternal vitamin D deficiency during pregnancy and low birth weight: a systematic review and meta-analysis","volume":"34","author":"Fang","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B51","doi-asserted-by":"publisher","first-page":"E2070","DOI":"10.1210\/jc.2012-2538","article-title":"The effect of maternal vitamin D concentration on fetal bone","volume":"97","author":"Ioannou","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B52","doi-asserted-by":"publisher","first-page":"106358","DOI":"10.1016\/j.jsbmb.2023.106358","article-title":"Does maternal vitamin D status influence placental weight or vascular and inflammatory pathology? Secondary analysis from the Kellogg Pregnancy Study","volume":"233","author":"Mead","year":"2023","journal-title":"J Steroid Biochem Mol Biol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.2337\/dc16-1728","article-title":"Physical activity\/exercise and diabetes: a position statement of the American Diabetes Association","volume":"39","author":"Colberg","year":"2016","journal-title":"Diabetes Care."},{"key":"B54","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/j.jand.2019.07.002","article-title":"Vitamin D supplementation during pregnancy: an evidence analysis center systematic review and meta-analysis","volume":"120","author":"Gallo","year":"2020","journal-title":"J Acad Nutr Diet."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1352617\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T06:15:21Z","timestamp":1721369721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1352617\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,3]]},"references-count":54,"alternative-id":["10.3389\/fnut.2024.1352617"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2024.1352617","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,3]]},"article-number":"1352617"}}