{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:00Z","timestamp":1753891920084,"version":"3.41.2"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There is a huge gap in the knowledge of the body\u2019s nutrient resources in women with multiple gestations. Due to the increased demand hypothesis and taking into account common vitamin D deficits in women with singleton pregnancies, this issue should also be investigated in twin pregnancies. This study evaluated blood vitamin D concentration in women with twin pregnancies and in the umbilical cord blood of their newborns as well as analyzed environmental factors that may affect the level of this nutrient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 56 women with twin pregnancies. Venous blood samples were collected from the women before delivery and umbilical cord blood at delivery to determine the total 25(OH)D concentration. The women were interviewed by a dietitian to collect data on their diet and lifestyle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average maternal 25(OH)D concentrations were 38.4\u2009\u00b1\u200911.0\u2009ng\/mL vs. 23.7\u2009\u00b1\u20096.1\u2009ng\/mL determined in the umbilical cord blood of the newborns. The concentration of 25(OH)D in the umbilical cord blood was strongly correlated with the concentration in the mother (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Vitamin D deficiency was found in 7% of women and 21% of newborns. Factors increasing the risk of too low 25(OH)D concentration in the mothers were age below 27\u2009years (<jats:italic>p<\/jats:italic>\u2009=\u20090.002) and short duration of pregnancy (<jats:italic>p<\/jats:italic>\u2009=\u20090.011). In newborns, the risk factors included low maternal concentrations (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and delivery before 36\u2009weeks of gestation (<jats:italic>p<\/jats:italic>\u2009=\u20090.008). The mean cord blood 25(OH)D levels were almost identical in both twins and amounted to 24.0\u2009\u00b1\u20096.1\u2009ng\/mL in the first-born and 23.4\u2009\u00b1\u20096.1\u2009ng\/mL in the second-born infant. Vitamin D supplementation was declared by 98% of the women, with 85% taking \u22642,000\u2009IU vitamin D daily.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Only a small percentage of women with twin pregnancies presented with vitamin D deficiency, which was probably related to the widespread supplementation of this nutrient. It can therefore be assumed that a dose of 2,000\u2009IU vitamin D currently recommended for pregnant women may also be appropriate for twin gestations, although further research is required to validate this finding.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2024.1433203","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:51:17Z","timestamp":1726635077000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin D concentration in the blood of women with twin pregnancies and in the umbilical cord blood of newborns in relation to environmental factors"],"prefix":"10.3389","volume":"11","author":[{"given":"Regina Ewa","family":"Wierzejska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwona","family":"Szymusik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Bomba-Opo\u0144","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iga","family":"Rzucid\u0142o-Szyma\u0144ska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Wojda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Biskupski-Brawura-Samaha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1097\/AOG.0b013e3181bb14c8","article-title":"Optimal nutrition for improved twin pregnancy outcome","volume":"114","author":"Goodnight","year":"2009","journal-title":"Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1053\/j.semperi.2005.08.004","article-title":"Nutrition and multiple gestation","volume":"29","author":"Luke","year":"2005","journal-title":"Semin Perinatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/j.1753-4887.2005.tb00144.x","article-title":"Twin pregnancies: eating for three? Maternal nutrition update","volume":"63","author":"Rosell\u00f3-Soberon","year":"2005","journal-title":"Nutr Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2553","DOI":"10.3390\/nu15112553","article-title":"Plasma retinol concentrations and dietary intakes of mother-infant sets in singleton versus twin pregnancy","volume":"15","author":"Akbar","year":"2023","journal-title":"Nutrients"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.cca.2021.11.022","article-title":"Gestational vitamin D3 supplementation and sun exposure significantly influence cord blood vitamin D status and 3-epi-25-hydroxyvitamin D3 levels in term newborns","volume":"524","author":"Vierucci","year":"2022","journal-title":"Clin Chim Acta"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.beem.2011.06.007","article-title":"Worldwide vitamin D status","volume":"25","author":"van Schoor","year":"2011","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.3390\/ijerph14101121","article-title":"Vitamin D concentration in maternal and umbilical cord blood by season","volume":"14","author":"Wierzejska","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.anpedi.2018.11.012","article-title":"Factors associated with the prevalence of hypovitaminosis D in pregnant women and their newborns","volume":"91","author":"Blarduni","year":"2019","journal-title":"An Pediatr (Engl Ed)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"301","DOI":"10.3390\/nu8050301","article-title":"Does maternal vitamin D deficiency increase the risk of preterm birth: a meta-analysis of observational studies","volume":"8","author":"Qin","year":"2016","journal-title":"Nutrients"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1038\/s41430-018-0373-x","article-title":"Vitamin D status during pregnancy and offspring outcomes: a systematic review and meta-analysis of observational studies","volume":"74","author":"Tous","year":"2020","journal-title":"Eur J Clin Nutr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2881","DOI":"10.1007\/s00394-022-02866-3","article-title":"Effect of maternal vitamin D status on risk of adverse birth outcomes: a systematic review and dose-response meta-analysis of observational studies","volume":"61","author":"Zhao","year":"2022","journal-title":"Eur J Nutr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e032626","DOI":"10.1136\/bmjopen-2019-032626","article-title":"Vitamin D supplementation to improve pregnancy and perinatal outcomes: an overview of 42 systematic reviews","volume":"10","author":"Bialy","year":"2020","journal-title":"BMJ Open"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1001\/jamapediatrics.2018.0302","article-title":"Association between vitamin D supplementation during pregnancy and offspring growth, morbidity, and mortality: a systematic review and meta-analysis","volume":"172","author":"Bi","year":"2018","journal-title":"JAMA Pediatr"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"CD008873","DOI":"10.1002\/14651858.CD008873","article-title":"Vitamin D supplementation for women during pregnancy","volume":"7","author":"Palacios","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1097\/AOG.0b013e3182941d9a","article-title":"Maternal 25-hydroxyvitamin D and preterm birth in twin gestations","volume":"122","author":"Bodnar","year":"2013","journal-title":"Obstet Gynecol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2239","DOI":"10.3390\/nu16142239","article-title":"Maternal circulating vitamin D level, targeted supplementation, and perinatal outcomes in twin pregnancy","volume":"16","author":"Roero","year":"2024","journal-title":"Nutrients"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.bone.2011.05.016","article-title":"Differences in bone metabolism between singleton pregnancy and twin pregnancy","volume":"49","author":"Nakayama","year":"2011","journal-title":"Bone"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/0029-7844(96)00159-7","article-title":"Bone turnover and mineral metabolism in the last trimester of pregnancy: effect of multiple gestation","volume":"88","author":"Okah","year":"1996","journal-title":"Obstet Gynecol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e04547","DOI":"10.2903\/j.efsa.2016.4547","article-title":"Scientific opinion. Dietary reference values for vitamin D","volume":"14","year":"2016","journal-title":"EFSA J"},{"volume-title":"Committee to review dietary reference intakes for vitamin D and calcium","year":"2011","author":"Ross","key":"ref20"},{"year":"2018","key":"ref21"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1017\/S1368980010001138","article-title":"Diet composition of pregnant Finnish women: changes over time and across seasons","volume":"13","author":"Prasad","year":"2010","journal-title":"Public Health Nutr"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1210\/jc.2015-2175","article-title":"Global consensus recommendations on prevention and management of nutritional rickets","volume":"101","author":"Munns","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"volume-title":"WHO antenatal care recommendations for a positive pregnancy experience: nutritional interventions update: vitamin D supplements during pregnancy","year":"2020","key":"ref24"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"695","DOI":"10.3390\/nu15030695","article-title":"Guidelines for preventing and treating vitamin D deficiency: a 2023 update in Poland","volume":"15","author":"P\u0142udowski","year":"2023","journal-title":"Nutrients"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"339","DOI":"10.3390\/nu15020339","article-title":"Longitudinal assessment of serum 25-hydroxyvitamin D levels during pregnancy and postpartum \u2013 are the current recommendations for supplementation sufficient?","volume":"15","author":"Palmrich","year":"2023","journal-title":"Nutrients"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"122","DOI":"10.3390\/nu16010122","article-title":"Vitamin D supplementation at a dose of 10 \u03bcg\/day in institutionalized children with severe motor and intellectual disabilities","volume":"16","author":"Sato","year":"2024","journal-title":"Nutrients"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.jsbmb.2016.12.006","article-title":"Vitamin D metabolite concentrations in umbilical cord blood serum and associations with clinical characteristics in large prospective mother-infant cohort in Ireland","volume":"167","author":"Kiely","year":"2017","journal-title":"J Steroid Biochem Mol Biol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"309","DOI":"10.32394\/rpzh.2021.0176","article-title":"Evaluation of prenatal vitamin-mineral preparations in the context of recommended dietary supplementation. Are pregnant women supplied with what they should get?","volume":"72","author":"Wierzejska","year":"2021","journal-title":"Rocz Panstw Zakl Hig"},{"volume-title":"Weight gain during pregnancy: reexamining the guidelines","year":"2009","key":"ref30"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e230201","DOI":"10.1530\/EC-23-0201","article-title":"Determination of vitamin D status in singleton and twin gestations using CLIA and LC-MS\/MS","volume":"12","author":"Zgliczy\u0144ska","year":"2023","journal-title":"Endocr Connect"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12884-021-03707-7","article-title":"Vitamin D status in women with dichorionic twin pregnancies and their neonates: a pilot study in China","volume":"21","author":"Li","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.jaci.2017.02.039","article-title":"Vitamin D supplementation during pregnancy: effect on the neonatal immune system in a randomized controlled trial","volume":"141","author":"Hornsby","year":"2018","journal-title":"J Allergy Clin Immunol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3390\/nu16010146","article-title":"The effect of vitamin D supplementation in pregnant women with overweight and obesity: a randomised controlled trial","volume":"16","author":"Ku","year":"2024","journal-title":"Nutrients"},{"key":"ref35","first-page":"49","article-title":"Dose of the vitamin D in prenatal supplements and the current prevention its deficiency at mothers and newborns","volume":"3","author":"Wierzejska","year":"2015","journal-title":"Gin Po\u0142 Med Proj"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jsbmb.2016.12.011","article-title":"The concept of the personal vitamin D response index","volume":"175","author":"Carlberg","year":"2018","journal-title":"J Steroid Biochem Mol Biol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"3493","DOI":"10.3390\/nu15153493","article-title":"Vitamin D intake and serum levels in pregnant and postpartum women","volume":"15","author":"Meija","year":"2023","journal-title":"Nutrients"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.jsbmb.2015.08.008","article-title":"Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: the B-PROOF study","volume":"164","author":"Brouwer-Brolsma","year":"2016","journal-title":"J Steroid Biochem Mol Biol"},{"key":"ref39","first-page":"170","article-title":"Rekomendacje Polskiego Towarzystwa Ginekolog\u00f3w i Po\u0142o\u017cnik\u00f3w dotycz\u0105ce suplementacji u kobiet ci\u0119\u017carnych","volume":"5","author":"Zimmer","year":"2020","journal-title":"Ginekologia i Perinatologia Praktyczna"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"246","DOI":"10.3389\/fendo.2018.00246","article-title":"Vitamin D supplementation guidelines for general population and groups at risk of vitamin D deficiency in Poland \u2013 recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the expert panel with participation of national specialist consultants and representatives of scientific societies-2018 update","volume":"9","author":"Rusi\u0144ska","year":"2018","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1093\/labmed\/lmad005","article-title":"Evaluation of vitamin D status and the analysis of risk factors of vitamin D deficiency in twin pregnancies","volume":"54","author":"Le","year":"2023","journal-title":"Lab Med"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1007\/s00431-018-3210-2","article-title":"Prevalence of vitamin D deficiency in cord blood of newborns and the association with maternal vitamin D status","volume":"177","author":"Ariyawatkul","year":"2018","journal-title":"Eur J Pediatr"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1186\/s12884-018-2045-1","article-title":"Vitamin D plasma concentrations in pregnant women and their preterm newborns","volume":"18","author":"Kassai","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.1093\/nutrit\/nuac023","article-title":"Vitamin D concentrations during pregnancy and in cord blood: a systematic review and meta-analysis","volume":"80","author":"Wong","year":"2022","journal-title":"Nutr Rev"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"188","DOI":"10.3945\/ajcn.112.035683","article-title":"Maternal vitamin D predominates over genetic factors in determining neonatal circulating vitamin D concentrations","volume":"96","author":"Novakovic","year":"2012","journal-title":"Am J Clin Nutr"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1111\/jog.13060","article-title":"Maternal and neonatal vitamin-D status in twin versus singleton pregnancies","volume":"42","author":"Goswami","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/S0022-3476(74)80024-7","article-title":"Human perinatal vitamin D metabolism. I. 25-hydroxyvitamin D in maternal and cord blood","volume":"84","author":"Hillman","year":"1974","journal-title":"J Pediatr"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1530\/EJE-13-0842","article-title":"Seasonal variation in maternal and umbilical cord 25(OH) vitamin D and their associations with neonatal adiposity","volume":"170","author":"Godang","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.3390\/nu14071326","article-title":"Maternal obesity in twin pregnancy: the role of nutrition to reduce maternal and fetal complications","volume":"14","author":"de la Calle","year":"2022","journal-title":"Nutrients"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"3781","DOI":"10.3390\/nu14183781","article-title":"Vitamin D3 supplementation in overweight\/obese pregnant women: no effects on the maternal or fetal lipid profile and body fat distribution-a secondary analysis of the multicentric, randomized, controlled vitamin D and lifestyle for gestational diabetes prevention trial (DALI)","volume":"14","author":"Harreiter","year":"2022","journal-title":"Nutrients"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"bvab170","DOI":"10.1210\/jendso\/bvab170","article-title":"Maternal and neonatal 3-epi-25-hydroxyvitamin D concentration and factors influencing their concentrations","volume":"6","author":"Mao","year":"2021","journal-title":"J Endocr Soc"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1093\/jn\/nxz290","article-title":"Vitamin D status increases during pregnancy and in response to vitamin D supplementation in rural Gambian women","volume":"150","author":"Jones","year":"2020","journal-title":"J Nutr"},{"key":"ref53","first-page":"86","article-title":"Rekomendacje Polskiego Towarzystwa Ginekolog\u00f3w i Po\u0142o\u017cnik\u00f3w dotycz\u0105ce indukcji porodu. Aktualizacja 2021","volume":"5","author":"Bomba-Opon","year":"2020","journal-title":"Ginekol Perinatol Prakt"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.3390\/ijms17101574","article-title":"Serum 25(OH) vitamin D levels in polish women during pregnancies complicated by hypertensive disorders and gestational diabetes","volume":"17","author":"Domaracki","year":"2016","journal-title":"Int J Mol Sci"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"363","DOI":"10.17772\/gp\/1590","article-title":"Vitamin D insufficiency in healthy pregnant women living in Warsaw","volume":"84","author":"Bartoszewicz","year":"2013","journal-title":"Ginekol Pol"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"933","DOI":"10.13075\/ijomeh.1896.01146","article-title":"Assessment of correlation between vitamin D level and prevalence of preterm births in the population of pregnant women in Poland","volume":"30","author":"Baczy\u0144ska-Strzecha","year":"2017","journal-title":"Int J Occup Med Environ Health"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e1085","DOI":"10.1210\/clinem\/dgz299","article-title":"Determinants and measurement of neonatal vitamin D: overestimation of 25(OH)D in cord blood using CLIA assay technology","volume":"105","author":"Lu","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"5268706","DOI":"10.1155\/2022\/5268706","article-title":"C3-Epimer of 25-hydroxyvitamin D3 as a superior marker for predicting the severity of chronic kidney disease in rheumatoid arthritis patients","volume":"2022","author":"Tang","year":"2022","journal-title":"Oxidative Med Cell Longev"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.jsbmb.2018.09.003","article-title":"The serum vitamin D metabolome: what we know and what is still to discover","volume":"186","author":"Tuckey","year":"2019","journal-title":"J Steroid Biochem Mol Biol"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1433203\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:51:21Z","timestamp":1726635081000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1433203\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":59,"alternative-id":["10.3389\/fnut.2024.1433203"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2024.1433203","relation":{},"ISSN":["2296-861X"],"issn-type":[{"type":"electronic","value":"2296-861X"}],"subject":[],"published":{"date-parts":[[2024,9,18]]},"article-number":"1433203"}}