{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T21:06:23Z","timestamp":1787691983761,"version":"build-2784847793"},"reference-count":37,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"4Ward North Wellcome Trust Clinical Research Training Fellowship","award":["203914\/Z\/16\/Z"],"award-info":[{"award-number":["203914\/Z\/16\/Z"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Vitamin D deficiency is linked to adverse pregnancy outcomes like gestational diabetes mellitus (GDM), but its effects across ethnic groups are unclear. This study examines the relationship among vitamin D levels, glucose tolerance, GDM prevalence, and neonatal outcomes in a multi-ethnic cohort of pregnant women. Methods: We conducted a retrospective analysis of 252 pregnant women from antenatal clinics between 2018 and 2022. Participants were divided into four groups based on serum vitamin D levels: severely deficient (&lt;25 nmol\/L), deficient (25\u201350 nmol\/L), insufficient (51\u201375 nmol\/L), and sufficient (&gt;75 nmol\/L). The analysis included multivariate linear regression models adjusted for age, ethnicity, BMI, gestational diabetes status, and seasonality. An area under the receiver operating characteristic (AUROC) analysis identified the vitamin D threshold linked to an increased GDM risk. Results: Women classified as severely deficient had higher fasting glucose levels (5.73 \u00b1 1.24 mmol\/L) than those in other groups (p = 0.003, adjusted). The AUROC analysis identified a vitamin D threshold of 45 nmol\/L associated with an elevated GDM risk (AUROC = 0.78, CI: 0.70\u20130.85). South Asian women had lower vitamin D levels (41.17 \u00b1 18.03 nmol\/L vs. 45.15 \u00b1 16.75 nmol\/L) and higher glucose tolerance test (GTT) levels than Caucasian women, despite having lower BMIs. Moreover, vitamin D levels positively correlated with neonatal birth weight (p = 0.02). Conclusions: There is a strong link between vitamin D deficiency and increased GDM risk, especially among South Asian women. These findings underscore the need for targeted interventions to improve vitamin D levels in high-risk ethnic groups.<\/jats:p>","DOI":"10.3390\/nu17030565","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T09:35:07Z","timestamp":1738575307000},"page":"565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of Vitamin D Deficiency on Gestational Diabetes and Pregnancy Outcomes Across Diverse Ethnic Groups: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Sushant","family":"Saluja","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK"},{"name":"Division of Medicine, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navin","family":"Sugathan","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne OL6 9RW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopa","family":"Krishnamurthy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne OL6 9RW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3186-4122","authenticated-orcid":false,"given":"Edward B.","family":"Jude","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK"},{"name":"Department of Diabetes and Endocrinology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne OL6 9RW, UK"},{"name":"Faculty of Science & Engineering, Manchester Metropolitan University, Manchester M15 6BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"ACOG (2018). Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet. Gynecol., 131, e49\u2013e64.","DOI":"10.1097\/AOG.0000000000002501"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.ogc.2017.02.002","article-title":"Gestational Diabetes: Diagnosis, Classification, and Clinical Care","volume":"44","author":"Mack","year":"2017","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"109050","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group\u2019s Criteria","volume":"183","author":"Wang","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Zhou, T., Du, S., Sun, D., Li, X., Heianza, Y., Hu, G., Sun, L., Pei, X., Shang, X., and Qi, L. (2022). Prevalence and Trends in Gestational Diabetes Mellitus Among Women in the United States, 2006\u20132017: A Population-Based Study. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.868094"},{"key":"ref_5","first-page":"e47500","article-title":"A Comprehensive Review of Gestational Diabetes Mellitus: Impacts on Maternal Health, Fetal Development, Childhood Outcomes, and Long-Term Treatment Strategies","volume":"15","author":"Nakshine","year":"2023","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1159\/000371628","article-title":"Gestational Diabetes Mellitus and Macrosomia: A Literature Review","volume":"66","author":"Kc","year":"2015","journal-title":"Ann. Nutr. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/aogs.12152","article-title":"Evolution of Diagnostic Criteria for Gestational Diabetes Mellitus","volume":"92","author":"Houshmand","year":"2013","journal-title":"Acta Obstet. Et Gynecol. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5489015","DOI":"10.1155\/2016\/5489015","article-title":"Trends in the Diagnosis of Gestational Diabetes Mellitus","volume":"2016","author":"Mishra","year":"2016","journal-title":"Scientifica"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Li, L.-J., Huang, L., Tobias, D.K., and Zhang, C. (2022). Gestational Diabetes Mellitus Among Asians\u2014A Systematic Review From a Population Health Perspective. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.840331"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/1735-1995.175148","article-title":"The Effect of Vitamin D Supplementation on Gestational Diabetes in High-Risk Women: Results from a Randomized Placebo-Controlled Trial","volume":"21","author":"Shahgheibi","year":"2016","journal-title":"J. Res. Med. Sci."},{"key":"ref_11","unstructured":"(2024, September 02). The Association Between Vitamin D Intake and Gestational Diabetes Mellitus: A Systematic Review. Available online: https:\/\/www.imrpress.com\/journal\/CEOG\/50\/5\/10.31083\/j.ceog5005096."},{"key":"ref_12","unstructured":"(2024, September 02). Vitamin D Deficiency 2.0: An Update on the Current Status Worldwide|European Journal of Clinical Nutrition. Available online: https:\/\/www.nature.com\/articles\/s41430-020-0558-y."},{"key":"ref_13","first-page":"V","article-title":"Vitamin D Deficiency\u2014An Ignored Epidemic","volume":"4","author":"Naeem","year":"2010","journal-title":"Int. J. Health Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e000501","DOI":"10.1136\/bmjdrc-2017-000501","article-title":"Lower Vitamin D Levels Are Associated with Higher Blood Glucose Levels in Asian Indian Women with Pre-Diabetes: A Population-Based Cross-Sectional Study in North India","volume":"6","author":"Bhatt","year":"2018","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"923","DOI":"10.3390\/ddc2040046","article-title":"The Effects of Vitamin D on Preventing Hyperglycemia and a Novel Approach to Its Treatment","volume":"2","author":"Monapati","year":"2023","journal-title":"Drugs Drug Candidates"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wilson, R.L., Leviton, A.J., Leemaqz, S.Y., Anderson, P.H., Grieger, J.A., Grzeskowiak, L.E., Verburg, P.E., McCowan, L., Dekker, G.A., and Bianco-Miotto, T. (2018). Vitamin D Levels in an Australian and New Zealand Cohort and the Association with Pregnancy Outcome. BMC Pregnancy Childbirth, 18.","DOI":"10.1186\/s12884-018-1887-x"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1907222","DOI":"10.1155\/2023\/1907222","article-title":"Vitamin D Supplementation for the Outcomes of Patients with Gestational Diabetes Mellitus and Neonates: A Meta-Analysis and Systematic Review","volume":"2023","author":"Wu","year":"2023","journal-title":"Int. J. Clin. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/s41387-024-00296-0","article-title":"Effects of Vitamin D in Pregnancy on Maternal and Offspring Health-Related Outcomes: An Umbrella Review of Systematic Review and Meta-Analyses","volume":"14","author":"Chien","year":"2024","journal-title":"Nutr. Diabetes"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Wu, J., Atkins, A., Downes, M., and Wei, Z. (2023). Vitamin D in Diabetes: Uncovering the Sunshine Hormone\u2019s Role in Glucose Metabolism and Beyond. Nutrients, 15.","DOI":"10.3390\/nu15081997"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e016404","DOI":"10.1136\/bmjopen-2017-016404","article-title":"Association between Maternal Vitamin D Deficiency and Small for Gestational Age: Evidence from a Meta-Analysis of Prospective Cohort Studies","volume":"7","author":"Chen","year":"2017","journal-title":"BMJ Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1210\/jc.2010-2704","article-title":"The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know","volume":"96","author":"Ross","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Amraei, M., Mohamadpour, S., Sayehmiri, K., Mousavi, S.F., Shirzadpour, E., and Moayeri, A. (2018). Effects of Vitamin D Deficiency on Incidence Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Front. Endocrinol., 9.","DOI":"10.3389\/fendo.2018.00007"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s11892-013-0451-3","article-title":"Vitamin D and Gestational Diabetes Mellitus","volume":"14","author":"Burris","year":"2014","journal-title":"Curr. Diab Rep."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Rizzo, G., Garzon, S., Fichera, M., Panella, M.M., Catena, U., Schiattarella, A., de Franciscis, P., Vilos, G., Tesarik, J., and T\u00f6r\u00f6k, P. (2019). Vitamin D and Gestational Diabetes Mellitus: Is There a Link?. Antioxidants, 8.","DOI":"10.3390\/antiox8110511"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhang, C., Qiu, C., Hu, F.B., David, R.M., van Dam, R.M., Bralley, A., and Williams, M.A. (2008). Maternal Plasma 25-Hydroxyvitamin D Concentrations and the Risk for Gestational Diabetes Mellitus. PLoS ONE, 3.","DOI":"10.1371\/journal.pone.0003753"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s12986-020-00509-0","article-title":"Sufficience Serum Vitamin D before 20 Weeks of Pregnancy Reduces the Risk of Gestational Diabetes Mellitus","volume":"17","author":"Yue","year":"2020","journal-title":"Nutr. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"742","DOI":"10.5114\/aoms.2020.94433","article-title":"Serum Vitamin D Deficiency and Risk of Gestational Diabetes Mellitus: A Meta-Analysis","volume":"16","author":"Wang","year":"2020","journal-title":"Arch. Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"23","DOI":"10.4274\/tjod.10170","article-title":"Vitamin D Deficiency in Pregnancy Is Not Associated with Diabetes Mellitus Development in Pregnant Women at Low Risk for Gestational Diabetes","volume":"13","author":"Bal","year":"2016","journal-title":"Turk. J. Obstet. Gynecol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mirzaei-Azandaryani, Z., Mohammad-Alizadeh-Charandabi, S., Shaseb, E., Abbasalizadeh, S., and Mirghafourvand, M. (2022). Effects of Vitamin D on Insulin Resistance and Fasting Blood Glucose in Pregnant Women with Insufficient or Deficient Vitamin D: A Randomized, Placebo-Controlled Trial. BMC Endocr. Disord., 22.","DOI":"10.1186\/s12902-022-01159-4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.clnu.2023.04.011","article-title":"Effect of Vitamin D Supplementation on Glucose Control in Mid-Late Gestation: A Randomized Controlled Trial","volume":"42","author":"Ma","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","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":"ref_32","first-page":"113","article-title":"The Relationship between Maternal Vitamin D Deficiency and Low Birth Weight Neonates","volume":"9","author":"Khalessi","year":"2015","journal-title":"J. Family Reprod. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nutos.2021.11.002","article-title":"Vitamin D Status and Seasonal Variation: A Retrospective Single Institution Database Study of Patients Pursuing Metabolic\/Bariatric Surgery","volume":"41","author":"Hays","year":"2022","journal-title":"Clin. Nutr. Open Sci."},{"key":"ref_34","first-page":"535","article-title":"Seasonal Variations in Serum Vitamin D According to Age and Sex","volume":"3","author":"Heidari","year":"2012","journal-title":"Caspian J. Intern. Med."},{"key":"ref_35","first-page":"CC01","article-title":"Normal Pregnancy- A State of Insulin Resistance","volume":"8","author":"Sonagra","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5320156","DOI":"10.1155\/2019\/5320156","article-title":"Determinants of Maternal Insulin Resistance during Pregnancy: An Updated Overview","volume":"2019","author":"Kampmann","year":"2019","journal-title":"J. Diabetes Res."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Zhou, Q., Wen, S., Liu, M., Zhang, S., Jin, X., and Liu, A. (2021). Association between Gene Polymorphisms of Vitamin D Receptor and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18010205"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/565\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:25:43Z","timestamp":1760027143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,2]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["nu17030565"],"URL":"https:\/\/doi.org\/10.3390\/nu17030565","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,2]]}}}