{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:09:13Z","timestamp":1769634553565,"version":"3.49.0"},"reference-count":41,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia in Portugal","award":["UIDP\/04923\/2020"],"award-info":[{"award-number":["UIDP\/04923\/2020"]}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia in Portugal","award":["UIDB\/50021\/2020"],"award-info":[{"award-number":["UIDB\/50021\/2020"]}]},{"name":"Portuguese National Health Service","award":["UIDP\/04923\/2020"],"award-info":[{"award-number":["UIDP\/04923\/2020"]}]},{"name":"Portuguese National Health Service","award":["UIDB\/50021\/2020"],"award-info":[{"award-number":["UIDB\/50021\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Numerous studies have shown that hypovitaminosis D is linked to adverse maternal and infant health outcomes, such as intrauterine growth restriction, preeclampsia, cholestasis, hypertension, and gestational diabetes, all of which are potential causes of prematurity. Recognizing the significance of this issue and its impact on maternal\u2013infant health, the VitDTracking research project was designed and registered on 4 March 2024, in the ClinicalTrials.gov database (Identifier: NCT06292195). The project includes a large-scale multicenter observational study, targeting a minimum initial sample size of 1800 participants. This paper describes the pilot study aimed at assessing the feasibility of the full-scale study. Methods: A multicenter observational pilot study was conducted in public health organizations in the Alentejo region, adhering to the research protocol. Data collection included 67 parameters: 37 obtained from a questionnaire and 30 from clinical records, with particular focus on maternal 25(OH)D levels and maternal\u2013infant health outcomes. Feasibility was assessed through predefined outcome indicators and success criteria. Results: The pilot study enrolled 30 pregnant women and successfully met all feasibility criteria. The global recruitment rate was 73.17%, with an eligible recruitment rate of 88.2%. The refusal rate was low (11%), and adherence, retention, and completion rates were all 100%, indicating strong participant engagement. The questionnaire comprehension rate was 86.6%. Participating centers demonstrated the capacity to implement the study, adhering to the protocol with a compliance rate exceeding 90%. The study also highlighted a concerning prevalence of hypovitaminosis D and identified cases of premature birth and miscarriage. Conclusions: The pilot study confirmed the feasibility of recruitment methodologies and procedures, supporting the implementation of the large-scale observational study. The planned study will recruit approximately 1800 pregnant women to achieve an eligible cohort of 1000 samples, and a statistically significant final sample of 100 cases meeting the prematurity criterion.<\/jats:p>","DOI":"10.3390\/nu17071160","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T12:41:02Z","timestamp":1743079262000},"page":"1160","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Maternal Vitamin D Levels on Prematurity: Feasibility Study in a Multicenter Observational Pilot"],"prefix":"10.3390","volume":"17","author":[{"given":"Olivia","family":"Barbosa","sequence":"first","affiliation":[{"name":"Comprehensive Health Research Centre (CHRC), 1150-082 Lisboa, Portugal"},{"name":"Escola Superior de Enfermagem S\u00e3o Jo\u00e3o de Deus, Universidade de \u00c9vora, 7000-811 \u00c9vora, Portugal"},{"name":"Neonatal Intensive Care Unit, Unidade Local de Sa\u00fade do Alentejo Central (ULSAC), 7000-811 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2997-5990","authenticated-orcid":false,"given":"Ana Teresa","family":"Freitas","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Investiga\u00e7\u00e3o e Desenvolvimento em Lisboa (INESC-ID), 1000-029 Lisboa, Portugal"},{"name":"Instituto Superior T\u00e9cnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9327-2897","authenticated-orcid":false,"given":"Marta P.","family":"Silvestre","sequence":"additional","affiliation":[{"name":"NOVA Medical School, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o em Tecnologias e Servi\u00e7os de Sa\u00fade (CINTESIS), NOVA Medical School, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-1839","authenticated-orcid":false,"given":"Andr\u00e9","family":"Moreira-Ros\u00e1rio","sequence":"additional","affiliation":[{"name":"NOVA Medical School, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o em Tecnologias e Servi\u00e7os de Sa\u00fade (CINTESIS), NOVA Medical School, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-7732","authenticated-orcid":false,"given":"Pedro","family":"Aguiar","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"}]},{"given":"Ana Isabel","family":"R\u00e9gua","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade do Baixo Alentejo (ULSBA), 7801-849 Beja, Portugal"}]},{"given":"Tatiana","family":"Madaleno","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade do Norte Alentejo (ULSNA), 7301-853 Portalegre, Portugal"}]},{"given":"Manuela","family":"Almeida","sequence":"additional","affiliation":[{"name":"Outpatient Consultation Service, Unidade Local de Sa\u00fade do Alentejo Central (ULSAC), 7005-169 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0949-3425","authenticated-orcid":false,"given":"Dulce","family":"Cruz","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre (CHRC), 1150-082 Lisboa, Portugal"},{"name":"Escola Superior de Enfermagem S\u00e3o Jo\u00e3o de Deus, Universidade de \u00c9vora, 7000-811 \u00c9vora, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Van der Pligt, P., Willcox, J., Szymlek-Gay, E.A., Murray, E., Worsley, A., and Daly, R.M. (2018). Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review. Nutrients, 10.","DOI":"10.3390\/nu10050640"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/nyas.13968","article-title":"Global prevalence and disease burden of vitamin D deficiency: A roadmap for action in low- and middle-income countries","volume":"1430","author":"Roth","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hollis, B.W., and Wagner, C.L. (2022). Substantial vitamin D supplementation is required during the prenatal period to improve birth outcomes. Nutrients, 14.","DOI":"10.3390\/nu14040899"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/0009922806289311","article-title":"Vitamin D deficiency in a healthy group of mothers and newborn infants","volume":"46","author":"Lee","year":"2007","journal-title":"Clin. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"w20238","DOI":"10.4414\/smw.2020.20238","article-title":"High prevalence of severe vitamin D deficiency during the first trimester in pregnant women in Switzerland and its potential contributions to adverse outcomes in the pregnancy","volume":"150","author":"Christoph","year":"2020","journal-title":"Swiss Med. Wkly."},{"key":"ref_6","first-page":"e23519","article-title":"Vitamin D deficiency and its clinical results in preeclamptic mothers and their babies","volume":"14","author":"Tammo","year":"2022","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Mansur, J.L., Oliveri, B., Giacoia, E., Fusaro, D., and Costanzo, P.R. (2022). Vitamin D: Before, during and after pregnancy: Effect on neonates and children. Nutrients, 14.","DOI":"10.3390\/nu14091900"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e2020087","DOI":"10.1590\/1984-0462\/2021\/39\/2020087","article-title":"Effects of vitamin D supplementation during pregnancy on newborns and infants: An integrative review","volume":"39","author":"Dutra","year":"2021","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1080\/15592294.2020.1734148","article-title":"Effects of maternal vitamin D3 supplementation on offspring epigenetic clock of gestational age at birth: A post-hoc analysis of a randomized controlled trial","volume":"15","author":"Chen","year":"2020","journal-title":"Epigenetics"},{"key":"ref_10","doi-asserted-by":"crossref","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":"ref_11","first-page":"104","article-title":"Vitamin D deficiency in pregnancy and its impact on the fetus, the newborn and in childhood","volume":"33","year":"2015","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000487370","article-title":"Maternal and foetal health implications of vitamin D status during pregnancy","volume":"72","author":"Morales","year":"2018","journal-title":"Ann. Nutr. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Barchitta, M., Maugeri, A., La Rosa, M.C., Magnano San Lio, R., Favara, G., Panella, M., Cianci, A., and Agodi, A. (2018). Single Nucleotide Polymorphisms in Vitamin D Receptor Gene Affect Birth Weight and the Risk of Preterm Birth: Results From the \"Mamma & Bambino\" Cohort and A Meta-Analysis. Nutrients, 10.","DOI":"10.3390\/nu10091172"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.gene.2017.10.087","article-title":"Vitamin D receptor (VDR) polymorphisms are associated to spontaneous preterm birth and maternal aspects","volume":"642","author":"Javorski","year":"2018","journal-title":"Gene"},{"key":"ref_15","first-page":"11","article-title":"Nutr gen\u00f3mica: Revolu\u00e7\u00e3o Gen\u00f3mica na Nutri\u00e7\u00e3o","volume":"62","author":"Conti","year":"2010","journal-title":"Ci\u00eancia E Cult."},{"key":"ref_16","first-page":"61","article-title":"Epigen\u00e9tica: Um novo campo da gen\u00e9tica","volume":"1","author":"Muller","year":"2008","journal-title":"RUBS"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1038\/nsmb.2489","article-title":"Epigenetic programming and reprogramming during development","volume":"20","author":"Cantone","year":"2013","journal-title":"Nat. Struct. Mol. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.nedt.2018.01.002","article-title":"Nursing genetics and genomics: The International Society of Nurses in Genetics (ISONG) survey","volume":"63","author":"Hickey","year":"2018","journal-title":"Nurse Educ. Today"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1547-5069.2010.01373.x","article-title":"Implications for educating the next generation of nurses on genetics and genomics in the 21st century","volume":"43","author":"Lea","year":"2011","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.nedt.2010.10.023","article-title":"Genetics and genomics in nursing: Evaluating Essentials implementation","volume":"31","author":"Thompson","year":"2011","journal-title":"Nurse Educ. Today"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/j.1547-5069.2007.00137.x","article-title":"Establishing the essential nursing competencies for genetics and genomics","volume":"39","author":"Jenkins","year":"2007","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Freitas, A.T., Calhau, C., Antunes, G., Ara\u00fajo, B., Bandeira, M., Barreira, S., Bazenga, F., Braz, S., Caldeira, D., and Santos, S.C.R. (2021). Vitamin D-related polymorphisms and vitamin D levels as risk biomarkers of COVID-19 disease severity. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-99952-z"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Thabane, L., Ma, J., Chu, R., Cheng, J., Ismaila, A., Rios, L.P., Robson, R., Thabane, M., Giangregorio, L., and Goldsmith, C.H. (2010). A tutorial on pilot studies: The what, why and how. BMC Med. Res. Methodol., 10.","DOI":"10.1186\/1471-2288-10-1"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1046\/j.1365-2648.2001.01757.x","article-title":"The importance of conducting and reporting pilot studies: The example of the Scottish Births Survey","volume":"34","author":"Rennie","year":"2001","journal-title":"J. Adv. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"335","author":"Altman","year":"2007","journal-title":"BMJ"},{"key":"ref_26","unstructured":"World Health Organization (2000). Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation, World Health Organization. Available online: https:\/\/iris.who.int\/handle\/10665\/42330."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1001\/archderm.1988.01670060015008","article-title":"The validity and practicality of sun-reactive skin types I through VI","volume":"124","author":"Fitzpatrick","year":"1988","journal-title":"Arch. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2310\/JIM.0b013e318214ea2d","article-title":"Vitamin D: A d-lightful solution for health","volume":"59","author":"Holick","year":"2011","journal-title":"J. Investig. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.mayocp.2013.05.011","article-title":"Vitamin D for health: A global perspective","volume":"88","author":"Holick","year":"2013","journal-title":"Mayo Clin. Proc."},{"key":"ref_30","unstructured":"Institute of Medicine and National Research Council (2009). Weight Gain During Pregnancy: Reexamining the Guidelines, The National Academies Press."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1161\/HYPERTENSIONAHA.115.06005","article-title":"Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus","volume":"66","author":"Heida","year":"2015","journal-title":"Hypertension"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"World Health Organization (2014). Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: A World Health Organization Guideline. Diabetes Res. Clin. Pract., 103, 341\u2013363.","DOI":"10.1016\/j.diabres.2013.10.012"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S0140-6736(23)00878-4","article-title":"National, regional, and global estimates of preterm birth in 2020, with trends from 2010: A systematic analysis","volume":"402","author":"Ohuma","year":"2023","journal-title":"Lancet"},{"key":"ref_34","unstructured":"(2007). WHO Child Growth Standards: Head Circumference-for-Age, Arm Circumference-for-Age, Triceps Skinfold-for-Age and Subscapular Skinfold-for-Age: Methods and Development, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241547185."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1111\/mcn.12210","article-title":"Global summary of maternal and newborn vitamin D status\u2014A systematic review. Matern","volume":"12","author":"Saraf","year":"2016","journal-title":"Child Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"749","DOI":"10.3390\/clinpract14030060","article-title":"The Correlation between Maternal and Neonatal Vit D (25(OH)D) Levels in Greece: A Cross-Sectional Study","volume":"14","author":"Kokkinari","year":"2024","journal-title":"Clin. Pract."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Motlagh, A.J., Davoodvandi, A., and Saeieh, S.E. (2023). Association between vitamin D level in mother\u2019s serum and the level of vitamin D in the serum of pre-term infants. BMC Pediatr., 23.","DOI":"10.1186\/s12887-023-03854-0"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_39","unstructured":"(2024, August 08). Available online: https:\/\/flower.ai\/."},{"key":"ref_40","unstructured":"Mar\u00f4co, J. (2021). An\u00e1lise Estat\u00edstica com o SPSS Statistics, Scientific Research Publishing Inc.. [8th ed.]. Editor: Report Number."},{"key":"ref_41","unstructured":"World Medical Association (2022, June 06). Declaration of Helsinki\u2014Ethical Principles for Medical Research Involving Human Subjects. Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/24141714\/."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/7\/1160\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:02:51Z","timestamp":1760029371000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/7\/1160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":41,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["nu17071160"],"URL":"https:\/\/doi.org\/10.3390\/nu17071160","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,27]]}}}