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Relationship between vitamin D status in the first trimester of the pregnancy and gestational weight gain: a mediation analysis

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the total, and direct effects of vitamin D, measured by circulating 25-hydroxyvitamin D [25(OH)D] levels, on GWG after adjustment for confounding variables, and then assess the indirect effects by demonstrating the role of gestational age at birth as a mediator in this association.

Methods

Data collected in “Khuzestan Vitamin D Deficiency Screening Program in Pregnancy” were used for the present study; it included the data of 900 pregnant women referred to the health centers of Shushtar (Khuzestan Province, Iran), whose vitamin D status during the third trimester of pregnancy was available. A mediation analysis was applied to detect the causal relationship between serum level of 25(OH)D, covariates (maternal age, parity, education level, and baseline maternal weight), mediator (gestational age), and outcome (GWG).

Results

Of 900 pregnant women referred to the health centers, a total of 726 eligible participants were analyzed for the study. The adjusted total effect of vitamin D on GWG was estimated 0.07 (95% CI 0.06, 0.09; P = 0.000). This study also revealed adjusted direct effect of vitamin D on GWG was statistically significant 0.02 (95% CI: 0.003, 0.04; P = 0.021). In addition, the adjusted indirect effect of this micronutrient on GWG by considering gestational age as a mediator was found to be significant [0.05 (95% CI 0.04, 0.06; P  = 0.000)]. This study revealed an increase in the trend of weight gain during pregnancy trimesters for women with different levels of 25(OH)D; however, women with severe vitamin D deficiency had the lowest speed as compared to moderate and normal levels.

Conclusion

This study shows that maternal vitamin D status directly affects the gestational weight gain independent of gestational age. Therefore, the detection and treatment of women with vitamin D inadequacy can directly improve the trend of their weight gain in addition to its indirect effect on reducing the risk of preterm delivery.

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Availability of data and material

The dataset used and analyzed for this submission is available from the corresponding author on reasonable request.

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Funding

The study has been supported and funded by the Shahid Beheshti University of Medical Sciences.

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Authors and Affiliations

  1. Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, Tehran, Iran

    Mina Amiri & Fahimeh Ramezani Tehrani

  2. Department of Social Medicine, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Maryam Rostami

  3. Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Razieh Bidhendi-Yarandi

  4. School of Medicine, Tehran University of Medical Science, Tehran, Iran

    Aida Fallahzadeh

  5. Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Masoumeh Simbar

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  1. Mina Amiri
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  6. Fahimeh Ramezani Tehrani
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Contributions

MA was involved in the study design, managed the literature search, interpretation of data, and manuscript drafting. MR was involved in the study design and data collection, carried out the sample analysis, and manuscript drafting. RBY was contributed in statistical analyses, interpreting of data, and manuscript drafting. AF was involved in searching literature, interpretation of data, and manuscript drafting. MS was contributed in the study design, interpretation of data, and manuscript drafting. FRT was involved in the study conception and design and carried out the analysis and interpretation of data, managed the literature search, and manuscript drafting.

Corresponding author

Correspondence to Fahimeh Ramezani Tehrani.

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The authors declare no competing interests. Completed disclosure of interest forms are available to view online as supporting information.

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This study was approved by the Ethics Committee of the Research Institute of Endocrine Sciences (IR.SBMU.ENDOCRINE.REC.1399.075) and a written informed consent was obtained from all participants.

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Amiri, M., Rostami, M., Bidhendi-Yarandi, R. et al. Relationship between vitamin D status in the first trimester of the pregnancy and gestational weight gain: a mediation analysis. Arch Gynecol Obstet 305, 495–504 (2022). https://doi.org/10.1007/s00404-021-06163-y

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