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Season, dietary factors, and physical activity modify 25-hydroxyvitamin D concentration during pregnancy

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Abstract

Purpose

The objectives of this cross-sectional study were to define maternal and umbilical cord blood (UCB) 25-hydroxyvitamin D (25(OH)D) to characterize maternal factors modifying 25(OH)D during pregnancy and predict UCB 25(OH)D in two subgroups with Declined [Δ25(OH)D <0 nmol/l] and Increased [Δ25(OH)D >0 nmol/l] 25(OH)D concentration.

Methods

A complete dataset was available from 584 women. 25(OH)D was determined at gestational weeks 6–13 and in UCB. Baseline characteristics were collected retrospectively using questionnaires. Δ25(OH)D was calculated as UCB 25(OH)D−early pregnancy 25(OH)D. Dietary patterns were generated with principal component analysis. Multivariate regression models were applied.

Results

Vitamin D deficiency was scarce, since only 1% had 25(OH)D concentration <50 nmol/l both in early pregnancy and in UCB. Shared positive predictors of UCB 25(OH)D in the subgroups of Declined and Increased, were early pregnancy 25(OH)D (P < 0.001) and supplemental vitamin D intake (P < 0.04). For the Increased subgroup summer season at delivery (P = 0.001) and “sandwich and dairy” dietary pattern characterized with frequent consumption of vitamin D fortified margarine and milk products (P = 0.009) were positive predictors of UCB 25(OH)D. Physical activity (P = 0.041) and maternal education (P = 0.004) were additional positive predictors in the Declined group

Conclusions

Maternal and newborn vitamin D status was sufficient, thus public health policies in Finland have been successful. The key modifiable maternal determinants for 25(OH)D during pregnancy, and of the newborn, were supplemental vitamin D intake, frequent consumption of vitamin D fortified foods, and physical activity.

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Abbreviations

DP:

Dietary pattern

FFQ:

Food frequency questionnaire

PA:

Physical activity

UCB:

Umbilical cord blood

VIDI:

Vitamin D intervention in infants

25(OH)D:

25-hydroxyvitamin D concentration

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Acknowledgements

We are grateful to research nurses Sirpa Nolvi, Rhea Paajanen, Nea Boman, and Päivi Turunen for their assistance in data collection. Lab technician Sari Linden is also acknowledged for her valuable work. We acknowledge the midwives at Kätilöopisto Maternity Hospital for obtaining umbilical cord blood samples, and most importantly all the families that participated in this study. We thank of the financial support from Academy of Finland, Governmental Subsidy for Clinical Research, Foundation for Pediatric Research, Finska Läkaresällskapet, Folkhälsan Research Foundation, Sigrid Jusélius Foundation, Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perkléns mine, and Päivikki and Sakari Sohlberg Foundation.

Authors contributions

The authors’ contributions are as follows: HHH, HTV, SA, OMM, and HJR designed the study; HHH, EMH, ME, TKH, and HTV conducted the research; H-MS provided early pregnancy serum samples; HHH and HJR analyzed the data; HHH, HTV, and EMH wrote the first draft of the manuscript; HHH and HTV had primary responsibility for final content; HJR, SA, OMM, SV, H-MS, JR, TKH, and OMH critically reviewed the manuscript. All of the authors read and approved the final version.

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Authors and Affiliations

  1. Children’s Hospital, University of Helsinki and Helsinki University Hospital, Tukholmankatu 8 C, Biomedicum Helsinki, P.O. Box 20, 00014, Helsinki, Finland

    Helena H. Hauta-alus, Elisa M. Holmlund-Suila, Maria Enlund-Cerullo, Jenni Rosendahl, Saara M. Valkama, Otto M. Helve, Timo K. Hytinantti, Outi M. Mäkitie, Sture Andersson & Heli T. Viljakainen

  2. Faculty of Agriculture and Forestry, University of Helsinki, Latokartanonkaari 7, P.O. Box 27, 00014, Helsinki, Finland

    Hannu J. Rita

  3. National Institute for Health and Welfare, Aapistie 1, P.O. Box 310, 90101, Oulu, Finland

    Heljä-Marja Surcel

  4. Center for Molecular Medicine, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden

    Outi M. Mäkitie

  5. Folkhälsan Research Center, Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 000014, Helsinki, Finland

    Outi M. Mäkitie & Heli T. Viljakainen

Authors
  1. Helena H. Hauta-alus
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  2. Elisa M. Holmlund-Suila
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  3. Hannu J. Rita
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  4. Maria Enlund-Cerullo
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  5. Jenni Rosendahl
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  6. Saara M. Valkama
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  7. Otto M. Helve
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  8. Timo K. Hytinantti
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  9. Heljä-Marja Surcel
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  10. Outi M. Mäkitie
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  11. Sture Andersson
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  12. Heli T. Viljakainen
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Corresponding author

Correspondence to Heli T. Viljakainen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was conducted according to the guidelines laid down in the 1964 Declaration of Helsinki and its later amendments. Ethical approval was obtained from the Research Ethics Committee of the Hospital District of Helsinki and Uusimaa (107/13/03/03/2012). Written informed consent was obtained from the participants at recruitment prior to their inclusion in the study. The project protocol is registered on ClinicalTrials.gov (NCT01723852).

Additional information

The project protocol is registered at ClinicalTrials.gov (NCT01723852).

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Hauta-alus, H.H., Holmlund-Suila, E.M., Rita, H.J. et al. Season, dietary factors, and physical activity modify 25-hydroxyvitamin D concentration during pregnancy. Eur J Nutr 57, 1369–1379 (2018). https://doi.org/10.1007/s00394-017-1417-z

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