Journal
NUTRIENTS
Volume 4, Issue 4, Pages 319-330Publisher
MDPI
DOI: 10.3390/nu4040319
Keywords
pregnancy; 25 hydroxyvitamin D; vitamin D deficiency; vitamin D insufficiency; dietary vitamin D intake; dietary calcium intake; parathyroid hormone; cesarean delivery; prolonged labor
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Funding
- National Institutes of Health [HD38329, HD58128]
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We examined the association of vitamin D deficiency to risk of cesarean delivery using prospective data in a cohort of 1153 low income and minority gravidae. Circulating maternal 25-hydroxyvitamin D and intact parathyroid hormone were measured at entry to care 13.73 +/- 5.6 weeks (mean +/- SD). Intake of vitamin D and calcium was assessed at three time points during pregnancy. Using recent Institute of Medicine guidelines, 10.8% of the gravidae were at risk of vitamin D deficiency, and 23.8% at risk of insufficiency. Maternal 25-hydroxyvitamin D was related positively to vitamin D and calcium intakes and negatively to circulating concentrations of parathyroid hormone. Risk for cesarean delivery was increased significantly for vitamin D deficient women; there was no increased risk for gravidae at risk of insufficiency. When specific indications were examined, vitamin D deficiency was linked to a 2-fold increased risk of cesarean for prolonged labor. Results were the similar when prior guidelines for vitamin D deficiency (25(OH) D < 37.5nmol/L) and insufficiency (37.5-80 nmol/L) were utilized.
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