Association of maternal serum 25-hydroxyvitamin D concentrations in second and third trimester with risk of gestational diabetes and other pregnancy outcomes

OBJECTIVES: To evaluate the maternal serum 25(OH) D concentrations and its association with gestational diabetes and other pregnancy outcomes. z METHODS: In our nested case-control study, 4718 pregnancy women were included, who were attending second- and third-trimester screening in Nanjing, China. Serum 25(OH) D concentrations were tested by enzyme-linked immunoassay, and the pregnancy and birth outcomes were obtained via electronic medical record collection and information extraction. The associations of 25(OH) D concentrations with gestational diabetes and other pregnancy outcomes were assessed by logistic regression analysis. And receiver-operator characteristic curve analysis was also conducted. RESULTS: For the total population, the median (IQR) concentrations of 25(OH) D was 43.7 (35.5-57.9) nmol l(-1), and 63.1% of women had concentrations o50.0 nmol l(-1). The 25(OH) D concentrations was significantly lower in gestational diabetes patients than in controls. Moreover, after adjustment for confounders, women with low 25(OH) D concentrations had significantly increased risks of gestational diabetes and some adverse pregnancy outcomes (anemia, macrosomia, abnormal amniotic fluid, and miscarriage or stillbirth). We also observed a threshold for 25(OH) D of 50.0 nmol l(-1) for gestational diabetes and a nice predictive accuracy of the 25(OH) D concentrations included panel, with an area under the curve of 0.625 for gestational diabetes. CONCLUSIONS: Low 25(OH) D concentrations (o50.0 nmol l(-1)) in pregnancy was significantly associated with gestational diabetes risk, and it may serve as biomarkers for the surveillance of high-risk pregnant women.