Download PDF
CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(10): 743-748
DOI: 10.1055/s-0041-1735158
Original Article
Obstetrics

The Assessment of Vitamin D Levels in Pregnant Women is not Associated to Fetal Growth Restriction: A Cross Sectional Study

A avaliação dos níveis de vitamina D em gestantes não está associada à restrição do crescimento fetal: um estudo transversal
Vivian Macedo Gomes Marçal 
1   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Francisco Lázaro Pereira Sousa 
2   Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas de Santos, Santos, SP, Brazil
,
Silvia Daher 
1   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Raquel Margiotte Grohmann 
1   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Alberto Borges Peixoto 
3   Department of Gynecology and Obstetrics, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
4   Gynecology and Obstetrics Service, Hospital Universitário Mário Palmério, Universidade de Uberaba, Uberaba, MG, Brazil
,
Edward Araujo Júnior 
1   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Luciano Marcondes Machado Nardozza 
1   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective To assess maternal serum levels of vitamin D in fetuses appropriate for gestational age (AGA), small for gestational age (SGA), and with fetal growth restriction (FGR) according to estimated fetal weight (EFW).

Methods This cross-sectional study included 87 pregnant women between 26 and 36 weeks of gestation: 38 in the AGA group, 24 in the SGA group, and 25 in the FGR group. Maternal serum vitamin D levels were assessed using the chemiluminescence method. The Fisher exact test was used to compare the results between the groups.

Results The mean ± standard deviation (SD) of maternal age (years) and body mass index (kg/m2) in the AGA, SGA, and FGR groups were 25.26 ± 8.40 / 26.57 ± 4.37; 25.04 ± 8.44 / 26.09 ± 3.94; and 25.48 ± 7.52 / 26.24 ± 4.66, respectively (p > 0.05). The maternal serum vitamin D levels (mean ± SD) of the AGA, SGA, and FGR groups were 22.47 ± 8.35 ng/mL, 24.80 ± 10.76 ng/mL, and 23.61 ± 9.98 ng/mL, respectively, but without significant differences between the groups (p = 0.672).

Conclusion Maternal serum vitamin D levels did not present significant differences among pregnant women with AGA, SGA, or FGR fetuses between 26 and 36 weeks of gestation according to EFW.

Resumo

Objetivo Avaliar o nível sérico materno de vitamina D em fetos adequados para idade gestacional (AIG), pequenos para idade gestacional (PIG) e com restrição de crescimento (RCF) de acordo com a estimativa de peso fetal (EPF).

Métodos Realizou-se um estudo transversal envolvendo 87 gestantes entre 26 e 36 semanas, sendo: 38 do grupo AIG, 24 do grupo PIG e 25 do grupo RCF. A dosagem sérica materna de vitamina D foi realizada pelo método de quimiluminescência. Para as comparações entre os grupos, utilizou-se o teste exato de Fisher.

Resultados A média ± desvio-padrão (DP) da idade materna (anos) e do índice de massa corporal (kg/m2) nos grupos AIG, PIG e RCF foram 25,26 ± 8,40 / 26,57 ± 4,37; 25,04 ± 8,44 / 26,09 ± 3,94; e 25,48 ± 7,52 / 26,24 ± 4,66, respectivamente (p > 0,05). A concentração sérica materna de vitamina D (médias ± desvios-padrão) dos grupos AIG, PG e RCF foram 22,47 ± 8,35 ng/ml; 24,80 ± 10,76 ng/ml; e 23,61 ± 9,98 ng/ml, respectivamente, contudo, sem diferenças significativas entre os grupos (p = 0,672).

Conclusão A concentração sérica materna de vitamina D não apresentou diferenças significantes entre gestantes com fetos AIG, PIG ou RCF entre 26 e 36 semanas de acordo com a EPF.

Keywords

pregnancy - maternal serum levels - vitamin D - small for gestational age - fetal growth restriction

Palavras-chave

gestação - concentração sérica materna - vitamina D - pequeno para idade gestacional - restrição de crescimento fetal

Contributions

All authors participated in the conception and design of the present study; analysis and interpretation of data; draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.




Publication History

Received: 21 January 2020

Accepted: 21 July 2021

Article published online:
16 November 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Frøen JF, Gardosi JO, Thurmann A, Francis A, Stray-Pedersen B. Restricted fetal growth in sudden intrauterine unexplained death. Acta Obstet Gynecol Scand 2004; 83 (09) 801-807
    CrossrefPubMedSearch in Google Scholar
  • 2 Barker ED, McAuliffe FM, Alderdice F. et al. The role of growth trajectories in classifying fetal growth restriction. Obstet Gynecol 2013; 122 (2 Pt 1): 248-254
    CrossrefPubMedSearch in Google Scholar
  • 3 Gordijn SJ, Beune IM, Thilaganathan B. et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol 2016; 48 (03) 333-339
    CrossrefPubMedSearch in Google Scholar
  • 4 Nardozza LMM, Zamarian ACP, Araujo Júnior E. New definition of fetal growth restriction: consensus regarding a major obstetric complication. Rev Bras Ginecol Obstet 2017; 39 (07) 315-316
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Pludowski P, Holick MF, Pilz S. et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev 2013; 12 (10) 976-989
    CrossrefPubMedSearch in Google Scholar
  • 6 Serrano NC, Guío E, Quintero-Lesmes DC. et al. Vitamin D deficiency and pre-eclampsia in Colombia: PREVitD study. Pregnancy Hypertens 2018; 14: 240-244
    CrossrefPubMedSearch in Google Scholar
  • 7 Hu L, Zhang Y, Wang X. et al. Maternal Vitamin D status and risk of gestational diabetes: a meta-analysis. Cell Physiol Biochem 2018; 45 (01) 291-300
    CrossrefPubMedSearch in Google Scholar
  • 8 Kassai MS, Cafeo FR, Affonso-Kaufman FA, Suano-Souza FI, Sarni ROS. Vitamin D plasma concentrations in pregnant women and their preterm newborns. BMC Pregnancy Childbirth 2018; 18 (01) 412
    CrossrefPubMedSearch in Google Scholar
  • 9 Bodnar LM, Catov JM, Zmuda JM. et al. Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women. J Nutr 2010; 140 (05) 999-1006
    CrossrefPubMedSearch in Google Scholar
  • 10 Gernand AD, Bodnar LM, Klebanoff MA, Parks WT, Simhan HN. Maternal serum 25-hydroxyvitamin D and placental vascular pathology in a multicenter US cohort. Am J Clin Nutr 2013; 98 (02) 383-388
    CrossrefPubMedSearch in Google Scholar
  • 11 Hadlock FP, Harrist RB, Martinez-Poyer J. In utero analysis of fetal growth: a sonographic weight standard. Radiology 1991; 181 (01) 129-133
    CrossrefPubMedSearch in Google Scholar
  • 12 Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements–a prospective study. Am J Obstet Gynecol 1985; 151 (03) 333-337
    CrossrefPubMedSearch in Google Scholar
  • 13 Arduini D, Rizzo G. Normal values of Pulsatility Index from fetal vessels: a cross-sectional study on 1556 healthy fetuses. J Perinat Med 1990; 18 (03) 165-172
    CrossrefPubMedSearch in Google Scholar
  • 14 Gómez O, Figueras F, Fernández S. et al. Reference ranges for uterine artery mean pulsatility index at 11-41 weeks of gestation. Ultrasound Obstet Gynecol 2008; 32 (02) 128-132
    CrossrefPubMedSearch in Google Scholar
  • 15 Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with the four-quadrant technique at 36-42 weeks' gestation. J Reprod Med 1987; 32 (07) 540-542
    PubMedSearch in Google Scholar
  • 16 Cohen J. Statistical power analysis for the behavioral sciences. New York: Routledge; 1988
    Search in Google Scholar
  • 17 Gourvas V, Dalpa E, Konstantinidou A, Vrachnis N, Spandidos DA, Sifakis S. Angiogenic factors in placentas from pregnancies complicated by fetal growth restriction (review). (review) Mol Med Rep 2012; 6 (01) 23-27
    CrossrefPubMedSearch in Google Scholar
  • 18 Bamfo JE, Odibo AO. Diagnosis and management of fetal growth restriction. J Pregnancy 2011; 2011: 640715
    CrossrefPubMedSearch in Google Scholar
  • 19 Harkness UF, Mari G. Diagnosis and management of intrauterine growth restriction. Clin Perinatol 2004; 31 (04) 743-764, vi
    CrossrefPubMedSearch in Google Scholar
  • 20 Ornoy A. Prenatal origin of obesity and their complications: Gestational diabetes, maternal overweight and the paradoxical effects of fetal growth restriction and macrosomia. Reprod Toxicol 2011; 32 (02) 205-212
    CrossrefPubMedSearch in Google Scholar
  • 21 Sawant LD, Venkat S. Comparative analysis of normal versus fetal growth restriction in pregnancy: the significance of maternal body mass index, nutritional status, anemia, and ultrasonography screening. Int J Reprod Med 2013; 2013: 671954
    CrossrefPubMedSearch in Google Scholar
  • 22 Tao RX, Meng DH, Li JJ. et al. Current recommended Vitamin D prenatal supplementation and fetal growth: results from the China-Anhui birth cohort study. J Clin Endocrinol Metab 2018; 103 (01) 244-252
    CrossrefPubMedSearch in Google Scholar
  • 23 Sahu M, Bhatia V, Aggarwal A. et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf) 2009; 70 (05) 680-684
    CrossrefPubMedSearch in Google Scholar
  • 24 Thandrayen K, Pettifor JM. Maternal vitamin D status: implications for the development of infantile nutritional rickets. Endocrinol Metab Clin North Am 2010; 39 (02) 303-320
    CrossrefPubMedSearch in Google Scholar
  • 25 Zhou J, Su L, Liu M. et al. Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China. Eur J Clin Nutr 2014; 68 (08) 925-930
    CrossrefPubMedSearch in Google Scholar
  • 26 Tous M, Villalobos M, Iglesias L, Fernández-Barrés S, Arija V. Vitamin D status during pregnancy and offspring outcomes: a systematic review and meta-analysis of observational studies. Eur J Clin Nutr 2020; 74 (01) 36-53
    CrossrefPubMedSearch in Google Scholar