Vitamin D Concentration during Early Pregnancy and Adverse Outcomes among HIV-Negative Women in Dar-es-Salaam, Tanzania: A Case-Control Study
by
Aneth V. Kalinjuma 1,2,*
, Anne Marie Darling 2, Christopher R. Sudfeld 2, Ferdinand Mugusi 3, Julie Wright 4, Ajibola I. Abioye 2, Said Aboud 3, Chloe McDonald 4, Ellen Hertzmark 2, Kevin C. Kain 4 and Wafaie W. Fawzi 2
Aneth V. Kalinjuma 1,2,*, Anne Marie Darling 2, Christopher R. Sudfeld 2, Ferdinand Mugusi 3, Julie Wright 4, Ajibola I. Abioye 2, Said Aboud 3, Chloe McDonald 4, Ellen Hertzmark 2, Kevin C. Kain 4 and Wafaie W. Fawzi 2
1
Intervention and Clinic Trials Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Morogoro, Tanzania
2
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
3
Departments of Internal Medicine; and Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar-es-Salaam, Tanzania
4
Department of Medicine, Tropical Disease Unit, University Health Network—Toronto General Hospital, University of Toronto, Toronto, ON M5G 1L7, Canada
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(12), 2906; https://doi.org/10.3390/nu11122906
Received: 5 August 2019 / Revised: 18 September 2019 / Accepted: 18 September 2019 / Published: 2 December 2019
We examined the associations of plasma vitamin D concentration and adverse pregnancy outcomes among HIV-negative women in Dar-es-Salaam, Tanzania. We used an unmatched case-control study design, with 25-hydroxyvitamin D [25(OH)D] concentration assessed in the first trimester. Cases were individuals with adverse pregnancy outcomes, including stillbirth, premature birth, or small for gestational age births (SGA). Unconditional logistic regression and weighted logistic regression models were used to describe the associations of 25(OH)D concentration with the composite of adverse pregnancy outcome and individual adverse pregnancy outcomes, respectively. We included 310 cases and 321 controls. In controls, 5(2%) were vitamin D deficient (25(OH)D < 20 ng/mL), and 17(5%) had insufficient 25(OH)D concentration (20.0–29.9 ng/mL). Women with 25(OH)D < 20 ng/mL had 1.82 times the odds of occurrence of the composite adverse pregnancy outcome (OR = 1.82, 95% CI: 0.56–5.93; p = 0.32), however we noted a non-linear association between 25(OH)D concentration and adverse pregnancy outcome (p = 0.02). We found a 3-fold increased odds of stillbirth in women with low 25(OH)D concentration (OR = 3.11, 95% CI: 1.18–8.23, p = 0.02). Vitamin D concentration in early pregnancy may be an important factor in determining the course of pregnancy. Further research is needed to investigate whether the association of maternal 25(OH)D concentration in early pregnancy and stillbirth is causal.
View Full-Text
Keywords:
first trimester; pregnant women; vitamin D concentration; stillbirth; premature; small for gestational age; non-linear
▼
Show Figures
Figure 1
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Kalinjuma, A.V.; Darling, A.M.; Sudfeld, C.R.; Mugusi, F.; Wright, J.; Abioye, A.I.; Aboud, S.; McDonald, C.; Hertzmark, E.; Kain, K.C.; Fawzi, W.W. Vitamin D Concentration during Early Pregnancy and Adverse Outcomes among HIV-Negative Women in Dar-es-Salaam, Tanzania: A Case-Control Study. Nutrients 2019, 11, 2906.
Show more citation formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.
- Supplementary File 1:
PDF-Document (PDF, 139 KB)
