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Maternal Vitamin D Status and Gestational Weight Gain as Correlates of Neonatal Bone Mass in Healthy Term Breastfed Young Infants from Montreal, Canada.

ABSTRACT: The implications of maternal gestational weight gain (GWG) and vitamin D status to neonatal bone health are unclear. We tested whether maternal 25-hydroxyvitamin D (25(OH)D) and GWG relate to neonatal bone mineral content (BMC) and bone mineral density (BMD). Healthy term appropriate for gestational age breastfed neonates (n = 142) and their mothers were recruited 24-36 h after delivery and followed at 1.0 ± 0.5 month. At birth, obstetric data were collected and newborn serum 25(OH)D was measured. At 1 month, neonatal whole-body (WB) BMC, WB BMC relative to body weight (WB BMC/kg), lumbar spine BMC and BMD, maternal and neonatal 25(OH)D concentrations, and anthropometry were measured. Infant BMC and BMD between maternal 25(OH)D (<50, ≥50 nmol/L) and GWG (insufficient, adequate, and excessive) categories were compared. Maternal 25(OH)D was not related to infant whole-body BMC, BMC/kg, lumbar spine BMC, and BMD. Infants in the excessive maternal GWG category had greater (p = 0.0003) whole-body BMC and BMC/kg and lumbar spine BMC and BMD than inadequate GWG, and greater (p = 0.0063) whole-body BMC/kg and lumbar spine BMC and BMD than adequate GWG. These results suggest that maternal GWG, but not vitamin D status, modestly relates to bone mass in neonates.

SUBMITTER: Gharibeh N

PROVIDER: S-EPMC8708298 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Maternal Vitamin D Status and Gestational Weight Gain as Correlates of Neonatal Bone Mass in Healthy Term Breastfed Young Infants from Montreal, Canada.

Gharibeh Nathalie N Razaghi Maryam M Vanstone Catherine A CA Wei ShuQin S McNally Dayre D Rauch Frank F Jones Glenville G Kaufmann Martin M Weiler Hope A HA

Nutrients 20211123 12

The implications of maternal gestational weight gain (GWG) and vitamin D status to neonatal bone health are unclear. We tested whether maternal 25-hydroxyvitamin D (25(OH)D) and GWG relate to neonatal bone mineral content (BMC) and bone mineral density (BMD). Healthy term appropriate for gestational age breastfed neonates (<i>n</i> = 142) and their mothers were recruited 24-36 h after delivery and followed at 1.0 ± 0.5 month. At birth, obstetric data were collected and newborn serum 25(OH)D was ...[more]

PMID: 34959742

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Project description:BackgroundMost pregnant or lactating women in Canada will not meet iodine requirements without iodine supplementation.ObjectivesTo assess the iodine status of 132 mother-infant pairs based on secondary analyses of a vitamin D supplementation trial in breastfed infants from Montréal, Canada.MethodsMaternal iodine status was assessed using the breastmilk iodine concentration (BMIC). Singleton, term-born infants were studied from 1-36 months of age. Usual (adjusted for within-person variation) iodine intakes were estimated from urinary iodine and creatinine concentrations. Iodine status was assessed using median urinary iodine concentrations (UICs) and by estimating inadequate intakes by the cut-point method using a proposed Estimated Average Requirement for infants 0-6 months of age (72 μg/d).ResultsAt 1, 3, and 6 months of age, 70%, 63%, and 3% of infants, respectively, were exclusively breastfed. From 1-36 months of age (n = 82-129), the median UICs were ≥100 μg/L (range, 246-403 μg/L), which is the cutoff for adequate intakes set by the WHO for children <2 years. Almost all (98%-99%) infants at 1 and 2 months, 2 and 3 months, and 3 and 6 months of age had usual creatinine-adjusted iodine intakes ≥ 72 μg/d. The median BMIC was higher (P < 0.001) at 1 month compared to 6 months of lactation [1 month, 198 μg/kg (IQR, 124-274; n = 105) and 6 months, 109 μg/kg (IQR, 67-168; n = 78)]. At 1 and 6 months, 96% and 79% of mothers, respectively, had a BMIC ≥ 60 μg/kg, the lower limit of a normal reference range. The percentages of mothers that used a multivitamin-mineral (MVM) supplement containing iodine were 90% in pregnancy and 79% and 59% at 1 and 6 months of lactation, respectively.ConclusionsThe iodine status of infants was adequate throughout infancy. These results support a recommendation that all women who could become pregnant, who are pregnant, or who are breastfeeding take a daily MVM supplement containing iodine.

Project description:BackgroundVitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation.ObjectivesWe aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status.MethodsIn this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy.ResultsInfants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07).ConclusionsIn this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.

Project description:Abstract Objectives To investigate sex differences in bone mass including whole body (WB) bone mineral content (BMC), lumbar spine (LS) BMC and LS bone mineral density (BMD) during infancy. Methods This is a secondary analysis of data from a double-blinded randomized clinical trial (NCT00381914), in which healthy term breastfed infants were randomized to 1 of 4 doses of oral vitamin D supplementation (400−1600 IU/d) at 1 mo of age (+/− 2 wk). Serum 25-hydroxyvitamin D (25(OH)D) using liquid chromatography-tandem mass spectrometry, and BMC and BMD using dual-energy x-ray absorptiometry (Hologic) were measured at 1, 3, 6, 9, and 12 mo of age (+/- 2 wk). No effect of supplementation on BMC (WB and LS) and BMD (LS) was reported in the primary study. Infants (32 males (M), 31 females (F)) with baseline serum 25(OH)D ≥ 50 nmol/L, based on the Institute of Medicine's cutoff in support of bone health, were included in this secondary analysis. Differences between sexes over time in BMC and BMD were tested using mixed model repeated measures ANOVA accounting for the fixed effects of sex, time, and sex*time and the random effect of infant ID, with Tukey multiple comparison test. Results Infants were on average 39.5 ± 1.1 wk gestational age, with weight for age z-score of 0.40 ± 0.97 at birth. There were no differences between sexes in mineral accretion rates of the WB (M: 12.94 ± 8.83, F: 12.20 ± 7.71 g/mo; p = 0.36) and at the LS (M: 0.26 ± 0.28, F: 0.22 ± 0.31 g/mo; p = 0.33) between 1 to 12 mo of age, but M had higher overall WB BMC than F (166.16 ± 57.30 vs. 153.34 ± 50.06 g, p = 0.03). When adjusted for weight or length, no sex differences were observed over time in WB BMC per weight (M: 22.02 ± 2.29, F: 22.20 ± 2.27 g/kg; p = 0.58) and WB BMC per length (M: 2.47 ± 0.60, F: 2.34 ± 0.53 g/cm, p = 0.06). Similarly, when using the WB less head BMC measurement, no sex differences were observed (M: 84.80 ± 30.24, F: 78.41 ± 7.57 g; p = 0.07). In addition, LS BMC (M: 3.77 ± 1.34, F: 3.75 ± 0.22 g; p = 0.93) and LS BMD (M: 0.273 ± 0.051, F: 0.284 ± 0.054 g/m2; p = 0.10) did not vary by sex. Conclusions Sex differences in BMC in infancy, if any, are mostly driven by infant size. Based on BMC and accretion rates, sex-specific normative data do not appear required during infancy. Funding Sources Canadian Institutes of Health Research, Nutricia Research Foundation, and the Canadian Foundation for Innovation.

Dataset Information

Maternal Vitamin D Status and Gestational Weight Gain as Correlates of Neonatal Bone Mass in Healthy Term Breastfed Young Infants from Montreal, Canada.

Publications

Maternal Vitamin D Status and Gestational Weight Gain as Correlates of Neonatal Bone Mass in Healthy Term Breastfed Young Infants from Montreal, Canada.

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