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Maternal vitamin D status and offspring bone fractures: prospective study over two decades in Aarhus City, Denmark.

ABSTRACT: Studies investigating the association between maternal vitamin D status and offspring bone mass measured by dual-energy X-ray absorptiometry (DXA) during childhood have shown conflicting results.We used occurrence of bone fractures up to the age of 18 as a measure reflecting offspring bone mass and related that to maternal vitamin D status.The Danish Fetal Origins 1988 Cohort recruited 965 pregnant women during 1988-89 at their 30th gestation week antenatal midwife visit. A blood sample was drawn and serum was stored, which later was analyzed for the concentration of 25-hydroxyvitamin D (25(OH)D) by the liquid chromatography coupled with a tandem mass spectrometric method (LC-MS/MS). Outcome was diagnosis of first time bone fractures extracted from the Danish National Patient Register.Vitamin D status was available for 850 women. The median (5th-95th percentile) 25(OH)D was 76.2 (23.0-152.1) nmol/l. During follow up 294 children were registered with at least one bone fracture diagnosis. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between maternal vitamin D status and first time bone fractures. However, there was a significantly increased hazard ratio (HR) during childhood for those who had maternal blood drawn in Dec/Jan/Feb compared with Jun/Jul/Aug (HR: 1.75, 95%CI: 1.11-2.74). Adjustment for vitamin D status strengthened this association (1.82, 1.12-2.97), which indicated a potential seasonal impact on offspring fractures independent of maternal vitamin D status. In a sensitivity analysis we found a borderline significant inverse association between continuous concentrations of 25(OH)D and offspring forearm fractures (P = 0.054).Overall, our results did not substantiate an association between maternal vitamin D status and offspring bone fractures. Further studies on this subject are needed, but the study populations must be large enough to allow for subdivision of fractures.

SUBMITTER: Petersen SB

PROVIDER: S-EPMC4256222 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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Project description:ObjectiveTo examine the association between prenatal gluten exposure and offspring risk of type 1 diabetes in humans.DesignNational prospective cohort study.SettingNational health information registries in Denmark.ParticipantsPregnant Danish women enrolled into the Danish National Birth Cohort, between January 1996 and October 2002, MAIN OUTCOME MEASURES: Maternal gluten intake, based on maternal consumption of gluten containing foods, was reported in a 360 item food frequency questionnaire at week 25 of pregnancy. Information on type 1 diabetes occurrence in the participants' children, from 1 January 1996 to 31 May 2016, were obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes.ResultsThe study comprised 101?042 pregnancies in 91?745 women, of whom 70?188 filled out the food frequency questionnaire. After correcting for multiple pregnancies, pregnancies ending in abortions, stillbirths, lack of information regarding the pregnancy, and pregnancies with implausibly high or low energy intake, 67?565 pregnancies (63?529 women) were included. The average gluten intake was 13.0 g/day, ranging from less than 7 g/day to more than 20 g/day. The incidence of type 1 diabetes among children in the cohort was 0.37% (n=247) with a mean follow-up period of 15.6 years (standard deviation 1.4). Risk of type 1 diabetes in offspring increased proportionally with maternal gluten intake during pregnancy (adjusted hazard ratio 1.31 (95% confidence interval 1.001 to 1.72) per 10 g/day increase of gluten). Women with the highest gluten intake versus those with the lowest gluten intake (?20 v <7 g/day) had double the risk of type 1 diabetes development in their offspring (adjusted hazard ratio 2.00 (95% confidence interval 1.02 to 4.00)).ConclusionsHigh gluten intake by mothers during pregnancy could increase the risk of their children developing type 1 diabetes. However, confirmation of these findings are warranted, preferably in an intervention setting.

Project description:The aim of this study was to evaluate the effects of maternal and dietary vitamin A (VA) level on growth performance, meat quality, antioxidant status, and immune function of offspring broilers. Chinese yellow-feathered breeder hens were fed a basal diet supplemented with 0, 5,400, 10,800, and 21,600 IU/kg VA for 8 wk, with 6 replicates of 22 hens per replicate. Then the offspring hatched from each of the 4 maternal groups were fed a basal diet supplemented with 0 or 5,000 IU/kg VA for 63 D. Overall, there were 8 treatment combinations, each with 6 replicate pens of 20 birds. Results showed that (1) providing VA in offspring diets increased final body weight (FW), average daily gain, and average daily feed intake but reduced feed-to-gain ratio and mortality of offspring broilers (P < 0.05), whereas maternal provision of VA did not significantly affect the growth performance and mortality of offspring broilers. Maternal or offspring VA did not affect proportion of breast or thigh muscle (P > 0.05). (2) Maternal feeding with 21,600 IU/kg VA increased (P < 0.05) pH 24 h postmortem of breast muscle, compared with those without maternal supplication of VA. Dietary provision of 5,000 IU/kg VA in the posthatching diet decreased (P < 0.05) drip loss, yellowness (b∗) value and lightness (L∗) value, and increased shear force and pH of breast muscle compared with those without dietary VA supplication. (3) Maternal or offspring VA did not affect the activities of total superoxide dismutase and glutathione peroxidase (GSH-Px) or the content of malondialdehyde; however, there was a significant interaction (P < 0.05) between maternal and offspring VA on the activity of GSH-Px in serum. (4) Dietary provision of 5,000 IU/kg VA increased (P < 0.05) the weight proportion of liver and bursa of fabricius, whereas maternal feeding with 21,600 IU/kg VA increased the hatchling BW. Maternal feeding with 5,400 and 21,600 IU/kg VA decreased (P < 0.05) splenic interferon-γ (IFN-γ) transcripts and increased (P < 0.05) those of interleukin-2 (IL-2) in the progeny. There were interactions (P < 0.05) between maternal and offspring VA on splenic IL-2, IL-1β, and IFN-γ expression. In summary, maternal and offspring provision of VA both had influence on meat quality and immune function in progeny broilers. Dietary VA increased growth performance, whereas the maternal VA affected the initial body weight of progeny when hatched, but the difference in performance caused by maternal VA level was able to be eliminated by dietary VA supplementation. Therefore, offspring provision had greater importance than maternal VA in the production; however, both should be considered in broiler nutrition to achieve good meat quality and immune status of broilers.

Project description:ObjectiveTo assess national and regional trends and causes-specific distribution of maternal mortality in India.DesignNationally representative cross-sectional surveys.SettingAll of India from 1997 to 2020.SampleAbout 10 000 maternal deaths among 4.3 million live births over two decades.MethodsWe analysed trends in the maternal mortality ratio (MMR) from 1997 through 2020, estimated absolute maternal deaths and examined the causes of maternal death using nationally representative data sources. We partitioned female deaths (aged 15-49 years) and live birth totals, based on the 2001-2014 Million Death Study to United Nations (UN) demographic totals for the country.Main outcome measuresMaternal mortality burden and distribution of causes.ResultsThe MMR declined in India by about 70% from 398/100 000 live births (95% CI 378-417) in 1997-98 to 99/100 000 (90-108) in 2020. About 1.30 million (95% CI 1.26-1.35 million) maternal deaths occurred between 1997 and 2020, with about 23 800 (95% CI 21 700-26 000) in 2020, with most occurring in poorer states (63%) and among women aged 20-29 years (58%). The MMRs for Assam (215), Uttar Pradesh/Uttarakhand (192) and Madhya Pradesh/Chhattisgarh (170) were highest, surpassing India's 2016-2018 estimate of 113 (95% CI 103-123). After adjustment for education and other variables, the risks of maternal death were highest in rural and tribal areas of north-eastern and northern states. The leading causes of maternal death were obstetric haemorrhage (47%; higher in poorer states), pregnancy-related infection (12%) and hypertensive disorders of pregnancy (7%).ConclusionsIndia could achieve the UN 2030 MMR goals if the average rate of reduction is maintained. However, without further intervention, the poorer states will not.Tweetable abstractWe estimated that 1.3 million Indian women died from maternal causes over the last two decades. Although maternal mortality rates have fallen by 70% overall, the poorer states lag behind.

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Maternal vitamin D status and offspring bone fractures: prospective study over two decades in Aarhus City, Denmark.

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