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Preconception vitamin D level may affect pregnancy outcome
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Women who maintain sufficient vitamin D concentrations before conception may achieve higher live birth pregnancy rates while also experiencing a reduced risk for pregnancy loss, according to a study published in The Lancet Diabetes & Endocrinology.
“Our findings are novel and particularly of interest among women seeking natural conception, as most studies thus far were done among in vitro fertilization populations or small studies unable to detect early pregnancy loss,” Sunni L. Mumford, PhD, an investigator in the epidemiology branch, division of intramural population health research, at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, told Endocrine Today. “Based on prospective and rigorous follow-up of a large group of healthy women who were trying to become pregnant, we were able to detect pregnancy and early pregnancy loss. Our findings may provide clinical insight on the importance of women’s preconception vitamin D status, as this may promote pregnancy while preventing subsequent pregnancy loss.”
Mumford and colleagues conducted a secondary analysis of a prospective cohort from the Effects of Aspirin in Gestation and Reproduction (EAGeR) study, a multicenter, block-randomized, double-blind and placebo-controlled trial assessing effect of daily aspirin on pregnancy outcomes. Participants were recruited from four clinical sites across the United States between June 2007 and July 2011 and were followed up for six menstrual cycles while attempting pregnancy or throughout pregnancy. Participants were 1,191 women who had available preconception 25-hydroxyvitamin D concentrations and who had one or two previous pregnancy losses (aged 18 to 40 years; mean age, 28.7 years; 95% white). Researchers acquired baseline data regarding demographic characteristics and reproductive history through questionnaires.
Researchers collected serum 25-(OH)D samples from each participant, which they measured at baseline and at 8 weeks’ gestation for women who conceived. The women were then categorized as having sufficient (n = 555; 75 nmol/L) or insufficient (n = 636; < 75 nmol/L) vitamin D concentrations.
After adjusting for age, BMI, race, physical activity, season of blood draw, treatment assignment, multivitamin use, previous pregnancy losses and previous live births, researchers found that women whose preconception 25-(OH)D concentrations were considered sufficient were more likely to become pregnant (RR = 1.1; 95% CI, 1.01-1.2) and have a live birth (RR = 1.15; CI, 1.02-1.29) than women with insufficient levels. Among the women who became pregnant, those with sufficient preconception vitamin D were less likely to experience pregnancy loss (RR per 25 nmol/L = 0.88; 95% CI, 0.77-0.99). Researchers did not find an association between early pregnancy 25-(OH)D concentrations and pregnancy loss after 8 weeks of gestation.
“These results highlight the potential protective role of preconception vitamin D for women trying to become pregnant,” Mumford said. “Further research should investigate the possible effects of preconception vitamin D supplementation on chances of conceiving and reducing the risk of pregnancy loss among couples seeking natural conception.” – by Melissa J. Webb
For more information:
Sunni L. Mumford, PhD, can be reached at mumfords@mail.nih.gov.
Disclosures: The authors report no relevant financial disclosures.
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