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Association of maternal vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study

Association of maternal vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study
Association of maternal vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study
Objective: Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.

Methods: Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26–28 weeks’ gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ?75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section.

Results: In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (? = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (? = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73).

Conclusions: 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.
1932-6203
1-16
Loy, See Ling
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Lek, Ngee
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Yap, Fabian
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Soh, Shu E.
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Padmapriya, Natarajan
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Tan, Kok Hian
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Biswas, Arijit
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Yeo, George Seow Heong
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Kwek, Kenneth
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Gluckman, Peter D
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Godfrey, Keith M.
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Saw, Seang Mei
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Müller-Riemenschneider, Falk
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Chong, Yap-Seng
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Chong, Mary Foong-Fong
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Chan, Jerry Kok Yen
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Loy, See Ling
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Lek, Ngee
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Yap, Fabian
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Soh, Shu E.
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Padmapriya, Natarajan
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Tan, Kok Hian
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Biswas, Arijit
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Yeo, George Seow Heong
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Kwek, Kenneth
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Gluckman, Peter D
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Godfrey, Keith M.
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Saw, Seang Mei
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Müller-Riemenschneider, Falk
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Chong, Yap-Seng
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Chong, Mary Foong-Fong
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Chan, Jerry Kok Yen
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Loy, See Ling, Lek, Ngee, Yap, Fabian, Soh, Shu E., Padmapriya, Natarajan, Tan, Kok Hian, Biswas, Arijit, Yeo, George Seow Heong, Kwek, Kenneth, Gluckman, Peter D, Godfrey, Keith M., Saw, Seang Mei, Müller-Riemenschneider, Falk, Chong, Yap-Seng, Chong, Mary Foong-Fong and Chan, Jerry Kok Yen (2015) Association of maternal vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study. PLoS ONE, 10 (11), 1-16. (doi:10.1371/journal.pone.0142239). (PMID:26571128)

Record type: Article

Abstract

Objective: Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.

Methods: Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26–28 weeks’ gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ?75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section.

Results: In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (? = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (? = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73).

Conclusions: 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.

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Accepted/In Press date: 15 October 2015
Published date: 16 November 2015
Organisations: Faculty of Medicine

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Local EPrints ID: 387069
URI: http://eprints.soton.ac.uk/id/eprint/387069
ISSN: 1932-6203
PURE UUID: 46c1bfd0-c783-4da1-8e29-3ac8aaea150c
ORCID for Keith M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 09 Feb 2016 09:27
Last modified: 07 Oct 2020 01:35

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Contributors

Author: See Ling Loy
Author: Ngee Lek
Author: Fabian Yap
Author: Shu E. Soh
Author: Natarajan Padmapriya
Author: Kok Hian Tan
Author: Arijit Biswas
Author: George Seow Heong Yeo
Author: Kenneth Kwek
Author: Peter D Gluckman
Author: Seang Mei Saw
Author: Falk Müller-Riemenschneider
Author: Yap-Seng Chong
Author: Mary Foong-Fong Chong
Author: Jerry Kok Yen Chan

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