Vitamin D3 Supplementation in Overweight/Obese Pregnant Women: No Effects on the Maternal or Fetal Lipid Profile and Body Fat Distribution-A Secondary Analysis of the Multicentric, Randomized, Controlled Vitamin D and Lifestyle for Gestational Diabetes Prevention Trial (DALI).

Maria G Dalfra, Alexandra Kautzky-Willer, Rosa Corcoy, Mireille N M van Poppel, Dagmar Bancher-Todesca, Christof Worda, Frank J Snoek, Judith G M Jelsma, David Hill, Agnieszka Zawiejska, Ewa Wender-Ozegowska, Alessandra Bertolotto, Gernot Desoye, Annunziata Lapolla, Fidelma Dunne, Lise Lotte T Andersen, Dorte M Jensen, Elisabeth R Mathiesen, Peter Damm, Sander Galjaard, Roland Devlieger, David Simmons, Lilian C Mendoza, Jürgen Harreiter

Journal: Nutrients 2022;14(18):3781

PMID: 36145157

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Plain Language Summary

Vitamin D is an important fat-soluble vitamin with steroid hormone function. It is predominately known for its essential role in calcium homeostasis and bone mineralisation. The aim of this study was to assess the effects of a vitamin D supplementation with 1600 IU Vitamin D3 per day starting in early pregnancy versus placebo on maternal and foetal lipid parameters, body fat distribution as well as pregnancy outcomes. This study is a secondary analysis of the vitamin D And LIfestyle for gestational diabetes prevention trial (DALI) Vitamin D study, including overweight/obese pregnant women with normal glucose tolerance at randomization before 20 weeks’ gestation. Results show a significant increase of maternal vitamin D levels throughout pregnancy and in cord blood in the supplementation group compared with the placebo group. However, there weren’t any significant differences between the treatment arms in maternal lipid parameters nor in foetal lipid parameters or birth outcomes. Authors conclude that daily vitamin D3 supplementation in overweight/obese pregnant women with high levels of vitamin D sufficiency does not improve maternal or foetal lipid parameters, body fat distribution or pregnancy outcomes and should not be used in pregnancy for these indications.

Abstract

Vitamin D deficiency is a common finding in overweight/obese pregnant women and is associated with increased risk for adverse pregnancy outcome. Both maternal vitamin D deficiency and maternal obesity contribute to metabolic derangements in pregnancy. We aimed to assess the effects of vitamin D3 supplementation in pregnancy versus placebo on maternal and fetal lipids. Main inclusion criteria were: women <20 weeks’ gestation, BMI ≥ 29 kg/m2. Eligible women (n = 154) were randomized to receive vitamin D3 (1600 IU/day) or placebo. Assessments were performed <20, 24−28 and 35−37 weeks and at birth. Linear regression models were used to assess effects of vitamin D on maternal and cord blood lipids. In the vitamin D group significantly higher total 25-OHD and 25-OHD3 levels were found in maternal and cord blood compared with placebo. Adjusted regression models did not reveal any differences in triglycerides, LDL-C, HDL-C, free fatty acids, ketone bodies or leptin between groups. Neonatal sum of skinfolds was comparable between the two groups, but correlated positively with cord blood 25-OH-D3 (r = 0.34, p = 0.012). Vitamin D supplementation in pregnancy increases maternal and cord blood vitamin D significantly resulting in high rates of vitamin D sufficiency. Maternal and cord blood lipid parameters were unaffected by Vitamin D3 supplementation.

Address: Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria.; Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), 08025 Barcelona, Spain.; Macarthur Clinical School, Western Sydney University, Sydney 2560, Australia.; Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria.; Department of Development and Regeneration, KU Leuven, University Leuven, 3000 Leuven, Belgium.; Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium.; Department of Obstetrics, Gynecology and Fertility, GZA Sint-Augustinus, 2610 Wilrijk, Belgium.; Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands.; Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, 5000 Odense, Denmark.; Department of Gynaecology and Obstetrics, Odense University Hospital, 5000 Odense, Denmark.; Department of Clinical Research, Faculty of Health, University of Southern Denmark, 5000 Odense, Denmark.; Clinical Research Facility (CRF) and National University of Ireland, H91 TK33 Galway, Ireland.; Department of Medicine, Universita Degli Studi di Padova, 35128 Padova, Italy.; Azienda Ospedaliero-Universitaria Pisana , 56126 Pisa, Italy.; Department of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, 60-525 Poznan, Poland.; Lawson Health Research Institute, London, ON N6A 4V2, Canada.; Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands.; Amsterdam UMC, Department of Medical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands.; Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria.; Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria.; CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, 28029 Madrid, Spain.; Gender Institute, La Pura, 3571 Gars am Kamp, Austria.

DOI: 10.3390/nu14183781

Patient Centred Factor

Triggers: Vitamin D3 supplementation

Clinical Imbalances

Hormonal

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet Exercise and movement

Jadad Score

Allocation Concealment

Yes

Nutrition Evidence Keywords

Diabetes BMI Obese Overweight Physical activity Cholesterol LDL Body mass index Gestational diabetes Low-density lipoprotein High-density lipoprotein Supplement Pregnant Lipid

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/vitaminddeficiency.html

MeSH Terms: Body Fat Distribution, Cholecalciferol, Cholesterol, LDL, Diabetes, Gestational, Dietary Supplements, Fatty Acids, Nonesterified, Female, Humans, Infant, Newborn, Ketone Bodies, Leptin, Life Style, Obesity, Overweight, Pregnancy, Pregnancy Outcome, Pregnant People, Triglycerides, Vitamin D, Vitamin D Deficiency, Vitamins