Vitamin D Deficiency During the First Trimester of Pregnancy and the Risk of Developing Gestational Diabetes Mellitus

Abstract

Objective: To investigate the relationships among various factors that affect serum vitamin D levels and vitamin D in the first trimester and the risk of developing gestational diabetes mellitus (GDM).

Design: A prospective cohort design.

Setting: The family health center of Ankara, Turkey.

Participants: Out of 889 pregnant women who participated in the study in the first trimester (6-13 weeks gestation), 814 participated in GDM screening in the second trimester (24-28 weeks gestation).

Methods: We determined serum vitamin D levels, demographic data, various biochemical and anthropometric parameters, and factors that affect vitamin D synthesis of participants in the first trimester and used logistic regression analysis to analyze the effects of the associations among vitamin D deficiency and the other variables on the occurrence of GDM.

Results: Vitamin D deficiency in the first trimester was present in 425 (82.5%) participants. In the second trimester, 198 participants (24.3%) were diagnosed with GDM through oral glucose tolerance test screening. We detected GDM in the second trimester in 5.7% of participants who had vitamin D deficiency in the first trimester. Even after adjustment for vitamin D intake, clothing style, and duration of exposure to the sun, the risk of GDM was significantly greater in participants who were vitamin D deficient than those who were not deficient. The risk of GDM among women with vitamin D deficiency was sustained or increased significantly after we adjusted for age, parity, prepregnancy body mass index, history of diabetes, triglyceride levels, vitamin D intake, clothing style, and length of sun exposure, OR = 10.60, p < .001, 95% confidence interval [2.82, 39.76].

Conclusions: Our results suggest that vitamin D deficiency in the first trimester may significantly increase the risk of developing GDM.

Keywords: 25-hydroxyvitamin D; fasting blood glucose; gestational diabetes mellitus; insulin resistance; oral glucose tolerance test.