Impact of Maternal and Neonatal Vitamin D Status on the Development of Congenital Anomalies in Egyptian Model

Suzan Abd Razik Mohamed; Mohamed N. El Barbary; Wafaa Osman Ahmed; Sahar S. Abd El Maksoud; Zakaria H. Ibrahim; Heba E. Hashem; Ahmad A. Obaid; Mohamed  Khalifa; Dalia Selim

doi:10.3889/oamjms.2022.7809

Authors

Suzan Abd Razik Mohamed Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mohamed N. El Barbary Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Wafaa Osman Ahmed Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt https://orcid.org/0000-0003-4081-0705
Sahar S. Abd El Maksoud Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Zakaria H. Ibrahim Department of General Surgery, El Azhar University, Cairo, Egypt
Heba E. Hashem Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ahmad A. Obaid Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
Mohamed Khalifa Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Dalia Selim Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2022.7809

Keywords:

Vitamin D, Congenital anomalies, Neonates

Abstract

Background: Vitamin D (VD) is a remarkable problem during pregnancy. VD plays a crucial role in cellular growth and differentiation during embryogenesis. VD deficiency in pregnancy is associated with various maternal and neonatal comorbidities.

Aim: In this study, we aimed to evaluate the potential association between maternal and neonatal vitamin D status and the subsequent development of congenital anomalies.

Patients and methods: A case-control study involving 30 mothers and their neonates born with gross structural congenital anomalies as cases and 30 mothers and their healthy neonates as controls recruited from Ain Shams University Children Hospital. Maternal and Neonatal blood samples were obtained to determine serum 25-hydroxyvitamin D. The 25-hydroxyvitamin D concentration was stratified into a severe deficient<10ng/ml, deficient <20ng/ml, insufficient 20-29ng/ml and sufficient >30ng/ml. Status above 150ng/ml presents high risk of toxicity.

Results: There were statistically significant differences between the two groups regarding maternal and neonatal vitamin D serum level within 29 days postpartum. Mean maternal vitamin D level in cases was 23.8ng/ml versus 42.13ng/ml in controls (P = 0,000). Mean neonatal vitamin D level in cases was 15.97ng/ml versus 28.9ng/ml in controls (P = 0,000).There was significant positive correlation between both maternal and neonatal vitamin D level with birth weight.

Conclusion: A compromised maternal vitamin D status is associated with an increased prevalence of congenital anomalies in offspring. Therefore, improvement of the periconceptional maternal vitamin D status is recommended.

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References

Onankpa A. Pattern and outcome of gross congenital malformations at birth amongst newborns admitted to a tertiary hospital in northern Nigeria. Niger J Paediatr. 2014;41(4):337-40. https://doi.org/10.4314/njp.v41i4.9 DOI: https://doi.org/10.4314/njp.v41i4.9

Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080S-6S. https://doi.org/10.1093/ajcn/87.4.1080S PMid:18400738 DOI: https://doi.org/10.1093/ajcn/87.4.1080S

Kim IM, Norris KC, Artaza JN. Vitamin D and cardiac differentiation. Vitam Horm. 2016;100:299-320. https://doi.org/10.1016/bs.vh.2015.10.008 PMid:26827957 DOI: https://doi.org/10.1016/bs.vh.2015.10.008

Zeitelhofer M, Adzemovic MZ, Gomez-Cabrero D, Bergman P, Hochmeister S, N’diaye M, et al. Functional genomics analysis of Vitamin D effects on CD4+ T cells in vivo in experimental autoimmune encephalomyelitis. Proc Natl Acad Sci USA. 2017;114(9):E1678-87. https://doi.org/10.1073/pnas.1615783114 PMid:28196884 DOI: https://doi.org/10.1073/pnas.1615783114

Karlic H, Varga F. Impact of Vitamin D metabolism on clinical epigenetics. Clin Epigenetics. 2011;2(1):55-61. https://doi.org/10.1007/s13148-011-0021-y PMid:22704269 DOI: https://doi.org/10.1007/s13148-011-0021-y

World Health Organization. Congenital Anomalies Fact Sheet. Geneva: WHO; 2016. Available from: http://www.who.int/news-room/factsheets/detail/congenital-anomalies. [Last accessed on 2021 Aug 25].

Botto LD, Mulinare J, Erickson JD. Occurrence of congenital heart defects in relation to maternal mulitivitamin use. Am J Epidemiol. 2000;151(9):878-84. https://doi.org/10.1093/oxfordjournals.aje.a010291 PMid:10791560 DOI: https://doi.org/10.1093/oxfordjournals.aje.a010291

Bodnar LM. Maternal Vitamin D status and the risk of mild and severe preeclampsia. Epidemiology. 2014;25(2):207-14. https://doi.org/10.1097/EDE.0000000000000039 PMid:24457526 DOI: https://doi.org/10.1097/EDE.0000000000000039

Bener A, Al-Ali M, Hoffmann GF. High prevalence of Vitamin D deficiency in young children in a highly sunny humid country: A global health problem. Minerva Pediatr. 2009;61:15-22. PMid:19179999

Koster MPH, van Duijn L, Krul-Poel YH, Laven JS, Helbing WA, Simsek S, et al. A compromised maternal vitamin D status is associated with congenital heart defects in offspring. Early Hum Dev. 2018;117:50-56. https://doi.org/10.1016/j.earlhumdev.2017.12.011 PMid:29287191 DOI: https://doi.org/10.1016/j.earlhumdev.2017.12.011

Dave A, Verma M, Jain N, Dave A. A study of Vitamin D levels and associated deficiency in pregnancy and its effect on maternal and fetal outcome. Int J Reprod Contracept Obstet Gynecol. 2017;6:84-8. DOI: https://doi.org/10.18203/2320-1770.ijrcog20164637

Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009;94(3):940-5. https://doi.org/10.1210/jc.2008-1217 PMid:19106272 DOI: https://doi.org/10.1210/jc.2008-1217

Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM. High prevalence of Vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007;137(2):447-52. https://doi.org/10.1093/jn/137.2.447 PMid:17237325 DOI: https://doi.org/10.1093/jn/137.2.447

Bowyer L, Catling-Paull C, Diamond T, Homer C, Davis G, Craig ME. Vitamin D, PTH and calcium levels in pregnant women and their neonates. Clin Endocrinol (Oxf). 2009;70(3):372-7. https://doi.org/10.1111/j.1365-2265.2008.03316.x PMid:18573121 DOI: https://doi.org/10.1111/j.1365-2265.2008.03316.x

Ghosh A, Bhardwa J. Cord blood Vitamin D and fluoride in congenital anomalies. Asian J Med Sci. 2020;11(3):17-21. DOI: https://doi.org/10.3126/ajms.v11i3.28101

Robinson CJ, Wagner CL, Hollis BW, Baatz JE, Johnson DD. Maternal Vitamin D and fetal growth in early-onset severe preeclampsia. Am J Obstet Gynecol. 2011;204:556.e1-4. https://doi.org/10.1016/j.ajog.2011.03.022 PMid:21507371 DOI: https://doi.org/10.1016/j.ajog.2011.03.022

Leffelaar ER, Vrijkotte TG, van Eijsden M. Maternal early pregnancy Vitamin D status in relation to fetal and neonatal growth: Results of the multi-ethnic Amsterdam born children and their development cohort. Br J Nutr. 2010;104:108-17. https://doi.org/10.1017/S000711451000022X PMid:20193097 DOI: https://doi.org/10.1017/S000711451000022X

Fang K, He Y, Mu M, Liu K. Maternal Vitamin D deficiency during pregnancy and low birth weight: A systematic review and meta-analysis, J Matern Fetal Neonatal Med. 2021;34(7):1167-73. https://doi.org/10.1080/14767058.2019.1623780 PMid:31122092 DOI: https://doi.org/10.1080/14767058.2019.1623780

Rabbani S, Afaq S, Fazid S, Khattak MI, Yousafzai YM, Habib SH, et al. Correlation between maternal and neonatal blood Vitamin D level: Study from Pakistan. Matern Child Nutr. 2021;17(1):e13028. https://doi.org/10.1111/mcn.13028 PMid:32815629 DOI: https://doi.org/10.1111/mcn.13028

Mokhtar WA, Fawzy A, Allam RM, Amer RM, Hamed MS. Maternal Vitamin D level and Vitamin D receptor gene polymorphism as a risk factor for congenital heart diseases in offspring; An Egyptian case-control study. Genes Dis. 2018;6(2):193-200. https://doi.org/10.1016/j.gendis.2018.08.001 PMid:31194013 DOI: https://doi.org/10.1016/j.gendis.2018.08.001

Turkmen GG, Timur H, Tokmak A, Yilmaz Z, Kirbas A, Daglar K, et al. Levels of serum Vitamin D and calcium in pregnancies complicated with fetal congenital diaphragmatic hernia and normal pregnancies. J Matern Fetal Neonatal Med. 2017;30(8):990-4. https://doi.org/10.1080/14767058.2016.1196 662 PMid:27245872 DOI: https://doi.org/10.1080/14767058.2016.1196662

Sirinoglu HA, Pakay K, Aksoy M, Bakırci IT, Ozkaya E, Sanverdi I. Comparison of serum folate, 25-OH Vitamin D, and calcium levels between pregnants with and without fetal anomaly of neural tube origin. J Matern Fetal Neonatal Med. 2018;31(11):1490-3. https://doi.org/10.1080/14767058.2017.1319924 PMid:28420274 DOI: https://doi.org/10.1080/14767058.2017.1319924