Objectives: To evaluate the maternal serum 25(OH)D concentrations and its association with gestational diabetes and other pregnancy outcomes.zMethods:In our nested case-control study, 4718 pregnancy women were included, who were attending second- and third-trimester screening in Nanjing, China. Serum 25(OH)D concentrations were tested by enzyme-linked immunoassay, and the pregnancy and birth outcomes were obtained via electronic medical record collection and information extraction. The associations of 25(OH)D concentrations with gestational diabetes and other pregnancy outcomes were assessed by logistic regression analysis. And receiver-operator characteristic curve analysis was also conducted.
Results: For the total population, the median (IQR) concentrations of 25(OH)D was 43.7 (35.5-57.9) nmol l-1, and 63.1% of women had concentrations <50.0 nmol l-1. The 25(OH)D concentrations was significantly lower in gestational diabetes patients than in controls. Moreover, after adjustment for confounders, women with low 25(OH)D concentrations had significantly increased risks of gestational diabetes and some adverse pregnancy outcomes (anemia, macrosomia, abnormal amniotic fluid, and miscarriage or stillbirth). We also observed a threshold for 25(OH)D of 50.0 nmol l-1 for gestational diabetes and a nice predictive accuracy of the 25(OH)D concentrations included panel, with an area under the curve of 0.625 for gestational diabetes.
Conclusions: Low 25(OH)D concentrations (<50.0 nmol l-1) in pregnancy was significantly associated with gestational diabetes risk, and it may serve as biomarkers for the surveillance of high-risk pregnant women.