Associations of Gestational Exposure to Air Pollution With Maternal Vitamin D Levels: A Meta-Analysis

J Clin Endocrinol Metab. 2025 Apr 22;110(5):1410-1418. doi: 10.1210/clinem/dgae395.

Abstract

Context: Maternal vitamin D level is an important determinant of pregnancy and child health outcomes. Exposure to air pollution is suspected to increase the risk of vitamin D deficiency, but the evidence is scarce.

Objective: We investigated the association between air pollution during pregnancy and maternal vitamin D levels.

Methods: A total of 15 935 pregnant women from 5 birth cohorts in Europe and the United States were included. Averaged concentrations of nitrogen oxides, fine and coarse particles, and composition of fine particles from conception until vitamin D measurement were estimated at participants' residential addresses using land-use regression or other spatiotemporal models. Cohorts measured vitamin D as 25(OH)D or 25(OH)D3 levels in serum or plasma at early or mid-pregnancy. We defined suboptimal vitamin D levels as levels below 20 ng/mL. We performed logistic regression models for each cohort to estimate the association between air pollution exposure and suboptimal vitamin D levels and pooled cohort-specific estimates in a random-effect meta-analysis. Models were adjusted for sociodemographic and lifestyle characteristics and month of conception.

Results: We found an association between particulate matter (PM)2.5 and higher odds of suboptimal vitamin D levels (ie, below 20 ng/mL) (odds ratio per 5 μg/m3 increase in PM2.5, 1.43; 95% CI: 1.02, 1.99). There was no association between other air pollutant exposure and vitamin D levels.

Conclusion: PM2.5 exposure might contribute to suboptimal levels of vitamin D in pregnancy. Reducing air pollution exposure should be a priority because vitamin D deficiency may adversely influence offspring development.

Keywords: air quality; particulate matter; pregnancy; vitamin D.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Air Pollutants / adverse effects
  • Air Pollution* / adverse effects
  • Cohort Studies
  • Europe / epidemiology
  • Female
  • Humans
  • Maternal Exposure* / adverse effects
  • Particulate Matter / adverse effects
  • Pregnancy
  • United States / epidemiology
  • Vitamin D Deficiency* / blood
  • Vitamin D Deficiency* / epidemiology
  • Vitamin D Deficiency* / etiology
  • Vitamin D* / blood

Substances

  • Vitamin D
  • Particulate Matter
  • Air Pollutants