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Am J Perinatol 2017; 34(05): 486-492
DOI: 10.1055/s-0036-1593536
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Severe Vitamin D Deficiency in Human Immunodeficiency Virus-Infected Pregnant Women is Associated with Preterm Birth

Jennifer Jao
1   Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
2   Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
,
Laura Freimanis
3   Westat, Inc., Rockville, Maryland
,
Marisa M. Mussi-Pinhata
4   Universidade de São Paulo, Brazil, Faculdade de Medicina de Ribeirão Preto, São Paulo, São Paulo, Brazil
,
Rachel A. Cohen
3   Westat, Inc., Rockville, Maryland
,
Jacqueline Pontes Monteiro
4   Universidade de São Paulo, Brazil, Faculdade de Medicina de Ribeirão Preto, São Paulo, São Paulo, Brazil
,
Maria Leticia Cruz
5   Hospital Federal dos Servidores do Estado, Brazil, Serviço de Doenças Infecciosas e Parasitárias, Rio de Janeiro, Brazil
,
Andrea Branch
2   Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
,
Rhoda S. Sperling
1   Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
,
George K. Siberry
6   Eunice Kennedy Shriver National Institute of Child Health and Human Development, Maternal and Pediatric Infectious Disease Branch, Bethesda, Maryland
,
for the NISDI LILAC Protocol› Author Affiliations
Further Information

Publication History

18 July 2016

31 August 2016

Publication Date:
07 October 2016 (online)

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Abstract

Background Low maternal vitamin D has been associated with preterm birth (PTB). Human immunodeficiency virus (HIV)-infected pregnant women are at risk for PTB, but data on maternal vitamin D and PTB in this population are scarce.

Methods In a cohort of Latin American HIV-infected pregnant women from the National Institute of Child Health and Human Development International Site Development Initiative protocol, we examined the association between maternal vitamin D status and PTB. Vitamin D status was defined as the following 25-hydroxyvitamin D levels: severe deficiency (< 10 ng/mL), deficiency (10–20 ng/mL), insufficiency (21–29 ng/mL), and sufficiency (≥30 ng/mL). PTB was defined as delivery at < 37 weeks' gestational age (GA). Logistic regression was used to assess the association between maternal vitamin D status and PTB.

Results Of 715 HIV-infected pregnant women, 13 (1.8%) were severely vitamin D deficient, 224 (31.3%) were deficient, and 233 were (32.6%) insufficient. Overall, 23.2% (166/715) of pregnancies resulted in PTB (median GA of PTBs = 36 weeks [interquartile range: 34–36]). In multivariate analysis, severe vitamin D deficiency was associated with PTB (odds ratio = 4.7, 95% confidence interval: 1.3–16.8]).

Conclusion Severe maternal vitamin D deficiency is associated with PTB in HIV-infected Latin American pregnant women. Further studies are warranted to determine if vitamin D supplementation in HIV-infected women may impact PTB.

Keywords

vitamin D - preterm birth - HIV - pregnant women - pregnancy

Note

The authors have no financial disclosures to make. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the National Institutes of Health or the Department of Health and Human Services.


* The members of the NISDI Perinatal Study Group may be found in Appendix.