Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations

Lisa M. Bodnar*, Dwight J. Rouse, Valerija Momirova, Alan M. Peaceman, Anthony Sciscione, Catherine Y. Spong, Michael W. Varner, Fergal D. Malone, Jay D. Iams, Brian M. Mercer, John M. Thorp, Yoram Sorokin, Marshall W. Carpenter, Julie Lo, Susan M. Ramin, Margaret Harper

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE:: To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies. METHODS:: Serum samples from women who participated in a clinical trial of 17 α-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestations (2004-2006) were assayed for 25-hydroxyvitamin D concentrations using liquid chromatography tandem mass spectrometry (n=211). Gestational age was determined early in pregnancy using a rigorous algorithm. Preterm birth was defined as delivery of the first twin or death of either twin at less than 35 weeks of gestation. RESULTS:: The mean serum 25-hydroxyvitamin D concentration was 82.7 nmol/L (standard deviation 31.5); 40.3% of women had concentrations less than 75 nmol/L. Preterm birth at less than 35 weeks of gestation occurred in 49.4% of women with 25-hydroxyvitamin D concentrations less than 75 nmol/L compared with 26.2% among those with concentrations of 75 nmol/L or more (P<.001). After adjustment for maternal race and ethnicity, study site, parity, prepregnancy body mass index, season, marital status, education, gestational age at blood sampling, smoking status, and 17 α- hydroxyprogesterone caproate treatment, maternal 25-hydroxyvitamin D concentration of 75 nmol/L or more was associated with a 60% reduction in the odds of preterm birth compared with concentrations less than 75 nmol/L (adjusted odds ratio [OR] 0.4, 95% confidence interval [CI] 0.2-0.8). A similar protective association was observed when studying preterm birth at less than 32 weeks of gestation (OR 0.2, 95% CI 0.1-0.6) and after confounder adjustment. CONCLUSIONS:: Late second-trimester maternal 25-hydroxyvitamin D concentrations less than 75 nmol/L are associated with an increase in the risk of preterm birth in this cohort of twin pregnancies.

Original languageEnglish (US)
Pages (from-to)91-98
Number of pages8
JournalObstetrics and gynecology
Volume122
Issue number1
DOIs
StatePublished - Jul 1 2013

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Premature Birth
Mothers
Pregnancy
17-alpha-Hydroxyprogesterone
Twin Pregnancy
Gestational Age
Odds Ratio
Confidence Intervals
Social Adjustment
Marital Status
Second Pregnancy Trimester
Tandem Mass Spectrometry
Parity
25-hydroxyvitamin D
Serum
Liquid Chromatography
Body Mass Index
Smoking
Clinical Trials
Education

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Bodnar, L. M., Rouse, D. J., Momirova, V., Peaceman, A. M., Sciscione, A., Spong, C. Y., ... Harper, M. (2013). Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations. Obstetrics and gynecology, 122(1), 91-98. https://doi.org/10.1097/AOG.0b013e3182941d9a
Bodnar, Lisa M. ; Rouse, Dwight J. ; Momirova, Valerija ; Peaceman, Alan M. ; Sciscione, Anthony ; Spong, Catherine Y. ; Varner, Michael W. ; Malone, Fergal D. ; Iams, Jay D. ; Mercer, Brian M. ; Thorp, John M. ; Sorokin, Yoram ; Carpenter, Marshall W. ; Lo, Julie ; Ramin, Susan M. ; Harper, Margaret. / Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations. In: Obstetrics and gynecology. 2013 ; Vol. 122, No. 1. pp. 91-98.
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abstract = "OBJECTIVE:: To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies. METHODS:: Serum samples from women who participated in a clinical trial of 17 α-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestations (2004-2006) were assayed for 25-hydroxyvitamin D concentrations using liquid chromatography tandem mass spectrometry (n=211). Gestational age was determined early in pregnancy using a rigorous algorithm. Preterm birth was defined as delivery of the first twin or death of either twin at less than 35 weeks of gestation. RESULTS:: The mean serum 25-hydroxyvitamin D concentration was 82.7 nmol/L (standard deviation 31.5); 40.3{\%} of women had concentrations less than 75 nmol/L. Preterm birth at less than 35 weeks of gestation occurred in 49.4{\%} of women with 25-hydroxyvitamin D concentrations less than 75 nmol/L compared with 26.2{\%} among those with concentrations of 75 nmol/L or more (P<.001). After adjustment for maternal race and ethnicity, study site, parity, prepregnancy body mass index, season, marital status, education, gestational age at blood sampling, smoking status, and 17 α- hydroxyprogesterone caproate treatment, maternal 25-hydroxyvitamin D concentration of 75 nmol/L or more was associated with a 60{\%} reduction in the odds of preterm birth compared with concentrations less than 75 nmol/L (adjusted odds ratio [OR] 0.4, 95{\%} confidence interval [CI] 0.2-0.8). A similar protective association was observed when studying preterm birth at less than 32 weeks of gestation (OR 0.2, 95{\%} CI 0.1-0.6) and after confounder adjustment. CONCLUSIONS:: Late second-trimester maternal 25-hydroxyvitamin D concentrations less than 75 nmol/L are associated with an increase in the risk of preterm birth in this cohort of twin pregnancies.",
author = "Bodnar, {Lisa M.} and Rouse, {Dwight J.} and Valerija Momirova and Peaceman, {Alan M.} and Anthony Sciscione and Spong, {Catherine Y.} and Varner, {Michael W.} and Malone, {Fergal D.} and Iams, {Jay D.} and Mercer, {Brian M.} and Thorp, {John M.} and Yoram Sorokin and Carpenter, {Marshall W.} and Julie Lo and Ramin, {Susan M.} and Margaret Harper",
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Bodnar, LM, Rouse, DJ, Momirova, V, Peaceman, AM, Sciscione, A, Spong, CY, Varner, MW, Malone, FD, Iams, JD, Mercer, BM, Thorp, JM, Sorokin, Y, Carpenter, MW, Lo, J, Ramin, SM & Harper, M 2013, 'Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations', Obstetrics and gynecology, vol. 122, no. 1, pp. 91-98. https://doi.org/10.1097/AOG.0b013e3182941d9a

Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations. / Bodnar, Lisa M.; Rouse, Dwight J.; Momirova, Valerija; Peaceman, Alan M.; Sciscione, Anthony; Spong, Catherine Y.; Varner, Michael W.; Malone, Fergal D.; Iams, Jay D.; Mercer, Brian M.; Thorp, John M.; Sorokin, Yoram; Carpenter, Marshall W.; Lo, Julie; Ramin, Susan M.; Harper, Margaret.

In: Obstetrics and gynecology, Vol. 122, No. 1, 01.07.2013, p. 91-98.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations

AU - Bodnar, Lisa M.

AU - Rouse, Dwight J.

AU - Momirova, Valerija

AU - Peaceman, Alan M.

AU - Sciscione, Anthony

AU - Spong, Catherine Y.

AU - Varner, Michael W.

AU - Malone, Fergal D.

AU - Iams, Jay D.

AU - Mercer, Brian M.

AU - Thorp, John M.

AU - Sorokin, Yoram

AU - Carpenter, Marshall W.

AU - Lo, Julie

AU - Ramin, Susan M.

AU - Harper, Margaret

PY - 2013/7/1

Y1 - 2013/7/1

N2 - OBJECTIVE:: To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies. METHODS:: Serum samples from women who participated in a clinical trial of 17 α-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestations (2004-2006) were assayed for 25-hydroxyvitamin D concentrations using liquid chromatography tandem mass spectrometry (n=211). Gestational age was determined early in pregnancy using a rigorous algorithm. Preterm birth was defined as delivery of the first twin or death of either twin at less than 35 weeks of gestation. RESULTS:: The mean serum 25-hydroxyvitamin D concentration was 82.7 nmol/L (standard deviation 31.5); 40.3% of women had concentrations less than 75 nmol/L. Preterm birth at less than 35 weeks of gestation occurred in 49.4% of women with 25-hydroxyvitamin D concentrations less than 75 nmol/L compared with 26.2% among those with concentrations of 75 nmol/L or more (P<.001). After adjustment for maternal race and ethnicity, study site, parity, prepregnancy body mass index, season, marital status, education, gestational age at blood sampling, smoking status, and 17 α- hydroxyprogesterone caproate treatment, maternal 25-hydroxyvitamin D concentration of 75 nmol/L or more was associated with a 60% reduction in the odds of preterm birth compared with concentrations less than 75 nmol/L (adjusted odds ratio [OR] 0.4, 95% confidence interval [CI] 0.2-0.8). A similar protective association was observed when studying preterm birth at less than 32 weeks of gestation (OR 0.2, 95% CI 0.1-0.6) and after confounder adjustment. CONCLUSIONS:: Late second-trimester maternal 25-hydroxyvitamin D concentrations less than 75 nmol/L are associated with an increase in the risk of preterm birth in this cohort of twin pregnancies.

AB - OBJECTIVE:: To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies. METHODS:: Serum samples from women who participated in a clinical trial of 17 α-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestations (2004-2006) were assayed for 25-hydroxyvitamin D concentrations using liquid chromatography tandem mass spectrometry (n=211). Gestational age was determined early in pregnancy using a rigorous algorithm. Preterm birth was defined as delivery of the first twin or death of either twin at less than 35 weeks of gestation. RESULTS:: The mean serum 25-hydroxyvitamin D concentration was 82.7 nmol/L (standard deviation 31.5); 40.3% of women had concentrations less than 75 nmol/L. Preterm birth at less than 35 weeks of gestation occurred in 49.4% of women with 25-hydroxyvitamin D concentrations less than 75 nmol/L compared with 26.2% among those with concentrations of 75 nmol/L or more (P<.001). After adjustment for maternal race and ethnicity, study site, parity, prepregnancy body mass index, season, marital status, education, gestational age at blood sampling, smoking status, and 17 α- hydroxyprogesterone caproate treatment, maternal 25-hydroxyvitamin D concentration of 75 nmol/L or more was associated with a 60% reduction in the odds of preterm birth compared with concentrations less than 75 nmol/L (adjusted odds ratio [OR] 0.4, 95% confidence interval [CI] 0.2-0.8). A similar protective association was observed when studying preterm birth at less than 32 weeks of gestation (OR 0.2, 95% CI 0.1-0.6) and after confounder adjustment. CONCLUSIONS:: Late second-trimester maternal 25-hydroxyvitamin D concentrations less than 75 nmol/L are associated with an increase in the risk of preterm birth in this cohort of twin pregnancies.

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