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Title: Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study
Authors: Loy, See Ling
Lek, Ngee 
Yap, Kok Peng Fabian 
Soh, Shu E. 
Natarajan, Padmapriya 
Tan, Kok Lian
Biswas, Arijit 
Yeo, George S. H.
Kwek, Yung Chiang Kenneth 
Gluckman, Peter David 
Saw, Seang Mei 
Chong, Foong Fong Mary 
Chan, Kok Yen Jerry 
Chinnadurai, Amutha 
Qiu, Anqi 
Lee, Bee Wah 
Broekman, Birit Froukje Philippien 
Shuter, Borys 
Hsu, Chin-Ying Stephen 
Chee, Yin Ing Cornelia 
Van Bever, Hugo P.S. 
Holbrook, Joanna Dawn 
Gooley, Joshua J. 
Niduvaje, Krishnamoorthy 
Singh, Leher 
Su, Lin Lin 
Shek, Pe-Chi Lynette 
Chua, Mei Chien 
Tint, Mya Thway 
Teoh, Oon Hoe 
Wong, Peng Cheang 
Rob Martinus, van Dam 
Rebello, Salome Antonette 
Chong, Shang Chee 
Cai, Shirong 
Rajadurai, Victor Samuel 
Pang, Wei Wei 
Goh, Yam Thiam Daniel 
Cheung, Yin Bun 
Chan, Yiong Huak 
Lee, Yung Seng 
Issue Date: 1-Nov-2015
Publisher: Public Library of Science
Citation: Loy, See Ling, Lek, Ngee, Yap, Kok Peng Fabian, Soh, Shu E., Natarajan, Padmapriya, Tan, Kok Lian, Biswas, Arijit, Yeo, George S. H., Kwek, Yung Chiang Kenneth, Gluckman, Peter David, Saw, Seang Mei, Chong, Foong Fong Mary, Chan, Kok Yen Jerry, Chinnadurai, Amutha, Qiu, Anqi, Lee, Bee Wah, Broekman, Birit Froukje Philippien, Shuter, Borys, Hsu, Chin-Ying Stephen, Chee, Yin Ing Cornelia, Van Bever, Hugo P.S., Holbrook, Joanna Dawn, Gooley, Joshua J., Niduvaje, Krishnamoorthy, Singh, Leher, Su, Lin Lin, Shek, Pe-Chi Lynette, RAUFF HOW JING,MARY, Chua, Mei Chien, Tint, Mya Thway, Teoh, Oon Hoe, Wong, Peng Cheang, Rob Martinus, van Dam, Rebello, Salome Antonette, Chong, Shang Chee, Cai, Shirong, Rajadurai, Victor Samuel, Pang, Wei Wei, Goh, Yam Thiam Daniel, Cheung, Yin Bun, Chan, Yiong Huak, Lee, Yung Seng (2015-11-01). Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study. PLoS ONE 10 (11) : 1-16. ScholarBank@NUS Repository.
Abstract: Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women. © 2015 Loy et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
ISSN: 19326203
DOI: 10.1371/journal.pone.0142239
Appears in Collections:Staff Publications

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