First trimester maternal vitamin D, ferritin, hemoglobin level and their associations with neonatal birthweight: Result from cohort study on vitamin D status and its impact during pregnancy and childhood in Indonesia

Article type: Research Article

Authors: Yuniati, T.^a | Judistiani, R.T. Dewi^{b; *} | Natalia, Y. Adelwin^b | Irianti, S.^c | Madjid, T. Husnitawati^c | Ghozali, M.^d | Sribudiani, Y.^d | Indrati, A. Rengga^e | Abdulah, R.^f | Setiabudiawan, Budi^a

Affiliations: [a] Department of Child Health, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia /dr Hasan Sadikin Hospital, Bandung, Indonesia | [b] Public Health Department-Centre for Immunology Studies, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia | [c] Obstetric and Gynecology Department, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia/dr Hasan Sadikin Hospital, Bandung, Indonesia | [d] Department of Biomedical Sciences, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia | [e] Clinical Pathology Department, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia/dr Hasan Sadikin Hospital, Bandung, Indonesia | [f] Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy Universitas Padjadjaran, Sumedang, Indonesia

Correspondence: [*] Address for correspondence: Raden Tina Dewi Judistiani, Department of Public Health – Centre for Immunology Studies, Faculty of Medicine Universitas Padjadajaran, Jln. Raya Bandung-Sumedang Km. 21, Jatinangor, Kab. Sumedang 45363, Jawa Barat Sumedang, Indonesia. Tel.: +62 22 2032170; Fax: +62 22 2037823; E-mails: tina.d.judistiani@unpad.ac.id, judistiani@gmail.com.

Abstract: INTRODUCTION:Vitamin D deficiency and anemia are examples of nutritional problems of global health significance. When these health issues effect pregnant women, they may become a threat to the fetus’ potention for intrauterine growth. It has been known that the first trimester is the golden period of fetal programming which influences the fetuses and their life after birth. This study was aiming to analyze the association between first trimester maternal vitamin D, serum ferritin, hemoglobin level and neonatal birth weight. METHODS:From July 2016 a prospective cohort of pregnant women had been observed in four cities in West Java, Indonesia. Two hundred ninety four pregnant women were recuited in the first trimester and 203 of them had complete follow up until delivery. Collected data included maternal demography, blood analysis for ferritin, 25(OH) vitamin D in the first trimester of pregnancy and the birth weight of neonates. Associations were analyzed with multiple regression models. RESULTS:Vitamin D deficiency was highly prevalent among pregnant women in this study (approximately 75%) while anemia was found in 7.5 %, a little above the target of 5 %. However, no significant association was found between maternal serum vitamin D, serum ferritin, hemoglobin level in the first trimester and birth weight of the neonates, before and after adjustment for maternal age, pre-pregnancy body mass index, and parity. CONCLUSION:There were no associations found between vitamin D, ferritin, and hemoglobin level in the first trimester and neonatal birth weight. The negative results in this study should not diminish the benefit of nutritional supplementation during pregnancy. The possibility of other explanatory variables that influence these associations warrants further studies.

Keywords: Birth weight, ferritin, hemoglobin, pregnancy, vitamin D

DOI: 10.3233/NPM-180043

Journal: Journal of Neonatal-Perinatal Medicine, vol. 13, no. 1, pp. 63-69, 2020