Maternal Vitamin D Status and Infant Outcomes in Rural Vietnam: A Prospective Cohort Study

Objective: Vitamin D deficiency affects 1 billion people globally. It has an important role in bone homeostasis, brain development and modulation of the immune system and yet the impact of antenatal vitamin D deficiency on infant outcomes is poorly understood. We assessed the association of 25- hydroxyvitamin D levels (25-OHD) in late pregnancy and early infant growth and developmental outcomes in rural Vietnam. Design and Methods: A prospective cohort study of 960 women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam was undertaken. Maternal 25-OHD concentration was measured at 32 weeks gestation, and infants were followed until 6 months of age. Main outcome measures were cognitive, motor, socio-emotional and language scores using the Bayley Scales of Infant Development, 3rd edition, and infant length-for-age z scores at 6 months of age. Results: 60 % (582/960) of women had 25-OHD levels,75 nmol/L at 32 weeks gestation. Infants born to women with 25-OHD deficiency (,37.5 nmol/L) had reduced developmental language scores compared to those born to women who were vitamin D replete ($75 nmol/L) (Mean Difference (MD) 23.48, 95 % Confidence Interval (CI) 25.67 to 21.28). For every 25 nmol increase in 25-OHD concentration in late pregnancy, infant length-for-age z scores at 6 months of age decrease