To investigate the association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes, and parameters of immune function and mortality due to a SARS-CoV-2 infection. The hospital data of 235 patients infected with COVID-19 were analyzed. Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient. After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality serum levels of C-reactive protein (CRP) and an increase in lymphocyte percentage. Only 9.7% of patients older than 40 years who were vitamin D sufficient succumbed to the infection compared to 20% who had a circulating level of 25(OH)D< 30 ng/ml. The significant reduction in serum CRP, an inflammatory marker, along with increased lymphocytes percentage suggest that vitamin D sufficiency also may help modulate the immune response possibly by reducing risk for cytokine storm in response to this viral infection. Therefore, it is recommended that improving vitamin D status in the general population and in particular hospitalized patients has a potential benefit in reducing the severity of morbidities and mortality associated with acquiring COVID-19.

Health in early life is crucial for health later in life. Exposure to air pollution during embryonic and early-life development can result in placental epigenetic modification and foetus reprogramming, which can influence disease susceptibility in later life. Objectives: The aim of this paper was to investigate the placental adaptation in the level of global DNA methylation and differential gene expression in the methylation cycle in new-borns exposed to high fine particulate matter in the foetal stage. This is a nested case-control study. We enrolled pregnant healthy women attending prenatal care clinics in Tehran, Iran, who were residents of selected polluted and unpolluted regions, before the 14th week of pregnancy. We calculated the regional background levels of particle mass- particles with aerodynamics diameter smaller than 2.5 μm (PM2.5) and 10 μm (PM10)—of two regions of interest. At the time of delivery, placental tissue was taken for gene expression and DNA methylation analyses. We also recorded birth outcomes (the new-born’s sex, birth date, birth weight and length, head and chest circumference, gestational age, Apgar score, and level of neonatal care required). As regards PM2.5 and PM10 concentrations in different time windows of pregnancy, there were significantly independent positive correlations between PM10 and PM2.5 in the first trimester of all subjects and placental global DNA methylation levels (p-value = 0.01, p-value = 0.03, respectively). The gene expression analysis showed there was significant correlation between S-adenosylmethionine expression and PM2.5 (p = 0.003) and PM10 levels in the first trimester (p = 0.03). Our data showed prenatal exposures to air pollutants in the first trimester could influence placental adaptation by DNA methylation.

We investigated the prevalence and outcome of gestational diabetes mellitus (GDM) in pregnant Iranian women. A total of 2,416 women, who were consecutive referrals for antenatal care to five university teaching hospitals in Tehran, were recruited. Patients with known diabetes were excluded. All 2,416 women were screened with a 50-g 1-hour glucose challenge test, and any woman with a plasma glucose concentration more than or equal to 130 mg/dL was given a 100-g 3-hour glucose tolerance test. Diagnosis of GDM was according to Carpenter and Coustan's criteria. The remainder served as controls for the study. There were 114 women (4.7%; 95% confidence interval [CI], 3.9-5.6%) who had GDM. Women with GDM had a significantly higher parity and body mass index than non-diabetic women. Women with GDM were also more likely to have a family history of diabetes and a history of poor obstetric outcome. Of the 114 women, 27 (23.6%) were younger than 25 years old, and 16 (14.0%) had no recognizable risk factor for diabetes. The odds ratio (OR) for cesarean section (OR, 2.28; p = 0.0002), macrosomia (OR, 1.93; p = 0.0374), neonatal hypoglycemia (OR, 3.2; p = 0.011) and hypocalcemia (OR, 3.045; p = 0.0195), and still birth (OR, 4.8; p = 0.003) were all significantly higher in women with GDM than non-GDM controls. One out of every 20 pregnant Iranian women will develop GDM, with significantly increased odds of adverse maternal and fetal outcome. The significant proportion of young and/or risk factor-free women in our sample means that there seems to be a case for universal GDM screening in pregnant Iranian women.

Poor maternal vitamin D status affects fetal and infant skeletal growth. The aim of the present study was to determine the association between newborn outcomes and maternal calcium and vitamin D intakes. Four hundred and forty-nine pregnant women, healthy at the point of delivery, and their newborns were enrolled in the study, which was performed in three university hospitals in Tehran in March 2004. Maternal anthropometric data and energy, protein, calcium and vitamin D intakes were collected, and newborn outcomes (weight, length, head circumference and 1-min Apgar score) were determined. Almost two-thirds of the mothers (64.3%) took no supplements during pregnancy. Only one-third of the mothers (33.8%) had adequate intakes of calcium and vitamin D (from supplements and foods) compared with the Recommended Dietary Allowances. Mean length at birth and 1-min Apgar score were higher in newborns whose mothers had adequate calcium and vitamin D intake than in newborns whose mothers had inadequate intake (p = 0.03 and p = 0.04, respectively). Significant correlations were found between adequate maternal calcium and vitamin D intake and both appropriate birth weight and 1-min Apgar score of newborns and weight gain of mothers during pregnancy. Informing mothers of the critical importance of consuming adequate amounts of calcium and vitamin D seems necessary.