Background: Folic acid supplementation in those with a low vitamin B-12 intake or status may have adverse effects. These effects are unknown with reg

The etiology of pre-eclampsia (PE) is not yet fully understood, though current literature indicates an upregulation of inflammatory mediators produced by the placenta as a potential causal mechanism. Vitamin D is known to have anti-inflammatory properties and there is evidence of an inverse relationship between dietary calcium intake and the incidence of PE. Evidence of the role of vitamin D status and supplementation in the etiology and prevention of PE is reviewed in this article along with identification of research gaps to inform future studies. We conducted a structured literature search using MEDLINE electronic databases to identify published studies until February 2015. These sources were retrieved, collected, indexed, and assessed for availability of pregnancy-related data on PE and vitamin D. Several case-control studies and cross-sectional studies have shown an association between vitamin D status and PE, although evidence has been inconsistent. Clinical trials to date have been unable to show an independent effect of vitamin D supplementation in preventing PE. The included clinical trials do not show an independent effect of vitamin D supplementation in preventing PE; however, issues with dose, timing, and duration of supplementation have not been completely addressed.

Background: Vitamin B₁₂deficiency during pregnancy has been associated with adverse maternal and infant health outcomes. Few prospective studies have investigated vitamin B₁₂status early in pregnancy, and its links to infant vitamin B₁₂status, particularly in India where the burden of vitamin B₁₂deficiency is estimated to be the highest globally. The objective of this study was to examine the associations of maternal vitamin B₁₂biomarkers with neonatal vitamin B₁₂status.Methods: Pregnant women (~12 weeks’ gestation) were enrolled in a perinatal cohort study in Bangalore, India. Total vitamin B₁₂, methylmalonic acid (MMA), and homocysteine concentrations were evaluated in maternal samples at enrollment and in neonates at birth using cord blood. Linear and binomial regression models were used to evaluate the associations of maternal vitamin B₁₂biomarkers with neonatal vitamin B₁₂status and perinatal outcomes.Results: A total of 63.2% of women had vitamin B₁₂deficiency (<148 pmol/L), 87.2% had vitamin B₁₂insufficiency (<221 pmol/L), and 47.3% had impaired vitamin B₁₂status (vitamin B₁₂0.26μmol/L) at enrollment; 40.8% of neonates had vitamin B₁₂deficiency, 65.6% were insufficiency, and 38.1% had impaired vitamin B₁₂status at birth. Higher maternal vitamin B₁₂concentrations at enrollment were associated with increased neonatal vitamin B₁₂concentrations (β(SE): 0.40 (0.05); p<0.0001) and lower risk of neonatal vitamin B₁₂deficiency (Risk Ratio [RR]: 0.53; 95% CI: [0.43, 0.65]; p<0.0001). Maternal vitamin B₁₂deficiency (RR: 1.97 [1.43, 2.71]; p<0.001), insufficiency (RR: 2.18 [1.23, 3.85]; p = 0.007), and impaired vitamin B₁₂status (RR: 1.49 [1.13, 1.97]; p = 0.005) predicted a two-fold increase in the risk of neonatal vitamin B₁₂deficiency at birth.Conclusions: The prevalence of vitamin B₁₂deficiency was high early in pregnancy and predicted neonatal vitamin B₁₂status. Future research is needed to determine the role of vitamin B₁₂in the development of pregnancy and infant outcomes, and to inform screening and interventions to improve maternal and child health.

The food frequency questionnaire (FFQ) was validated against multiple 24-hour dietary recalls (24-HDRs) and for a few blood biomarkers in 154 pregnant women at the obstetrics and gynecology department of St John’s Medical College Hospital, Bangalore, India. Absolute nutrient intakes from the FFQ correlated positively with the average 24-HDR during pregnancy. Energy-adjusted nutrients from the FFQ in all trimesters, except proteins, carbohydrate, folate intake, and vitamin B ₆ in the third trimester, correlated positively with average 24-HDR. Overestimation by the FFQ compared with the 24-HDR ranged from 9% to 41%. Vitamin B ₁₂ status in the first and second trimesters positively correlated with energy-adjusted and absolute vitamin B ₁₂ intakes from the FFQ. The Bland Altman plots showed a pattern such that a trend was seen toward underreporting of intakes through the FFQ, with increasing mean intakes by the 2 methods, considering 24-HDR as the reference tool. We conclude that the FFQ is a valid tool to measure dietary intakes during pregnancy.

Background: A high prevalence of vitamin D deficiency exists in pregnant Indian women (~90%). Increasing evidence suggests that vitamin D could play a pivotal role in maintaining normal glucose homeostasis. We aimed to determine the association between maternal vitamin D concentrations in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods: A prospective observational study was conducted on healthy pregnant women (n = 392) attending routine antenatal care at St. John's Medical College Hospital, Bangalore recruited at ~12 weeks of gestation. At baseline, details on socio-economic status, obstetric history, dietary intakes, and anthropometry were collected. Venous plasma total vitamin D concentration was assessed using tandem liquid chromatography mass spectrophotometry (LC-MS/MS). Oral glucose tolerance test (OGTT) at recruitment, followed by glucose tolerance test (GTT) at mid-pregnancy was conducted. GDM was diagnosed and confirmed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) classification. Univariate and adjusted logistic regression models were used to evaluate the associations between total vitamin D concentrations at enrollment with GDM. Results: Of the cohort, 10.2% were diagnosed as GDM. Women with GDM were older (26 vs. 24 years) and heavier (51.6 vs. 51.2 kg) compared to the rest. A higher prevalence of GDM was observed among women with 1st trimester plasma total vitamin D in the lowest quartile (≤23.6 nmol/L) compared to the subjects in the other three quartiles (16.1 vs. 8.6%, p = 0.033). Adjusted multivariable regression analysis showed that women in the lowest quartile of plasma total vitamin D had twice the odds of GDM compared to women belonging to the remaining quartiles [OR = 2.32 (95%CI: 1.10, 4.91), p = 0.028]. Conclusions: Low plasma total vitamin D concentrations in early pregnancy may be associated with a higher risk of GDM.