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Pre-pregnancy habitual intake of vitamin D from diet and supplements in relation to risk of gestational diabetes mellitus: a prospective cohort study

Authors

  • Wei Bao,

    1. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
    2. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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  • Yiqing Song,

    1. Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
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  • Kimberly A. Bertrand,

    1. Slone Epidemiology Center, Boston University, Boston, MA, USA
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  • Deirdre K. Tobias,

    1. Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
    2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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  • Sjurdur F. Olsen,

    1. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
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  • Jorge E. Chavarro,

    1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
    2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
    3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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  • James L. Mills,

    1. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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  • Frank B. Hu,

    1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
    2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
    3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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  • Cuilin Zhang

    Corresponding author
    1. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
    • Corresponding author: Dr. Cuilin Zhang, Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD 20817, USA; Phone/Fax: 301-435-6917; Email: zhangcu@mail.nih.gov.

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ABSTRACT

Background

Vitamin D may play a pivotal role in regulating insulin secretion and insulin sensitivity. However, the impact of vitamin D intake either from diet or from supplements on the development of gestational diabetes mellitus (GDM) remains unknown. We prospectively examined the association of pre-pregnancy habitual intake of vitamin D from diet and supplements with risk of incident GDM in a well-established cohort.

Methods

We included 21,356 singleton pregnancies from 15,225 women in the Nurses' Health Study II cohort. Diet information, including vitamin D intakes from food sources and supplements, was assessed in 1991 and every four years thereafter by validated food frequency questionnaires. We used log-binomial models with generalized estimating equations to estimate the relative risks (RRs) and 95% confidence intervals (CIs).

Results

We documented 865 incident GDM cases during 10 years of follow-up. After adjustment for age, parity, race/ethnicity, family history of diabetes, dietary and lifestyle factors, and body mass index, the RRs (95% CIs) of GDM risk associated with supplemental vitamin D intake of 0, 1–399, ≥ 400 IU/d were 1.00 (reference), 0.80 (0.67-0.96), and 0.71 (0.56-0.90), respectively (P for trend = 0.002). Dietary and total vitamin D intakes were also inversely associated with GDM risk, but the associations were not statistically significant.

Conclusions

Pre-pregnancy supplemental vitamin D intake was significantly and inversely associated with risk of GDM. Our study indicates potential benefits of increasing vitamin D intake from supplements in the prevention of GDM in women of reproductive age.

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