Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes
Prenatal vitamin D deficiency and prenatal depression are both separately associated with adverse perinatal outcomes; however, to our knowledge no studies have investigated the effects of having both risk factors. Our objective was to determine to what extent vitamin D deficiency predicts adverse pe...
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| Veröffentlicht in: | Journal of behavioral medicine 2018-10, Vol.41 (5), p.680-689 |
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| description | Prenatal vitamin D deficiency and prenatal depression are both separately associated with adverse perinatal outcomes; however, to our knowledge no studies have investigated the effects of having both risk factors. Our objective was to determine to what extent vitamin D deficiency predicts adverse perinatal outcomes and whether elevated depressive symptoms in pregnancy places women at additional increased risk. This study was a secondary data analysis of prospective data collected from a cohort of pregnant women (N = 101) in an obstetric clinic of a large medical center. Maternal vitamin D deficiency (serum 25(OH)D ≤ 20 ng/ml) and depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS) were assessed in early pregnancy. A composite of four adverse perinatal outcomes (low birth weight, preterm birth, small-for-gestational age, and preeclampsia) were abstracted from medical charts. Nineteen of the 101 women had one or more adverse perinatal outcome and 84% with an adverse outcome (16/19) were not White. Both prenatal and time of delivery vitamin D deficiency were associated with developing an adverse outcome compared to those vitamin D sufficient (prenatal relative risk 3.43; 95% CI 1.60–7.34,
p
= 0.004; delivery time relative risk 5.14, 95% CI 2.68–9.86,
p
= 0.004). These both remained significant after adjusting for BMI. A higher rate of adverse outcome was found when women had both prenatal vitamin D deficiency and elevated depressive symptoms (EPDS ≥ 10). Sixty percent with both risk factors had an adverse perinatal outcome versus 17% with only one or neither risk factor (relative risk 3.60; 95% CI 1.55–8.38,
p
= 0.045), worthy of investigation with larger samples. Together, prenatal vitamin D deficiency and elevated depressive symptoms in pregnancy may increase risk for adverse perinatal outcomes, especially in racial minorities. Obstetric providers should consider routine prenatal depression screening. The impact of vitamin D supplementation to reduce risk for adverse perinatal outcomes should be studied in prospective trials. Our results suggest that supplementation early in pregnancy might be especially beneficial for depressed women. |
| doi_str_mv | 10.1007/s10865-018-9924-9 |
| format | Article |
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p
= 0.004; delivery time relative risk 5.14, 95% CI 2.68–9.86,
p
= 0.004). These both remained significant after adjusting for BMI. A higher rate of adverse outcome was found when women had both prenatal vitamin D deficiency and elevated depressive symptoms (EPDS ≥ 10). Sixty percent with both risk factors had an adverse perinatal outcome versus 17% with only one or neither risk factor (relative risk 3.60; 95% CI 1.55–8.38,
p
= 0.045), worthy of investigation with larger samples. Together, prenatal vitamin D deficiency and elevated depressive symptoms in pregnancy may increase risk for adverse perinatal outcomes, especially in racial minorities. Obstetric providers should consider routine prenatal depression screening. The impact of vitamin D supplementation to reduce risk for adverse perinatal outcomes should be studied in prospective trials. Our results suggest that supplementation early in pregnancy might be especially beneficial for depressed women.</description><identifier>ISSN: 0160-7715</identifier><identifier>EISSN: 1573-3521</identifier><identifier>DOI: 10.1007/s10865-018-9924-9</identifier><identifier>PMID: 29671167</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Adverse ; Body mass index ; Care and treatment ; Childbirth & labor ; Clinical assessment ; Complications and side effects ; Data processing ; Depression (Mood disorder) ; Depression - blood ; Depression - prevention & control ; Depression, Postpartum - blood ; Development and progression ; Dietary Supplements ; Family Medicine ; Female ; General Practice ; Gestational age ; Health aspects ; Health Psychology ; Humans ; Low birth weight ; Medical screening ; Medicine ; Medicine & Public Health ; Mental depression ; Minority groups ; Obstetrics ; Perinatal factors ; Postpartum depression ; Postpartum period ; Postpartum Period - blood ; Pre-eclampsia ; Preeclampsia ; Pregnancy ; Pregnancy Complications - blood ; Pregnancy Complications - prevention & control ; Pregnant women ; Premature birth ; Prenatal care ; Prenatal depression ; Prenatal Diagnosis ; Prospective Studies ; Psychological aspects ; Risk factors ; Risk reduction ; Serum ; Small for gestational age ; Supplements ; Symptoms ; Vitamin D ; Vitamin D - blood ; Vitamin D deficiency ; Vitamin D Deficiency - blood ; Vitamin D Deficiency - diagnosis ; Vitamin deficiency ; Young Adult</subject><ispartof>Journal of behavioral medicine, 2018-10, Vol.41 (5), p.680-689</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Journal of Behavioral Medicine is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-5506ba197073b60dd971ec6c84cbef44320242c727b33ad243263ece274f014d3</citedby><cites>FETCH-LOGICAL-c477t-5506ba197073b60dd971ec6c84cbef44320242c727b33ad243263ece274f014d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10865-018-9924-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10865-018-9924-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,12846,27924,27925,30999,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29671167$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Accortt, Eynav Elgavish</creatorcontrib><creatorcontrib>Lamb, Amy</creatorcontrib><creatorcontrib>Mirocha, James</creatorcontrib><creatorcontrib>Hobel, Calvin J.</creatorcontrib><title>Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes</title><title>Journal of behavioral medicine</title><addtitle>J Behav Med</addtitle><addtitle>J Behav Med</addtitle><description>Prenatal vitamin D deficiency and prenatal depression are both separately associated with adverse perinatal outcomes; however, to our knowledge no studies have investigated the effects of having both risk factors. Our objective was to determine to what extent vitamin D deficiency predicts adverse perinatal outcomes and whether elevated depressive symptoms in pregnancy places women at additional increased risk. This study was a secondary data analysis of prospective data collected from a cohort of pregnant women (N = 101) in an obstetric clinic of a large medical center. Maternal vitamin D deficiency (serum 25(OH)D ≤ 20 ng/ml) and depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS) were assessed in early pregnancy. A composite of four adverse perinatal outcomes (low birth weight, preterm birth, small-for-gestational age, and preeclampsia) were abstracted from medical charts. Nineteen of the 101 women had one or more adverse perinatal outcome and 84% with an adverse outcome (16/19) were not White. Both prenatal and time of delivery vitamin D deficiency were associated with developing an adverse outcome compared to those vitamin D sufficient (prenatal relative risk 3.43; 95% CI 1.60–7.34,
p
= 0.004; delivery time relative risk 5.14, 95% CI 2.68–9.86,
p
= 0.004). These both remained significant after adjusting for BMI. A higher rate of adverse outcome was found when women had both prenatal vitamin D deficiency and elevated depressive symptoms (EPDS ≥ 10). Sixty percent with both risk factors had an adverse perinatal outcome versus 17% with only one or neither risk factor (relative risk 3.60; 95% CI 1.55–8.38,
p
= 0.045), worthy of investigation with larger samples. Together, prenatal vitamin D deficiency and elevated depressive symptoms in pregnancy may increase risk for adverse perinatal outcomes, especially in racial minorities. Obstetric providers should consider routine prenatal depression screening. The impact of vitamin D supplementation to reduce risk for adverse perinatal outcomes should be studied in prospective trials. Our results suggest that supplementation early in pregnancy might be especially beneficial for depressed women.</description><subject>Adult</subject><subject>Adverse</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Childbirth & labor</subject><subject>Clinical assessment</subject><subject>Complications and side effects</subject><subject>Data processing</subject><subject>Depression (Mood disorder)</subject><subject>Depression - blood</subject><subject>Depression - prevention & control</subject><subject>Depression, Postpartum - blood</subject><subject>Development and progression</subject><subject>Dietary Supplements</subject><subject>Family Medicine</subject><subject>Female</subject><subject>General Practice</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Health Psychology</subject><subject>Humans</subject><subject>Low birth weight</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental depression</subject><subject>Minority groups</subject><subject>Obstetrics</subject><subject>Perinatal factors</subject><subject>Postpartum depression</subject><subject>Postpartum period</subject><subject>Postpartum Period - blood</subject><subject>Pre-eclampsia</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - blood</subject><subject>Pregnancy Complications - prevention & control</subject><subject>Pregnant women</subject><subject>Premature birth</subject><subject>Prenatal care</subject><subject>Prenatal depression</subject><subject>Prenatal Diagnosis</subject><subject>Prospective Studies</subject><subject>Psychological aspects</subject><subject>Risk factors</subject><subject>Risk reduction</subject><subject>Serum</subject><subject>Small for gestational age</subject><subject>Supplements</subject><subject>Symptoms</subject><subject>Vitamin D</subject><subject>Vitamin D - blood</subject><subject>Vitamin D deficiency</subject><subject>Vitamin D Deficiency - blood</subject><subject>Vitamin D Deficiency - diagnosis</subject><subject>Vitamin deficiency</subject><subject>Young Adult</subject><issn>0160-7715</issn><issn>1573-3521</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1ks1u1DAUhS0EokPhAdigSGzYpPjf8bIqFJAqsQG2lmPfTF0ldrCTVvP2eDqFCjTIC8vX3zm6vj4IvSb4jGCs3heCOylaTLpWa8pb_QRtiFCsZYKSp2iDicStUkScoBel3GCMpeb6OTqhWipCpNqg6x9hsVOIzYfGwxBcgOh2jY2-HucMpYRbaMpumpc0laZytbiN9h7K0NhSkgt2Ad_cheW6sf4WcoFmhhyiXezYpHVxaYLyEj0b7Fjg1cN-ir5ffvx28bm9-vrpy8X5Veu4UksrBJa9JVphxXqJvdeKgJOu466HgXNGMeXUKap6xqyntSAZOKCKD5hwz07Ru4PvnNPPFcpiplAcjKONkNZiql4JrRiTFX37D3qT1hxrd3tKdoR1kj1SWzuCCXFIS7Zub2rOhehExymllWqPUFuIkO2YYh1tLf_Fnx3h6_IwBXdUQA4Cl1MpGQYz5zDZvDMEm30azCENpqbB7NNgdNW8eXjg2k_g_yh-f38F6AEo9SpuIT9O4P-uvwAojb2p</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Accortt, Eynav Elgavish</creator><creator>Lamb, Amy</creator><creator>Mirocha, James</creator><creator>Hobel, Calvin J.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20181001</creationdate><title>Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes</title><author>Accortt, Eynav Elgavish ; Lamb, Amy ; Mirocha, James ; Hobel, Calvin J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-5506ba197073b60dd971ec6c84cbef44320242c727b33ad243263ece274f014d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Adverse</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Childbirth & labor</topic><topic>Clinical assessment</topic><topic>Complications and side effects</topic><topic>Data processing</topic><topic>Depression (Mood disorder)</topic><topic>Depression - blood</topic><topic>Depression - prevention & control</topic><topic>Depression, Postpartum - blood</topic><topic>Development and progression</topic><topic>Dietary Supplements</topic><topic>Family Medicine</topic><topic>Female</topic><topic>General Practice</topic><topic>Gestational age</topic><topic>Health aspects</topic><topic>Health Psychology</topic><topic>Humans</topic><topic>Low birth weight</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental depression</topic><topic>Minority groups</topic><topic>Obstetrics</topic><topic>Perinatal factors</topic><topic>Postpartum depression</topic><topic>Postpartum period</topic><topic>Postpartum Period - blood</topic><topic>Pre-eclampsia</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - blood</topic><topic>Pregnancy Complications - prevention & control</topic><topic>Pregnant women</topic><topic>Premature birth</topic><topic>Prenatal care</topic><topic>Prenatal depression</topic><topic>Prenatal Diagnosis</topic><topic>Prospective Studies</topic><topic>Psychological aspects</topic><topic>Risk factors</topic><topic>Risk reduction</topic><topic>Serum</topic><topic>Small for gestational age</topic><topic>Supplements</topic><topic>Symptoms</topic><topic>Vitamin D</topic><topic>Vitamin D - blood</topic><topic>Vitamin D deficiency</topic><topic>Vitamin D Deficiency - blood</topic><topic>Vitamin D Deficiency - diagnosis</topic><topic>Vitamin deficiency</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Accortt, Eynav Elgavish</creatorcontrib><creatorcontrib>Lamb, Amy</creatorcontrib><creatorcontrib>Mirocha, James</creatorcontrib><creatorcontrib>Hobel, Calvin J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of behavioral medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Accortt, Eynav Elgavish</au><au>Lamb, Amy</au><au>Mirocha, James</au><au>Hobel, Calvin J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes</atitle><jtitle>Journal of behavioral medicine</jtitle><stitle>J Behav Med</stitle><addtitle>J Behav Med</addtitle><date>2018-10-01</date><risdate>2018</risdate><volume>41</volume><issue>5</issue><spage>680</spage><epage>689</epage><pages>680-689</pages><issn>0160-7715</issn><eissn>1573-3521</eissn><abstract>Prenatal vitamin D deficiency and prenatal depression are both separately associated with adverse perinatal outcomes; however, to our knowledge no studies have investigated the effects of having both risk factors. Our objective was to determine to what extent vitamin D deficiency predicts adverse perinatal outcomes and whether elevated depressive symptoms in pregnancy places women at additional increased risk. This study was a secondary data analysis of prospective data collected from a cohort of pregnant women (N = 101) in an obstetric clinic of a large medical center. Maternal vitamin D deficiency (serum 25(OH)D ≤ 20 ng/ml) and depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS) were assessed in early pregnancy. A composite of four adverse perinatal outcomes (low birth weight, preterm birth, small-for-gestational age, and preeclampsia) were abstracted from medical charts. Nineteen of the 101 women had one or more adverse perinatal outcome and 84% with an adverse outcome (16/19) were not White. Both prenatal and time of delivery vitamin D deficiency were associated with developing an adverse outcome compared to those vitamin D sufficient (prenatal relative risk 3.43; 95% CI 1.60–7.34,
p
= 0.004; delivery time relative risk 5.14, 95% CI 2.68–9.86,
p
= 0.004). These both remained significant after adjusting for BMI. A higher rate of adverse outcome was found when women had both prenatal vitamin D deficiency and elevated depressive symptoms (EPDS ≥ 10). Sixty percent with both risk factors had an adverse perinatal outcome versus 17% with only one or neither risk factor (relative risk 3.60; 95% CI 1.55–8.38,
p
= 0.045), worthy of investigation with larger samples. Together, prenatal vitamin D deficiency and elevated depressive symptoms in pregnancy may increase risk for adverse perinatal outcomes, especially in racial minorities. Obstetric providers should consider routine prenatal depression screening. The impact of vitamin D supplementation to reduce risk for adverse perinatal outcomes should be studied in prospective trials. Our results suggest that supplementation early in pregnancy might be especially beneficial for depressed women.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29671167</pmid><doi>10.1007/s10865-018-9924-9</doi><tpages>10</tpages></addata></record> |
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| ispartof | Journal of behavioral medicine, 2018-10, Vol.41 (5), p.680-689 |
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| source | MEDLINE; SpringerNature Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adult Adverse Body mass index Care and treatment Childbirth & labor Clinical assessment Complications and side effects Data processing Depression (Mood disorder) Depression - blood Depression - prevention & control Depression, Postpartum - blood Development and progression Dietary Supplements Family Medicine Female General Practice Gestational age Health aspects Health Psychology Humans Low birth weight Medical screening Medicine Medicine & Public Health Mental depression Minority groups Obstetrics Perinatal factors Postpartum depression Postpartum period Postpartum Period - blood Pre-eclampsia Preeclampsia Pregnancy Pregnancy Complications - blood Pregnancy Complications - prevention & control Pregnant women Premature birth Prenatal care Prenatal depression Prenatal Diagnosis Prospective Studies Psychological aspects Risk factors Risk reduction Serum Small for gestational age Supplements Symptoms Vitamin D Vitamin D - blood Vitamin D deficiency Vitamin D Deficiency - blood Vitamin D Deficiency - diagnosis Vitamin deficiency Young Adult |
| title | Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes |
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