Serum PGF2 alpha levels during late pregnancy, labour and the puerperium

The serum prostaglandin (PG) F2alpha levels of women in the last trimester of pregnancy have been measured and compared with the levels found in samples taken during labor, during the 1st week postpartum, and from nonpregnant women. The laboratory procedures for drawing the samples and making the radioimmunoassay measurements are explained. 40 samples were taken during late pregnancy, 46 during labor, 7 during the 1st week postpartum, and 8 from nonpregnant women. The results are graphed. PGF2alpha levels during late pregnancy resemble those found in nonpregnant women. A significant rise (p.05) occurs during labor, most markedly during the late 1st stage. Levels during the 1st week postpartum were found to be very low. There was no difference between serum levels during the 33rd-36th weeks and those found during weeks 34-40. Serum levels did not differ according to whether labor was spontaneous, induced by artificial rupture of fetal membranes and infusion of Syntocinon, or merely accelerated by syntocinon infusion. This indicates that PG release occurs as a result of labor rather than as a triggering mechanism for the onset of labor. The highest levels of serum PGF2alpha seem to be associated with the time of greatest uterine activity and the period of greatest cervical stretching.     

Effect of prostaglandin F2 alpha on the secretion of human prolactin

This study examines the role of PGF2a (prostaglandin F2alpha) in increasing the secretion rate of human prolactin. 11 women (mean gestational period, 18 weeks) seeking pregnancy termination were divided into 4 groups: 1) Group 1 consisted of 6 women who received 30 mg initially of PGF2a injected intramuscularly and an additional 15 mg after 24 hours if abortion had not occured; mean induction to termination period was 38 hours; 2) Group 2 comprised of 3 women who received PGF2a (500-1500 ug) via the transcervical route at 1 to 2 hourly interval; average number of injections was 20; mean induction to termination period, 24 hours; 3) Group 3 had 2 women receiving hypertonic saline by intraamniotic injection; mean induction to termination period was 51 hours; 4) Group 4 had 4 women who served as controls; mean observation period, 20 hours. Venous blood samples were heparinized in tubes at intervals of 2 to 3 hours. A homologous radioimmunoassay using highly purified human prolactin (for iodination and standards) plus rabbit antihuman prolactin measured serum prolactin. Spikes of serum prolactin up to 550 ng/ml were observed at irregular intervals in 5 women in Group 1; the spikes were less frequent and of smaller amplitude in Groups 3 and 4. The increase in serum prolactin was dramatic and more sustained in Group 2 patients and peaked towards the end of the prostaglandin infusion. Serum prolactin of Group 2 patients were significantly higher than those of Groups 3 and 4 (p0.01). 5 of 9 women whose pregnancies were terminated by PGF2a lactated. However, there was no significant difference between the mean serum prolactin levels in women who lactated (136 ng/ml) and those who did not (120 ng/ml). Although PGF2a is not a lactogenic hormone, this study shows that PGF2a stimulates the secretion of human prolactin during second trimester pregnancy. The fact that the transcervical route caused a significant increase in serum prolactin and the intraamniotic route did not is attributed to the increased systemic absorption of PGF2a following transcervical administration. No correlation was seen between the presence or absence of lactation and the serum prolactin level following pregnancy termination with PGF2a.     

Amniotic fluid beta-2 microglobulin in normal and complicated pregnancies

Beta-2 microglobulin concentrations were measured in amniotic fluid samples obtained from normal pregnant women at various stages of gestation and complicated pregnancies during weeks 32-42 of gestation by the ELISA method. The concentration of beta-2 microglobulin in amniotic fluid increases markedly up to the 20-24th weeks of pregnancy and reaches a peak during the second trimester, occasionally reaching an eightfold value compared to the maternal serum concentration, while at term the values are similar. The decrease of amniotic fluid beta-2 microglobulin level in the third trimester reflects the maturation of foetal renal tubular function and suggests that this test may be of significance in determining foetal age. Our results revealing elevated concentrations of beta-2 microglobulin in patients with diabetes, toxaemia and placental insufficiency may indicate slower renal maturation of the foetus.     

Serum prolactin level changes in the maternal and fetal circulation between the 28th-40th weeks of pregnancy

Serum prolactin concentration was determined in blood samples taken from the maternal cubital vein, the umbilical vein and artery between the 28th-40th weeks of pregnancy from 108 parturients, of whom 74 gave birth prematurely and 34 gave birth at term. Results indicated that during this period the prolactin level rose in the umbilical vein and artery but not in the maternal vein. Correlative analysis showed a significant positive correlation between gestational age and the serum prolactin concentration of umbilical arterial and venous blood, but no correlation was found in the case of maternal blood. During the 28th-32nd weeks the prolactin level of maternal blood was found to be higher than that of umbilical blood while during the 33rd-36th weeks and at the 40th week the prolactin level was higher in the umbilical vein and artery. No correlation was found between the prolactin concentration of maternal and umbilical blood. On the basis of these results the authors conclude that fetal prolactin concentration changes occur independently of the maternal organism and increases during the 28th-40th weeks of pregnancy.     

Serum cortisol level changes in the maternal-fetoplacental unit between the 28th-40th weeks of pregnancy

Changes in the serum cortisol level of maternal venous, umbilical venous and umbilical arterial blood were studied separately between the 28th-36th weeks in cases of preterm deliveries (n = 74) and in the 40th week in cases of term delivery (n = 34). Results indicate that between the 28th-40th weeks of pregnancy the cortisol concentration increased only in the serum of the umbilical artery; the "umbilical arterial/umbilical venous concentration X100" quotient rose from a value of 86% measured at 28th-32nd weeks to 103% in the 40th week of pregnancy. Positive correlation was found between the cortisol concentration of the three samples. On the basis of these results the authors believe that fetal adreno-cortical activity increases before birth.     

Serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha in the induction of abortion.

Abortion was successfully induced in 62 of 68 patients in the 9th to the 26th week of pregnancy be serial intramuscular administration of 15(S)-15-methyl-prostaglandin F2alpha (15-ME-PGF2alpha). In 6 patients who failed to abort after 24 hours of prostaglandin administration, a concomitant infusion of oxytocin was initiated; 5 of these patients aborted within 12 hours of the combined therapy. A single patient failed to abort, even with the combined therapy, and underwent surgical evacuation. The mean abortion time in the 67 successful inductions was 14.56 hours. Parous patients aborted somewhat fasteter, mean 13.98 hours, as compared to nulliparous patients, mean 15.02 hours, but this difference was not statistically significant. In this study initial intramuscular injection of 100 mug 15-ME-PGF2alpha was followed in 1 hour by 250 mug and then 250 mug every 2 hours with concomitant oxytocin therapy initiated after 24 hours. The results with this dose schedule were compared to the results obtained in a previous study with a higher dose schedule, an initial dose of 100 mug 15-ME-PGF2alpha, followed in 1 hour by 250 mug then 500 mug every 2 hours. There was significant difference in the mean abortion time and the incidence of side effects between the 2 dose schedules. The mean abortion time for patients with gestational ages 16 weeks and less was the same with both dose schedules, however patients with gestational ages of 17 weeks and higher aborted somewhat faster with the higher dose schedule. It might therefore be advisable for patients with gestations of 17 weeks and higher to be treated with the higher dose schedule. In earlier gestations patients could be started on the lower schedule, and if abortion had not occurred within 15 hours the dose of 15-ME-PGF2alpha could then be increased to 500 mug every 2 hours.     

First-Trimester Maternal Serum Levels of sFLT1, PGF and ADMA Predict Preeclampsia

Background

Placental growth factor (PGF), soluble fms-like tyrosine kinase 1 (sFLT1) and asymmetric dimethylarginine (ADMA) are involved in the pathogenesis of preeclampsia. Abnormal maternal sFLT1, PGF and ADMA levels are detectable weeks before the onset of preeclampsia.

Objective

To investigate sFLT1, PGF and ADMA in the first trimester of pregnancy as predictors of preeclampsia.

Methods

In this prospective nested case-control study, 740 pregnant women enrolled at 12–16 weeks of gestation and followed up until 6 weeks after delivery at the Shanghai First Maternity and Infant Health Hospital of Tongji University between January 2010 and December 2012. Forty-four women developed preeclampsia. Urinary proteins were measured using 24-hour collection or dipsticks. sFLT1, PGF and ADMA were measured by ELISA in the first trimester. Pulsatility index (PI) was measured by Doppler ultrasound in the second trimester.

Results

First-trimester serum sFLT1 and ADMA levels of women who developed preeclampsia were significantly higher compared with women with normal pregnancies (sFLT1: 0.321±0.023 vs. 0.308±0.019 ng/ml, P = 0.001; ADMA: 0.86±0.16 vs. 0.68±0.20 μM, P<0.001). First-trimester serum PGF levels of women who developed preeclampsia were significantly lower than in women with normal pregnancies (115.72±32.55 vs. 217.30±74.48 pg/ml, P<0.001). Multiple logistic regression and receiver-operating characteristic curves identified first-trimester PGF and ADMA to be sensitive and selective predictors of preeclampsia (area under the curve [AUC]: 0.902), as well as second-trimester uterine artery pulse index (AUC: 0.836).

Conclusion

In the first trimester, maternal serum sFLT1, PGF and ADMA levels, as well as second-trimester uterine artery PI, could predict preeclampsia.     

Serum concentrations of secretory IgA in pregnancies delivering at term or preterm.

Secretory component (SC) is a phospholipase A2 inhibitor possibly associated with pregnancy maintenance and in serum is bound either to IgA (sIgA) or IgM (sIgM). To determine if serum secretory component levels a) increase during pregnancy, b) fall as term approaches, c) are low in women who will deliver prematurely, serum sIgA was measured at "booking in" and related to weeks of gestation and length of gestation at subsequent noninduced delivery. Levels of sIgA increased during pregnancy; sIgA increased from a non-pregnant value of 1.6 nM +/- 0.2 (mean +/- SEM) to 2.8 nM +/- 0.3 at the end of the second trimester, then fell significantly between 31-34 weeks. Delivery before 37 weeks was associated with significantly reduced serum sIgA levels, particularly in women who delivered before 32 weeks and in whom sIgA concentrations were similar to those of nonpregnant women.     

Bile acid and cholesterol excretion in the pregnant guinea pig: Studies on the hypercholesterolemia of pregnancy

The relationship of bile acid and cholesterol excretion to changes in plasma cholesterol during pregnancy were studied in guinea pigs. Plasma cholesterol level increased in the first trimester of pregnancy, reached to a peak during the second trimester and decreased in the third trimester reaching the lowest level at one week prior to parturition. Cholesterol level returned to the control level after parturition. Plasma triglyceride level followed a similar trend attaining peak values at second trimester and gradually returned to the control level at the third trimester of pregnancy. Bile acid and total sterol excretion were significantly higher in guinea pigs during the last phase of pregnancy while they remained unchanged during early stage of pregnancy.     

Intramuscular prostaglandin (15S)-15-methyl PGF2α (THAM) in midtrimester abortion

Elective termination of second trimester pregnancies in 63 patients by means of intramuscular prostaglandin (15S)-15-Methyl PGF2α (THAM) is reported. In 44 of 61 cases with a successful outcome the duration of pregnancy calculated from a last normal menstrual period was between 13 and 17 weeks. An overall success rate of 96.8 percent was achieved; and this agent and method warrant further clinical evaluation.     

Serum level of 19-hydroxyandrostenedione during pregnancy and at delivery determined by gas chromatography/mass spectrometry

19-Hydroxyandrostenedione (19-OHA) is secreted from the adrenal glands in men and women and also from the placenta during pregnancy. It has been found to cause hypertension in animal models. We have synthesized [7,7-2H2]-19-OHA with high deuterium content and, together with [7,7-2H2]A and [9,11-2H2]estrone (E1), have developed a quantitative assay of serum level 19-OHA, A, and E1 using the gas chromatography/mass spectrometry-mass fragmentography method to monitor individual subjects throughout pregnancy. The labeled 19-OHA, used as internal standard, showed only 6.73% of unlabeled compound. Recovery of standard 19-OHA, A, and E1 (5,000 pg each) added to male plasma was 97.4 +/- 2.3%, 96.3 +/- 2.1%, and 100.1 +/- 4.1% (mean +/- SD), respectively; the intraassay coefficient of variation was 2.1%, 3.5%, and 3.8%, respectively. Ten pregnant subjects without complications and 10 pregnant subjects near term with hypertension were selected (with informed consent). The 19-OHA and E1 serum concentrations of maternal venous blood from uncomplicated pregnancies increased significantly as gestation progressed (19-OHA: first trimester, 225 +/- 72; second trimester, 656 +/- 325; third trimester, 1,518 +/- 544 pg/ml), reaching the highest level at delivery (19-OHA: 1,735 +/- 684 pg/ml). Whereas a positive correlation was found between the level of 19-OHA and E1, no apparent change of the A level was observed during pregnancy. Levels of the three steroid hormones in pregnancy complicated by hypertension in the second and third trimester were not found to be significantly different from those of normal pregnancy (19-OHA of hypertensive subjects: second trimester, 762 +/- 349; third trimester, 1,473 +/- 491 pg/ml).(ABSTRACT TRUNCATED AT 250 WORDS)     

Changes in estrogen levels in maternal venous plasma after intra-amniotic infusion of prostaglandin F2 for therapeutic abortion

Peripheral plasma levels of estrone, estradiol-17beta and estriol were measured by the method of Shutt and Cox in 10 women following intra-amniotic infusion of prostaglandin F2alpha (PGF2a) for therapeutic abortion. Initial dose was 30 mg, followed if necessary, by doses of 15 mg at 24 hours and 42 hours. Gestational age of pregnancies ranged from 14 to 19 weeks, with a mean of 16 weeks. All 10 women completely aborted. Mean induction-abortion interval was 24 + or - 12 hours. The mean estrone, estradiol 17beta and estriol levels declined to about half of the pre-infusion levels after 80% of the induction-abortion interval had elapsed. The main decline in estrogen levels occurred in individual women either during the 1st quarter or during the last quarter of the induction-abortion interval. There were no significant relationships between changes in estrogen levels and the interval from 1st administration of PGF2a to subsequent abortion.     

Maternal thyroid function in early and late pregnancy.

Thyroid function was investigated during and after pregnancy in 12 healthy euthyroid women. During pregnancy, serum total T4 (TT4) levels were significantly elevated and nearly stable, while thyroxine-binding globulin (TBG) levels progressively increased till the 7th month. A slight elevation, though not significant, of free T4 (fT4) was recorded in early pregnancy. In the following months, fT4, free T3 (fT3) and the T4/TBG ratio progressively diminished, reaching a plateau at the 7th month. Serum TSH levels, measured by an ultrasensitive immunofluorometric assay, were comparable to postpartum values during the first trimester and showed a moderate upward trend with the progression of pregnancy. The evaluation of 24-hour TSH profiles was performed in 5 women during the first trimester of pregnancy. In all women, the circadian rhythm of TSH was present with a normal nocturnal surge, though anticipated in 1 case. In summary (1) during the first trimester of pregnancy, the increased thyroid activity does not seem to be only sustained by pituitary TSH which remains unmodified; the negative correlation between TSH and hCG levels might suggest that hCG also stimulates the gland to increase thyroid hormone output, and the presence of a normal TSH circadian rhythm indicates that the central mechanism of neuroregulation of the pituitary-thyroid axis is preserved in early pregnancy, and (2) in late pregnancy, a marked decrease in free thyroid hormone fractions is accompanied by serum TSH levels still in the normal range, indicating a modification of thyroid homeostasis which might recognize various etiological factors.     

Pregnancy-associated inflammatory markers are elevated in pregnant women with systemic lupus erythematosus

During normal pregnancy a dampening in T cell-mediated immunity is compensated by an increased pro-inflammatory activity. Likewise, the autoimmune disease systemic lupus erythematosus (SLE) is associated with inflammatory activity and pregnancy complications occur frequently in women with SLE. The aim of this study was to elucidate how SLE influences the chemokine and cytokine balance during and after pregnancy. Blood samples were taken from pregnant women with or without SLE at second and third trimester and 8-12 weeks after pregnancy. Cytokines (interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-10, IL-12p70, IL-17A, TNF, IFN-γ and IFN-α), chemokines (CXCL8/IL-8, CXCL9/MIG, CXCL10/IP-10, CCL2/MCP-1, CCL5/RANTES and CCL17/TARC), soluble IL-6 receptor (sIL-6R) and soluble glycoprotein 130 (gp130) were measured in serum using cytometric bead array (CBA) or enzyme-linked immunosorbent assay (ELISA). Women with SLE had increased serum concentrations of CXCL8/IL-8, CXCL9/MIG, CXCL10/IP-10 and IL-10 compared to controls both during and after pregnancy. Further, when dividing the patients based on disease activity, the women with active disease had the highest levels. Importantly, women with SLE seemed to respond to pregnancy in a similar way as controls, since the changes of cytokines and chemokines over the course of pregnancy were similar but with overall higher levels in the patient group. In conclusion, changes in pro- and anti-inflammatory serum components during pregnancy in women with SLE, occurring on top of already more pro-inflammatory levels, might increase their risk for pregnancy complications and flares. How their children are affected by this heightened inflammatory milieu during pregnancy needs further investigation.     

Antibodies against beta 2-glycoprotein I (beta 2-GP I) and their relationship to fetoplacental antigens

Binding of beta 2-GP I to anionic phospholipids is thought to be the major antigen required in the reaction of anticardiolipin antibodies to phospholipids. The aim of this study was to investigate the changes of anti-beta 2-GP I IgG during the first and second trimester of pregnancy and the relationship between the levels of anti-beta 2-GP I and fetoplacental antigens and the correlation between anti-beta 2-GP I IgG and antibodies against oxidized low-density lipoprotein IgG (oLAb) in serum of pregnant women. We determined anticardiolipin antibodies (ACA) IgG and maternal serum levels of alpha 1-fetoprotein (AFP), human chorionic gonadotrophin (HCG) and trophoblast-specific beta 1-glycoprotein (SP1) in 204 pregnant women in the first and second trimester. From this group we selected 52 serum samples positive for ACA IgG and 16 samples negative for ACA IgG. In the samples of selected patients, the levels of anti-beta 2-GP I IgG and oLAb IgG were determined. Anti-beta 2-GP I IgG levels significantly decreased in the second trimester (6.2+/-9.3 U/ml, mean +/- S.D.) in comparison with the first trimester (8.3+/-10.4 U/ml) (p=0.05). Multiple of median (MoM) AFP correlated negatively but not significantly in the first trimester with anti-beta 2-GP I (r = -0.261, p = 0.12). In the second trimester this correlation was significantly negative (r = -0.278, p = 0.04). The Spearman correlation coefficients for MoM HCG and anti-beta 2-GP I were 0.158 for the first trimester and 0.174 for the second trimester. MoM SP1 also did not correlate significantly with anti-beta 2-GP I in both trimesters. The correlation between anti-beta 2-GP I IgG and oLAb IgG was not significant (r = -0.06). In the first trimester 40 % serum samples were positive for anti-beta 2-GP I IgG and negative for oLAb IgG or vice versa, while 60 % samples in the second trimester were positive only for one determined autoantibody. We can conclude that the levels of anti-beta 2-GP I IgG decrease during the second trimester probably as the result of the effects of some immunosuppressive agents associated with pregnancy. The finding of negative correlation between AFP and anti-beta 2-GP I suggests that anti-beta 2-GP I has an influence on fetus development.     

Low polarity ligands of sex hormone-binding globulin in pregnancy. Part I--Characterization

Certain previously unidentified substances of low polarity binding to the sex hormone binding globulin (SHBG) in pregnancy were investigated. This material consisted of four major peaks (designated 1a, 1b, 2 and 3) as defined in maternal serum on Sephadex LH-20 chromatography. They were characterized with respect to changes in their concentration at various gestational ages and at premature and term labour in maternal serum, cord serum, placenta and maternal urine. Levels were much higher in placenta than in serum, suggesting that all four peaks were of placental origin. In the serum of mothers not in labour, while there was a significant increase in the mean serum concentration of peak (1a + 1b) and peak 3 for 12-24 weeks to 30-38 weeks gestation, there was no significant difference in the mean level of peak 2. However, there was a significant decrease in the serum levels of peak 2, but not peaks (1a + 1b) and 3, from 30-38 weeks gestation to 39-41 weeks gestation (P less than or equal to 0.05). In the serum of mothers in premature labour (30-38 weeks gestation), the levels of peak 2 but not those of peak (1a + 1b) and 3, were decreased (P less than or equal to 0.01) compared to those not in labour. These findings are consistent with the identification of peak 1a as 5 alpha-dihydroprogesterone, peak 1b as progesterone and peak 3 as 2-methoxyestrone as described in part 2. The decrease in the levels of peak 2 (for which the identification remains unconfirmed) in association with premature and impending term spontaneous labour suggest that it may be involved in the maintenance of pregnancy.     

圈养雌性非洲象妊娠期尿中性激素水平的变化

非洲象(Loxodonta africana)属于哺乳纲、长鼻目、象科、非洲象属,主要分布于非洲东部、中部、西部、西南部和东南部等广大地区,目前在世界大部分地区都有人工圈养.非洲象没有固定的发情季节,常年均可交配繁殖,雌兽的怀孕期为21 ～23个月,略长于亚洲象,是哺乳动物中孕期最长的动物.     

Ultrasonographic fetometry and prenatal fetal sex assessment in camels (Camelus dromedarius)

The aims of this study were to determine the developmental patterns of some fetal parts to achieve a high accuracy level in the assessment of gestational age and to assess the feasibility and accuracy of ultrasonic prenatal fetal sex assessment in camels. Serial ultrasonographic examinations were carried out on seven pregnant dromedary camels. A total of 329 ultrasonographic examinations were conducted between the second and the 54th weeks of pregnancy. Intrauterine fluid accumulation was detected between the second and third weeks of pregnancy. The embryo proper was noticed between the third and fourth weeks. Organization of the embryo was first observed between the sixth and seventh weeks. Ossification was first detected between the seventh and ninth weeks. The accessibility during the total gestational period was 35/329 (10.6%) for crown-rump length, 35/329 (10.6%) for biparietal diameter, 42/329 (12.8%) for abdominal diameter, 42/329 (12.8%) for ruminal length, and 126/329 (38.3%) for eyeball diameter. A high correlation was found between gestational age and each of the studied parameters (P < 0.0001). The highest correlation was found with the crown-rump length and the biparietal diameter during the first trimester and with the eyeball diameter during the third trimester of pregnancy. The overall accuracy of the ultrasonic prenatal fetal sex assessment was 91.7%. The best window was found during the 11th week of pregnancy. It was concluded that sonographic fetometry can be useful for the evaluation of fetal development, the estimation of gestational age, and the prediction of prenatal fetal sex in camels.     

Changes in circulating inhibin levels during pregnancy and early lactation in the Japanese monkey

Changes in immunoreactive (ir-) inhibin concentrations in serum throughout pregnancy and early lactation up to one month after parturition were characterized in 6 Japanese monkeys (Macaca fuscata fuscata) by a heterologous radioimmunoassay (RIA) based on a bovine RIA. Serum levels of FSH, LH/monkey chorionic gonadotropin (mCG), estradiol-17 beta, and progesterone were also monitored for the entire period. Ir-inhibin levels in the serum were low (under 0.5 ng/ml) before conception. Three marked increases in serum ir-inhibin levels were found during pregnancy. The first increase was noted during early pregnancy, with a peak (2.2 +/- 0.2 ng/ml) at Day 22 of pregnancy (Day 0 = day of LH surge). The second increase was noted after Day 38 until Day 72 of pregnancy, when a peak value was noted (19.0 +/- 1.4 pg/ml). Plateau levels were maintained until late pregnancy, and a final rise was evident near the term with a peak (36.7 +/- 3.8 ng/ml) at Day 158 of pregnancy, 5 days before parturition. After parturition, ir-inhibin levels in the serum plummeted to nonpregnant levels within one day, and were maintained during early lactation. The first rise in serum inhibin during pregnancy was parallel to the rise of mCG and estradiol-17 beta, and the second and third rise were well correlated with serum estradiol-17 beta. Serum FSH was maintained at low levels throughout pregnancy, followed by a slight increase after parturition when serum inhibin decreased abruptly. Both bioactivity and immunoreactivity of inhibin were detected in the placental homogenates obtained at 120 days of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)     

Maternal Serum and Breast Milk Vitamin D Levels: Findings from the Universiti Sains Malaysia Pregnancy Cohort Study

Background

Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels.

Methods

Data was obtained from the Universiti Sains Malaysia Pregnancy Cohort Study. This study was conducted from April 2010 to December 2012 in the state of Kelantan, Malaysia. Blood samples from pregnant women aged 19 to 40 years were drawn in the second and third trimesters of pregnancy, while breast milk samples at delivery, 2, 6 and 12 months postpartum were collected to analyze for 25(OH)D levels. A total of 102 pregnant women were included in the analysis.

Results

Vitamin D deficiency [25(OH)D <50 nmol/L] was detected in 60% and 37% of women in the second and third trimesters of pregnancy, respectively. There were 6% and 23% of women who reached normal level of vitamin D status in the second trimester and the third trimester, respectively. Multivitamin intakes during pregnancy were significantly associated with higher serum 25(OH)D levels in the second trimester (β = 9.16, p = 0.005) and the third trimester (β = 13.65, p = 0.003). 25(OH)D levels in breast milk during the first year of lactation ranged from 1.01 to 1.26 nmol/L. Higher maternal serum 25(OH)D level in the second trimester of pregnancy was associated with an elevated level of 25(OH)D in breast milk at delivery (β = 0.002, p = 0.026).

Conclusions

This study shows that high proportions of Malay pregnant women are at risk of vitamin D deficiency. Maternal vitamin D status in the second trimester of pregnancy was found to influence vitamin D level in breast milk at delivery.