Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: The growing up in Singapore towards healthy outcomes study

the GUSTO Study Group

doi:10.1371/journal.pone.0142239

Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: The growing up in Singapore towards healthy outcomes study

the GUSTO Study Group

KK Research Centre
KK Women's and Children's Hospital
Duke-National University of Singapore Medical School
Allergy Service
School of Psychology
University of New South Wales
Agency for Science, Technology and Research, Singapore
Department of Obstetrics and Gynaecology
National University of Singapore
Division of Obstetrics and Gynaecology
Department of Maternal Fetal Medicine
Developmental Epigenetics Group
The University of Auckland
MRC Lifecourse Epidemiology Unit
NIHR Southampton Biomedical Research Centre
University Hospital Southampton NHS Foundation Trust
Saw Swee Hock School of Public Health
Institute for Social Medicine
Charité – Universitätsmedizin Berlin
Department of Ophthalmology
Department of Pediatrics
Department of Reproductive Medicine
Department of Neonatology
Department of Biomedical Engineering
Clinical Imaging Research Centre
Singapore National Eye Center
Department of Diagnostic Radiology
Dental Service
Department of Opthalmology
National University Hospital
Department of Preventive Dentistry
MRC Life-course Epidemiology Unit
University of Southampton
Mental Wellness Service
Department of Paediatrics
Department of Psychology
School of Social Sciences
Singapore Management University
Department of Diagnostic Imaging
Growth
Program in Neuroscience and Behavioral Disorders
Division of Sleep and Circadian Disorders
Brigham and Women’s Hospital
Division of Sleep Medicine
Harvard University
Department of Neonatology
Department of Diagnostic Imaging
Department of Psychiatry and Neurology and Neurosurgery
McGill University
Respiratory Medicine Service
Life Sciences Institute
Division of Paediatric Neurology
MOH Holdings Pte Ltd.
Department of Child Development
Department of Nutrition and Dietetics
Center for Quantitative Medicine
Department for International Health
Tampere University
Medicine Dean's Office

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.

Original language	English
Article number	e0142239
Journal	PLoS ONE
Volume	10
Issue number	11
DOIs	https://doi.org/10.1371/journal.pone.0142239
Publication status	Published - 1 Nov 2015
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1371/journal.pone.0142239

Association-of-maternal-vitamin-d-status-with-glucose-tolerance-and-caesarean-section-in-a-multi-ethnic-asian-cohort.pdfFinal published version, 702 KBLicence: CC BY

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@article{ddec9d8d6f53443a85d1adf663d3a775,

title = "Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: The growing up in Singapore towards healthy outcomes study",

abstract = "Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3\%) women had 25OHD inadequacy. Of these, 131 (33.8\%), 155 (39.9\%) and 102 (26.3\%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95\% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95\% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95\% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95\% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95\% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.",

author = "\{the GUSTO Study Group\} and Loy, \{See Ling\} and Ngee Lek and Fabian Yap and Soh, \{Shu E.\} and Natarajan Padmapriya and Tan, \{Kok Hian\} and Arijit Biswas and Yeo, \{George Seow Heong\} and Kenneth Kwek and Gluckman, \{Peter D.\} and Godfrey, \{Keith M.\} and Saw, \{Seang Mei\} and Falk M{\"u}ller-Riemenschneider and Chong, \{Yap Seng\} and Chong, \{Mary Foong Fong\} and Chan, \{Jerry Kok Yen\} and Allan Sheppard and Amutha Chinnadurai and Goh, \{Anne Eng Neo\} and Anne Rifkin-Graboi and Anqi Qiu and Lee, \{Bee Wah\} and Broekman, \{Birit F.P.\} and Quah, \{Boon Long\} and Borys Shuter and Chng, \{Chai Kiat\} and Cheryl Ngo and Hsu, \{Stephen Chin Ying\} and Bong, \{Choon Looi\} and Henry, \{Christiani Jeyakumar\} and Chee, \{Cornelia Yin Ing\} and Doris Fok and Hazel Inskip and Helen Chen and \{Van Bever\}, \{Hugo P.S.\} and Iliana Magiati and Wong, \{Inez Bik Yun\} and Lau, \{Ivy Yee Man\} and Jeevesh Kapur and Richmond, \{Jenny L.\} and Holbrook, \{Joanna D.\} and Gooley, \{Joshua J.\} and Krishnamoorthy Niduvaje and Leher Singh and Su, \{Lin Lin\} and Mary Daniel and Shek, \{Lynette Pei Chi\} and Fortier, \{Marielle V.\} and Mark Hanson and Mary Rauff and Chua, \{Mei Chien\} and Michael Meaney and Tint, \{Mya Thway\} and Teoh, \{Oon Hoe\} and Wong, \{Peng Cheang\} and Pratibha Agarwal and \{Van Dam\}, \{Rob M.\} and Rebello, \{Salome A.\} and Chong, \{Shang Chee\} and Shirong Cai and Lim, \{Sok Bee\} and Rajadurai, \{Victor Samuel\} and Walter Stunkel and Han, \{Wee Meng\} and Pang, \{Wei Wei\} and Goh, \{Yam Thiam Daniel\} and Cheung, \{Yin Bun\} and Chan, \{Yiong Huak\} and Lee, \{Yung Seng\}",

note = "Publisher Copyright: {\textcopyright} 2015 Loy et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2015",

month = nov,

day = "1",

doi = "10.1371/journal.pone.0142239",

language = "English",

volume = "10",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "11",

}

TY - JOUR

T1 - Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort

T2 - The growing up in Singapore towards healthy outcomes study

AU - the GUSTO Study Group

AU - Loy, See Ling

AU - Lek, Ngee

AU - Yap, Fabian

AU - Soh, Shu E.

AU - Padmapriya, Natarajan

AU - Tan, Kok Hian

AU - Biswas, Arijit

AU - Yeo, George Seow Heong

AU - Kwek, Kenneth

AU - Gluckman, Peter D.

AU - Godfrey, Keith M.

AU - Saw, Seang Mei

AU - Müller-Riemenschneider, Falk

AU - Chong, Yap Seng

AU - Chong, Mary Foong Fong

AU - Chan, Jerry Kok Yen

AU - Sheppard, Allan

AU - Chinnadurai, Amutha

AU - Goh, Anne Eng Neo

AU - Rifkin-Graboi, Anne

AU - Qiu, Anqi

AU - Lee, Bee Wah

AU - Broekman, Birit F.P.

AU - Quah, Boon Long

AU - Shuter, Borys

AU - Chng, Chai Kiat

AU - Ngo, Cheryl

AU - Hsu, Stephen Chin Ying

AU - Bong, Choon Looi

AU - Henry, Christiani Jeyakumar

AU - Chee, Cornelia Yin Ing

AU - Fok, Doris

AU - Inskip, Hazel

AU - Chen, Helen

AU - Van Bever, Hugo P.S.

AU - Magiati, Iliana

AU - Wong, Inez Bik Yun

AU - Lau, Ivy Yee Man

AU - Kapur, Jeevesh

AU - Richmond, Jenny L.

AU - Holbrook, Joanna D.

AU - Gooley, Joshua J.

AU - Niduvaje, Krishnamoorthy

AU - Singh, Leher

AU - Su, Lin Lin

AU - Daniel, Mary

AU - Shek, Lynette Pei Chi

AU - Fortier, Marielle V.

AU - Hanson, Mark

AU - Rauff, Mary

AU - Chua, Mei Chien

AU - Meaney, Michael

AU - Tint, Mya Thway

AU - Teoh, Oon Hoe

AU - Wong, Peng Cheang

AU - Agarwal, Pratibha

AU - Van Dam, Rob M.

AU - Rebello, Salome A.

AU - Chong, Shang Chee

AU - Cai, Shirong

AU - Lim, Sok Bee

AU - Rajadurai, Victor Samuel

AU - Stunkel, Walter

AU - Han, Wee Meng

AU - Pang, Wei Wei

AU - Goh, Yam Thiam Daniel

AU - Cheung, Yin Bun

AU - Chan, Yiong Huak

AU - Lee, Yung Seng

N1 - Publisher Copyright: © 2015 Loy et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.

AB - Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.

UR - https://www.scopus.com/pages/publications/84957112266

U2 - 10.1371/journal.pone.0142239

DO - 10.1371/journal.pone.0142239

M3 - Article

C2 - 26571128

AN - SCOPUS:84957112266

SN - 1932-6203

VL - 10

JO - PLoS ONE

JF - PLoS ONE

IS - 11

M1 - e0142239

ER -

Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: The growing up in Singapore towards healthy outcomes study

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