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Nutr J. 2018 Nov 2;17(1):100. doi: 10.1186/s12937-018-0403-5.

In utero exposure to extra vitamin D from food fortification and the risk of subsequent development of gestational diabetes: the D-tect study.

Author information

1
Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark. amelie.cleo.keller@regionh.dk.
2
Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark.
3
Cardiovascular, Renal and Metabolic Disease (CVRM) Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden.
4
Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
5
Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
6
Research Unit for Chronic Conditions, Center of Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Capital Region, Frederiksberg, Denmark.
7
The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia.
8
The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
9
The Department of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark.

Abstract

BACKGROUND:

The primary aim of this study was to assess whether exposure during fetal life to extra vitamin D from food fortification was associated with a reduction in the risk of subsequently developing gestational diabetes mellitus (GDM). Furthermore, we examined whether the effect of the vitamin D from fortification differed by women's season of birth.

METHODS:

This semi-ecological study is based on the cancellation in 1985 of the mandatory policy to fortify margarine with vitamin D in Denmark, with inclusion of entire national adjacent birth cohorts either exposed or unexposed to extra vitamin D in utero. The identification of GDM cases later in life among both exposure groups was based on the Danish national health registers. Logistic regression analyses generating odds ratios (ORs) and 95% confidence intervals (95% CIs) were performed.

RESULTS:

Women who were prenatally exposed to the extra vitamin D from fortification tended to have a lower risk of subsequently developing GDM than unexposed women (OR 0.87, 95%CI 0.74,1.02, P = 0.08). When analyses were stratified by women's season of birth, exposed women born in spring had a lower risk of developing GDM compared to unexposed subjects (OR 0.68, 95%CI 0.50,0.94, p = 0.02).

CONCLUSION:

This study suggests that prenatal exposure to extra vitamin D from mandatory fortification may lower the risk of developing gestational diabetes among spring-born women.

TRIAL REGISTRATION:

This study is part of the D-tect project, which is registered on clinicaltrials.gov: NCT03330301 .

KEYWORDS:

Fetal programming; Food intake; Gestational diabetes mellitus; Public health epidemiology; Vitamin D

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