Black women are at higher risk for vitamin D deficiency due to increased melanin, which inhibits vitamin D absorption and metabolism while protecting against harmful UV rays, the researchers wrote. According to the National Health and Nutrition Examination Survey (NHANES), 72% of the non-Hispanic black population was vitamin D deficient.
“In 2021, the disparity in preterm birth (PTB) for non-Hispanic black women was twice as high (14.8%) compared to non-Hispanic white women (9.5%), with a sustained increase in risk after decades of “, the researchers added. “Large epidemiological studies have not shown that higher socioeconomic status, maternal education, or insurance coverage improve PTB risk in Black women. No intervention observed.”
Additionally, pregnant women who are deficient in vitamin D are at increased risk of developing depressive symptoms during pregnancy and the postpartum period. Previous research also suggests that pregnant black women with more depressive symptoms are at higher risk for PTB than black women without depressive symptoms.
highest rate of preterm birth
This study investigated whether vitamin D deficiency in early pregnancy increases the risk of PTB in late pregnancy in a cohort of black women, controlling for other variables.
Data for this study were obtained from a subset of the Biosocial Influences on Black Birth (BIBB) study. The BIBB study was funded by the National Institutes of Health and recruited pregnant black women from two geographically distinct locations in the Midwest. The researchers recruited participants from December 2017 to March 2020, but the study was put on hold due to the coronavirus pandemic.
BIBB refers to women who identify as African American or Black, are between 18 and 45 years of age, are pregnant with one baby at a time, are registered between 8 and 29 weeks of pregnancy, and are literate. participated in the research. She writes English. Researchers took blood samples from 57 women with PTB two to three times during pregnancy and had them fill out pregnancy questionnaires.
Women with serum 25(OH)D < 20 ng/mL were 2.1 times more likely to develop PTB before 34 weeks after adjusting for maternal race, prepregnancy BMI, and other important variables .
The researchers measured symptoms of depression using the Center for Epidemiological Studies Depression Scale (CES-D). They also included participants with a diagnosis of hypertensive disorders during pregnancy, including pre-eclampsia, eclampsia, gestational hypertension, pre-pregnancy hypertension, and superimposed pre-eclampsia (pre-pregnancy hypertension with onset of pre-eclampsia). was identified.
“Plasma vitamin D deficiency during pregnancy was a significant predictor of PTB in our cohort of black women, after controlling for depressive symptoms and hypertensive syndrome of pregnancy (HDP),” the researchers wrote. . “Vitamin D deficiency was more strongly associated with PTB after controlling for HDP, which is the main cause of non-spontaneous (medically indicated) PTB.” Supports the need to develop approaches to D supplementation. Research is needed on how to utilize supplements more effectively and efficiently, especially among black women who are most vulnerable to vitamin D deficiency and have the highest rates of PTB. .”
Dr. Kecia Gaither, a dual board-certified physician in obstetrics and gynecology and maternal-fetal medicine, is director of perinatal services at NYC Health + Hospitals/Lincoln in the Bronx, New York. Gaither is also a scientific advisory member of the Organic & Natural Health Association, which has conducted extensive research with physicians on vitamin D education. She said this study reiterates the importance of vitamin D supplementation for pregnant women of color.
“Vitamin D is produced in the skin through exposure to sunlight, so this finding does not surprise us,” said Gaither, who was not part of the research team but reviewed the findings. “D deficiency occurs when melanin inhibits vitamin D production in the skin. Vitamin D, a valuable fat-soluble vitamin, plays an important role in a variety of bodily functions.”
As a maternal-fetal medicine specialist, Gaither serves South Bronx residents, approximately 98% of whose population is from Africa, which faces a high burden of economic challenges and adverse perinatal outcomes. She is a melanin-pigmented woman from the Hispanic and Hispanic diaspora.
“Vitamin D supplementation is essential to my patient care,” she said. “I consider vitamin D to be a wonder vitamin, an inexpensive yet invaluable asset to the body. This study focused on a specific population of black women and is associated with a wide range of morbidity and mortality rates. This highlights the significant impact of vitamin D on a demographic affected by the disease.”
However, the researchers added: “Multiple randomized controlled trials (RCTs) have been conducted to assess whether vitamin D supplementation can improve the risk of PTB and preeclampsia. Results are conflicting. Nonuniform doses of the vitamin D-supplement use and flawed study design have plagued supplement trials to date… Even in RCTs, full treatment/supplement doses (i.e., 400 IU) have rarely been used. Timing of D supplementation and focusing on people with severe vitamin D deficiency may also be important factors in reducing the risk of PTB.”
Twice the recommended supplements
There is ample evidence that vitamin D-related genetic mutations have a significant impact on vitamin D metabolism and may be associated with PTB. People of African descent often carry the homozygous 1F allelic mutation of the VDBP gene, and based on research on vitamin D supplementation, people with this mutation are less likely to achieve normal vitamin D levels. You need almost twice the recommended supplements. This is clinically important and may explain why vitamin D supplementation trials have yielded conflicting results, the researchers wrote.
“While we have typically used a one-size-fits-all approach to nutritional supplementation, achieving improved outcomes incorporates precision medicine approaches and individualized supplementation based on diet and genotype. may be necessary,” they added. “The results of this study indicate that vitamin D status in black women may be an important biomarker for further research.”
sauce: nutrients
“The status of vitamin D as a significant predictor of preterm birth in a cohort of black women.”
Doi: doi.org/10.3390/nu15214637
Author: Jennifer Wu et al.
