Research On The Correlation Between Maternal Vitamin D Levels And Neonatal Congenital Heart Disease

ObjectiveBy measuring and analyzing the serum 25(OH)D concentrations of pregnant women and neonates,the vitamin D levels of pregnant women and neonates were investigated.The related factors of the serum 25(OH)D concentrations of neonates were studied.The correlation between maternal vitamin D levels in early pregnancy and the prevalence of neonatal congenital heart disease was discussed,and other related factors of congenital heart disease of neonates were analyzed.MethodsA case-control study was performed in pregnant women and neonates from Lanzhou University First Hospital between September 2020 and September 2021.The serum 25(OH)D concentrations were tested by ELISA to evaluate the vitamin D nutritional status of pregnant women and neonates.We analyzed the related factors of neonatal serum 25(OH)D concentrations.For mathers,a serum 25(OH)D level≤20ng/ml was defined deficiency,a serum 25(OH)D level ≤30ng/ml and >20ng/ml was defined insufficiency,a serum 25(OH)D level > 30ng/ml was defined sufficient.As for neonates,a serum 25(OH)D level ≤15ng/ml was defined deficiency,a serum 25(OH)D level ≤20ng/ml and > 15ng/ml was defined insufficiency,a serum 25(OH)D level >20ng/ml was defined sufficient.All neonates in the study were screened for congenital heart disease after birth,and the neonates whose screenings were positive needed to examine echocardiography by cardiology specialists.The diagnostic criteria of congenital heart disease in neonates was defined according to China Birth Defects Monitoring Program and China Birth Defects Monitoring System-Reporting Guidelines for Difficult and Minor Anomalies.We analyzed the correlation between maternal serum 25(OH)D concentrations in early pregnancy and the prevalence of neonatal congenital heart disease,and studied other related factors of neonatal congenital heart disease.SPSS 26.0 was used for statistical analysis.Independent sample T-test or rank-sum test were used for measurement data according to whether the data conformed to normal distribution,and chi-square test was used for counting data.Linear regression analysis and Logistic regression analysis were used to conduct cross-sectional analysis of correlation and related influencing factors.ROC curve method was used to explore the predictive value of maternal factors on neonatal congenital heart disease and determine the optimal threshold.Results1.A total of 457 mother-infant pairs were enrolled.The serum 25(OH)D concentrations of mothers in early and middle pregnancy were(10.92±6.73)ng/ ml and(14.73±7.79)ng/ ml.96.5% of mothers had vitamin D deficiency and insufficiency in early pregnancy.94.5% of mothers had vitamin D deficiency and insufficiency in middle pregnancy.The 25(OH)D concentrations of neonatal cord blood were(15.80±3.74)ng/ml.81.7% of the neonates had vitamin D deficiency and insufficiency.Linear regression analysis showed birth weight was a significant factor affecting neonatal serum 25(OH)D concentrations.Logistic regression analysis showed maternal prenatal BMI was negatively correlated with vitamin D deficiency and insufficiency in neonates(OR=0.920,95%CI: 0.856?0.989,P<0.05).2.According to whether the neonates had congenital heart disease,there were 83 neonates in congenital heart disease group and 374 neonates in non-congenital heart disease group.Logistic regression analysis showed the preconception BMI of the pregnant women was positively correlated with the prevalence of congenital heart disease(OR=1.096,95%CI: 1.004?1.197,P<0.05),history of adverse pregnancy was an independent risk factor for congenital heart disease(OR=10.403,95%CI:4.383 ? 24.691,P < 0.001),the serum 25(OH)D concentrations in early pregnancy(OR=0.893,95%CI: 0.837 ? 0.953,P < 0.05),gestational age of neonates(OR=0.716,95%CI: 0.629 ? 0.815,P < 0.001)were negatively correlated with the prevalence of congenital heart disease.When the receiver operating characteristic curve for maternal preconception BMI was used to predict congenital heart disease in neonates,the area under the curve was 0.623(95%CI: 0.562?0.684,P<0.001).The sensitivity and specificity of maternal preconception BMI≥21.57 to predict congenital heart disease in neonates were 72% and 52%,respectively.When the receiver operating characteristic curve for matanal serum 25(OH)D concentrations in early pregnancy was used to predict congenital heart disease in neonates,the area under the curve was0.607(95%CI: 0.541 ? 0.672,P < 0.05).The sensitivity and specificity of maternal serum 25(OH)D concentrations in early pregnancy ≤9.30 ng/ml to predict congenital heart disease in neonates were 66% and 53%,respectively.ConclusionThis study showed that vitamin D deficiency and insufficiency were common in pregnant women and neonates from Lanzhou University First Hospital.The serum 25(OH)D concentrations of neonates were significantly affected by birth weights.Maternal adverse pregnancy history and preconception high BMI were independent risk factors for congenital heart disease in neonates.Maternal serum 25(OH)D concentrations in early pregnancy and gestational age of neonates were negatively correlated with the prevalence of congenital heart disease in neonates.