142nd APHA Annual Meeting and Exposition

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Vitamin D Deficiency and Insufficiency in Pregnant Women in the Pacific Northwest Participating in the Pregnancy, Exercise & Nutrition (PEN) Study

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Margaret McLain, MPH, BBA , Division of Health Promotion and Sports Medicine, Oregon Health Science University, Portland, OR
Esther Moe, PhD, MPH , Division of Health Promotion and Sports Medicine, Oregon Health & Science University, Portland, OR
Diane Stadler, PhD, RD, LD , Graduate Programs in Human Nutrition, Oregon Health & Science University, Portland, OR
Lucy Glaize, BS
Bharti Garg, MPH
Cassandra Graziano, BS , OR
Linn Goldberg, MD

Serum 25-OH-vitamin D concentrations ≥30 ng/mL are recommended for bone growth and general health. Research suggests a relationship between maternal vitamin D status and pregnancy complications including preeclampsia, caesarian sections, and gestational diabetes.


Vitamin D status was assessed during a team-based, peer-led intervention designed to reduce gestational diabetes risk through healthy nutrition and physical activity during pregnancy. Serum 25-OH-vitamin D concentrations were measured in 28 participants in the first (1T; January-June) and third (3T; June-October) trimesters and results were shared with healthcare providers.


At 1T, 10 (35.7%) participants had serum 25-OH-vitamin D concentrations <20 ng/mL and 12 (43.9%) had values between 20-30 ng/mL; at 3T, 4 (14.3%) had levels <20 ng/mL and 14 (50%) had values between 20-30 ng/mL. All participants reported taking a daily prenatal multivitamin containing at least 400 IU vitamin D. Five (17.9%) supplemented with additional vitamin D throughout pregnancy and 14 (50%) did not. At 3T, of the 13 participants taking additional vitamin D, 5 (38.5%) continued to have 25-OH-vitamin D concentrations <30 ng/mL.


Women in the Pacific Northwest have an elevated risk of vitamin D deficiency given insufficient sun exposure and sunscreen use. The high percentage of women with insufficient vitamin D status supports screening for vitamin D deficiency during pregnancy. This preliminary analysis supports emerging evidence that daily 1,000-2,000 IU supplementation of vitamin D during pregnancy is insufficient to attain optimal vitamin D levels. Randomized controlled trials could determine whether higher daily doses of vitamin D are necessary.

Learning Areas:

Administer health education strategies, interventions and programs
Public health or related education
Public health or related research

Learning Objectives:
Identify sources of vitamin D Discuss the connection between vitamin D, health, and pregnancy outcomes Identify the reference ranges for vitamin D for adults Discuss factors in increasing prevalence of vitamin D deficiency in the U.S. and Pacific Northwest Discuss current vitamin D supplementation and screening recommendations and the need for additional research on vitamin D supplementation during pregnancy

Keyword(s): Perinatal Health, Vitamins

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the study coordinator for the pilot study of Pregnancy, Exercise & Nutrition at OHSU. I was responsible for recruiting participants, carrying out study visits, and completing data collection and data entry. I helped develop the PEN curriculum (a 20 session, peer-led, team-based program) and help write and edit the general OHSU employee wellness program called Healthy TEAM Healthy U, which is based on 25 years of research on team-based, peer-led wellness programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.