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In utero exposure to extra vitamin D from food fortification and the risk of subsequent development of gestational diabetes: the D-tect study
- Keller, Amélie, Stougård, Maria, Frederiksen, Peder, Thorsteinsdottir, Fanney, Vaag, Allan, Damm, Peter, Jacobsen, Ramune, L. Heitmann, Berit
- Nutrition journal 2018 v.17 no.1 pp. 100
- confidence interval, food fortification, gestational diabetes, issues and policy, margarine, maternal exposure, maternal nutrition, nutrition risk assessment, odds ratio, regression analysis, spring, vitamin D, women, Denmark
- 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 .