Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels

Frontiers in Endocrinology

Endocrinology

Jonathan C. Y. Tang¹  William D. Fraser²  Katharina Tischlinger³  Wolfgang Högler⁴  Suma Uday⁵ 

[1] Department of Medicine, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom;Clinical Biochemistry, Departments of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom;Department of Medicine, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom;Departments of Diabetes and Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospital, Norwich, United Kingdom;Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria;Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria;Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom;Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom;Department of Endocrinology and Diabetes, Birmingham Women’s and Children’s Hospital, Birmingham, United Kingdom;

关键词: income;    vitamin D (25-hydroxyvitamin D);    employment;    housing;    micronutrients;    neonate - age;   

DOI  :  10.3389/fendo.2022.978580

 received in 2022-06-26, accepted in 2022-10-24,  发布年份 2022

来源: Frontiers

【 摘 要 】

ObjectivesVitamin D deficiency in neonates can have life-threatening consequences, hence the knowledge of risk factors is essential. This study aimed to explore the effect of maternal socioeconomic status (SES) on newborn 25-hydroxyvitamin D (25OHD) concentrations.DesignOver two 1-week periods (winter and summer of 2019), 3000 newborn heel prick dried blood spots (DBS) and additional data of newborns, from a regional newborn screening laboratory (52° N) in the West Midlands, UK, were gathered. Post code was replaced with lower layer super output area (LSOA). Index of Multiple Deprivation (IMD) quintiles for the corresponding LSOA was used to assess SES [quintile one (Q1): most deprived 20%, quintile five (Q5): least deprived 20%]. Each of the seven domains of deprivation were examined (income, employment, education, health, barriers to housing and services, crime and living environment). 25OHD was measured on 6mm sub-punch from DBS using quantitative liquid chromatography tandem mass spectrometry and equivalent plasma values were derived.ResultsIn total 2999 (1500 summer-born, 1499 winter-born) newborn DBS (1580 males) were analysed. Summer-born newborns had significantly higher 25OHD (IQR) concentrations [49.2 (34.3; 64.8) nmol/l] than winter-born newborns [29.1 (19.8; 40.6) nmol/l, p<0.001].25OHD levels varied significantly between the different IMD quintiles in the whole (p<0.001) and summer-born cohort (p<0.001), but not in the winter-born cohort (p=0.26), whereby Q1 had the lowest 25OHD concentrations. Among the domains of deprivation, living environment had a significant influence on 25OHD levels (β=0.07, p=0.002). In this subdomain, 25OHD levels varied significantly between quintiles in the whole (p<0.001) and summer-born cohort (mean 25OHD Q1 46.45 nmol/l, Q5 54.54 nmol/l; p<0.001) but not in the winter-born cohort (mean 25OHD Q1 31.57 nmol/l, Q5 31.72 nmol/l; p=0.16). In a regression model, living environment was still significant (p=0.018), albeit less than season of birth and ethnicity.ConclusionAmong the seven domains of deprivation, maternal living environment had the greatest effect on newborn 25OHD levels. Whilst improved living environment positively influenced vitamin D status in the summer-born babies, winter-born had low 25OHD levels irrespective of the environment. Strategies such as enhanced supplementation and food fortification with vitamin D should be considered to overcome the non-modifiable main risk factors for vitamin D deficiency.

【 授权许可】

Unknown   
Copyright © 2022 Högler, Tischlinger, Fraser, Tang and Uday