IMR Press / CEOG / Volume 49 / Issue 7 / DOI: 10.31083/j.ceog4907158
Open Access Original Research
Association between Preterm Premature Rupture of Membranes and Vitamin D Levels in Maternal Plasma and Umbilical Cord Blood of Newborns: A Prospective Study
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1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Seoul Medical Center, 02053 Seoul, Republic of Korea
2 Department of Obstetrics and Gynecology, Ilsan Paik Hospital, InJe University College of Medicine, 10380 Goyang, Republic of Korea
3 Department of Pediatrics, Ilsan Paik Hospital, InJe University College of Medicine, 10380 Goyang, Republic of Korea
4 Division of Biology and Public Health, Mokwon University, 35349 Daejeon, Republic of Korea
5 Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, 05278 Seoul, Republic of Korea
*Correspondence: hanjungyeol055@gmail.com (Jung Yeol Han)
Academic Editor: Michael H. Dahan
Clin. Exp. Obstet. Gynecol. 2022, 49(7), 158; https://doi.org/10.31083/j.ceog4907158
Submitted: 18 February 2022 | Revised: 24 April 2022 | Accepted: 25 April 2022 | Published: 11 July 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Preterm premature rupture of membranes (PPROM) is a major cause of preterm birth. There are few reports on vitamin D deficiency associated with PPROM. We aimed to investigate the association between PPROM and vitamin D levels in maternal plasma and the umbilical cord blood of newborns. Methods: This prospective study included 355 pregnant women who delivered live infants between March 2017 and December 2018 at a medical center. Vitamin D levels were measured in the maternal plasma at the first, second, third trimesters of pregnancy and just before delivery, and in the umbilical cord blood of newborns at birth. In addition, we evaluated the pregnancy and neonatal outcomes according to vitamin D status. Results: The rate of PPROM in the vitamin D deficiency group (25(OH)D <20 ng/mL) was higher than in the non-deficiency group (25(OH)D 20 ng/mL) (p = 0.003). Vitamin D levels were significantly lower in the PPROM group than non-PPROM group in maternal plasma [at the first (p = 0.020) and second trimesters (p = 0.029), just before delivery (p = 0.015)], and in the cord blood of newborns (p = 0.006). Multiple logistic regression analysis showed that the odds ratio of PPROM by the increase of 1ng/mL of vitamin D levels in the cord blood of newborns was 0.907 (95% confidence interval 0.836–0.983) after adjustment for other confounders (age, gravidity, parity, and body mass index). Conclusions: Vitamin D deficiency has a significant association with PPROM. Our study would aid in understanding the mechanism of prevention of PPROM associated with vitamin D deficiency as well as reduction in preterm births.

Keywords
preterm premature rupture of membranes
vitamin D deficiency
cord blood
inflammation
oxidative stress
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