Abstract
Vitamin D is known to regulate innate and adaptive immune processes at the cellular level, but the role of vitamin D status on associated inflammatory processes across pregnancy is unclear. Our primary objective was to evaluate the relationships between serum biomarkers of inflammation (interleukin [IL]-6, IL-10, tumor necrosis factor [TNF]-α), acute-phase proteins (C-reactive protein and hepcidin) and vitamin D status, 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)(2)D), measured across pregnancy and in the neonate at birth. A second objective was to identify associations between vitamin D status and clinically diagnosed infections. In this study, 158 racially and ethnically diverse pregnant adolescents were recruited from the Rochester Adolescent Maternity Program (RAMP) in Rochester, NY. Serum 1,25(OH)(2)D was significantly lower in adolescents and neonates with IL-6 concentrations above the 75th percentile at delivery ( P = .04) and at birth ( P = .004), respectively. After adjusting for other potential covariates of inflammation, maternal serum 1,25(OH)(2)D was significantly positively associated with TNF-α during pregnancy ( P = .02), but at delivery 1,25(OH)(2)D and TNF-α were inversely associated with one another ( P = .02). Teens with 25(OH)D concentrations <30 ng/mL were more likely to test positive for candida ( P = .002) and bacterial vaginosis ( P = .02) during pregnancy. African Americans exhibited significantly lower TNF-α concentrations at both mid-gestation ( P = .009) and delivery ( P = .001) compared to the Caucasian adolescents. These results suggest that lower maternal vitamin D status may increase risk of infection across gestation.