Pediatric research · 2026
Maternal vitamin D status modifies the association between GDM and offspring neurodevelopment: a prospective birth cohort study.
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Yin Wan-Jun, Zhao Xue, Zhou Zi-Hao, Tao Rui-Xue, Hu Hong-Lin, Jiang Xiao-Min, Zhang Ying, Zhu Peng
Аннотация
BACKGROUND: Intrauterine hyperglycemia is a risk factor for offspring neurodevelopmental delay. While vitamin D is neuroprotective, its role in improving outcomes for the offspring of women with gestational diabetes mellitus (GDM) is unclear.
METHODS: In a prospective cohort of 7438 pregnant women, serum 25-hydroxyvitamin D [25(OH)D] was measured at 16-23 weeks. GDM was diagnosed at 24-28 weeks, with simultaneous assessment of insulin resistance (HOMA-IR). Umbilical cord blood C-peptide concentrations were measured at delivery. Offspring neurodevelopment was screened at 5-7, 11-13, and 24-36 months.
RESULTS: GDM was associated with a 26% higher risk of neurodevelopmental delay (HR = 1.26, 95% CI: 1.02, 1.56), along with higher HOMA-IR and cord blood C-peptide. Serum 25(OH)D was negatively associated with HOMA-IR and cord blood C-peptide (P for trend < 0.05). In vitamin D-deficient women (25(OH)D < 50 nmol/L), HOMA-IR correlated with cord C-peptide (r = 0.48, P < 0.001), and GDM increased risks of neurodevelopmental delay (HR = 1.34, 95%CI: 1.05, 1.70) and hyperinsulinemia (HR = 1.39, 95%CI: 1.13, 1.72). These associations were absent in vitamin D-sufficient women.
CONCLUSIONS: Adequate gestational vitamin D may attenuate the intergenerational transmission of glucose metabolism disorders, thereby reducing neurodevelopmental delay risk in GDM offspring. This protective effect requires validation in randomized trials.
IMPACT: This study demonstrates that adequate maternal vitamin D status may protect against gestational diabetes mellitus (GDM)-associated neurodevelopmental delays in offspring, identifying a potentially modifiable prenatal factor. It proposes a novel mechanistic pathway, suggesting vitamin D may attenuate the intergenerational transmission of maternal glucose dysregulation, thereby mitigating fetal hyperinsulinemia and subsequent neurodevelopmental risk. The findings support integrating vitamin D assessment and optimization into prenatal care for women with GDM, offering a nutritional strategy for promoting offspring neurodevelopment.
METHODS: In a prospective cohort of 7438 pregnant women, serum 25-hydroxyvitamin D [25(OH)D] was measured at 16-23 weeks. GDM was diagnosed at 24-28 weeks, with simultaneous assessment of insulin resistance (HOMA-IR). Umbilical cord blood C-peptide concentrations were measured at delivery. Offspring neurodevelopment was screened at 5-7, 11-13, and 24-36 months.
RESULTS: GDM was associated with a 26% higher risk of neurodevelopmental delay (HR = 1.26, 95% CI: 1.02, 1.56), along with higher HOMA-IR and cord blood C-peptide. Serum 25(OH)D was negatively associated with HOMA-IR and cord blood C-peptide (P for trend < 0.05). In vitamin D-deficient women (25(OH)D < 50 nmol/L), HOMA-IR correlated with cord C-peptide (r = 0.48, P < 0.001), and GDM increased risks of neurodevelopmental delay (HR = 1.34, 95%CI: 1.05, 1.70) and hyperinsulinemia (HR = 1.39, 95%CI: 1.13, 1.72). These associations were absent in vitamin D-sufficient women.
CONCLUSIONS: Adequate gestational vitamin D may attenuate the intergenerational transmission of glucose metabolism disorders, thereby reducing neurodevelopmental delay risk in GDM offspring. This protective effect requires validation in randomized trials.
IMPACT: This study demonstrates that adequate maternal vitamin D status may protect against gestational diabetes mellitus (GDM)-associated neurodevelopmental delays in offspring, identifying a potentially modifiable prenatal factor. It proposes a novel mechanistic pathway, suggesting vitamin D may attenuate the intergenerational transmission of maternal glucose dysregulation, thereby mitigating fetal hyperinsulinemia and subsequent neurodevelopmental risk. The findings support integrating vitamin D assessment and optimization into prenatal care for women with GDM, offering a nutritional strategy for promoting offspring neurodevelopment.