Association of Chinese maternal lifestyle during pregnancy and lactation with vitamin D levels in offspring: a multicenter retrospective cohort Jiangsu study

Abstract

Background: This study aims to investigate the association between maternal lifestyle during pregnancy and lactation and vitamin D levels in their offspring, providing insights for interventions against vitamin D deficiency. Methods: A stratified random cluster sampling approach was used to recruit children aged 0–5 years in Jiangsu Province. Self-designed questionnaires were utilized to explore maternal lifestyle. Subsequently, the serum 25-hydroxyvitamin D levels were quantified using the enzyme-linked immunosorbent assay technique. Results: We recruited 5243 mother–child pairs. Factors significantly associated with an increased risk of vitamin D deficiency in offspring included maternal vitamin D and calcium supplementation, fish and shrimp intake ≥2 times per week, and <1 hour of outdoor activity per day during pregnancy, and initiation of vitamin D and calcium supplementation after labour and delivery, daily vitamin D and calcium supplementation deficiencies, fish and shrimp intake ≥4 times per week, and <1 hour of outdoor activity per day during lactation, with OR values of 1.26, 1.47, 1.45, 2.31, 1.89, 1.49, and 1.23 and β values of −3.67, −10.44, −5.13, −8.64, −7.55, −5.14, and −2.73, respectively. 25-Hydroxyvitamin D levels were significantly higher in offspring of mothers who started VD and calcium supplementation at 5–12 weeks and 12 weeks or more of pregnancy and in offspring who consumed 250–500 ml of milk per day during pregnancy and 500 ml or more of milk per day by 7.60, 9.58, 8.93, and 9.36 nmol L⁻¹, respectively, all with P < 0.05. Conclusion: Lower levels of vitamin D in offspring were associated with higher weekly intake of fish and shrimp by mothers during pregnancy and lactation, less daily outdoor activity, vitamin D and calcium supplementation during pregnancy, supplementation started before or early in pregnancy, insufficient milk intake during pregnancy, vitamin D supplementation immediately after delivery, and lack of daily vitamin D and calcium supplementation during lactation.