A major strength of our study the prospective design from fetal life onwards within a population-based cohort. This study is among the largest that examined the association of fetal vitamin D status with body composition and cardiovascular outcomes in a multi-ethnic sample of school-age children. We measured 25(OH)D concentrations in mid- pregnancy and cord blood at birth, assessing diff erent critical periods. 25(OH)D concentrations are the most widely used indicator of vitamin D status.42
Next to BMI, we also measured fat mass and lean mass using DXA.
Due to the young age of the children, it was not possible to obtain fasting blood samples, which may have led to an underestimation of the associations. Of the singleton live born children 58 % participated in the follow up measurements. Mothers of the children who were lost to follow up had on average lower 25(OH)D concentrations and were on average lower educated, suggesting that our study population had a selection towards a healthier popula- tion. Finally, although we performed adjustment for many potential maternal and childhood confounders, residual confounding for the observed associations might be present.
CONCLUSION
Results from this population-based prospective cohort study suggest that severe vitamin D defi ciency during mid-pregnancy may infl uence childhood body composition. Further studies are needed to examine the causality of these associations and to identify the long term-clinical consequences.
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