Relationship between Maternal Vitamin D Level and Small for Gestational Age Infant in West Java, Indonesia

Setyorini Irianti, Raden Tina Dewi Judistiani, Sylvia Rachmayati, Jusuf Sulaeman Effendi, Budi Setiabudiawan


Small for gestational age (SGA) infants is one of the unfavorable outcomes of pregnancy that needs to be prevented. There are not many studies available on the association of maternal vitamin D levels during pregnancy and SGA infants. This study aimed to discover the association between maternal vitamin D level and SGA infants in West Java. A cohort study was performed from February 2018 to January 2019 by recruiting 304 pregnant women in Bandung, Cimahi, Waled, and Sukabumi, West Java Province, Indonesia. Of that number, 203 women were followed until the delivery date. Data were collected from the results of serial ultrasonography examinations and maternal vitamin D level measurements. Bivariate analysis and logistic regression were then performed to determine the relationship between variables. This study showed that 30 of 203 (14.78%) infants were born as SGA infants. The mothers of these SGA infants had a lower maternal vitamin D level at the beginning of the second trimester and smaller anthropometric measurements at the beginning of the third trimester. However, no significant difference was found between normal infants and SGA infants when the overall values for all trimesters were compared. It can be inferred that the maternal vitamin D level has a negative relationship with SGA infants in West Java, Indonesia. Further studies are required to prove the relationship between maternal vitamin Dl level and SGA infants.

Hubungan Kadar Vitamin D Ibu dan Bayi Kecil Masa Kehamilan di Jawa Barat

Bayi kecil masa kehamilan (KMK) adalah luaran kehamilan yang perlu dicegah. Informasi tentang hubungan kadar vitamin D ibu dengan kejadian bayi KMK di Indonesia masih terbatas. Kadar vitamin D dan karakteristik ibu diduga berpengaruh dalam kejadian bayi KMK. Tujuan penelitian ini adalah mengetahui hubungan kadar vitamin D ibu dengan kejadian KMK pada bayi. Studi kohort dilakukan dari Februari 2018 hingga Januari 2019 dengan merekrut 304 ibu hamil di Bandung, Cimahi, Waled, dan Sukabumi, Provinsi Jawa Barat, Indonesia.  Dari jumlah 203 orang diantaranya berhasil diikuti sejak trimester satu hingga persalinan dan terpilih menjadi  subjek penelitian kasus kontrol. Pemeriksaan ultrasonografi, kadar vitamin D dan hemoglobin ibu dilakukan serial tiap trimester. Dilakukan analisis bivariat dan regresi logistik untuk menentukan hubungan antar variabel yang diteliti. Dari penelitian ini didapatkan sebanyak 30 dari 203 (14,78%) persalinan  dengan luaran bayi KMK.  Bayi KMK cenderung  mempunyai riwayat kadar vitamin  D yang lebih rendah pada awal trimester kedua dan hasil antropometri yang lebih rendah pada awal trimester tiga, namun secara statistik tidak berbeda signifikan. Simpulan penelitian ini bahwa kadar vitamin D ibu hamil memiliki korelasi negatif dengan bayi KMK. Penelitian lebih lanjut diperlukan untuk membuktikan hubungan antara kadar vitamin D ibu dan bayi KMK.



fetal anthropometry, maternal, small for gestational age, vitamin D, West Java

Full Text:



Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc. 2013;88(7):720–55.

Lowe NM and Bhojani I. Special considerations for vitamin D in the South Asian population in the UK. Ther Adv Musculoskelet Dis. 2017;9(6):137–44.

Agarwal N, Mithal A, Shukla M. Effect of two different doses of oral cholecalciferol supplementation on serum 25-hydroxy-vitamin D levels in healthy Indian postmenopausal women: A randomized controlled trial. Indian J Endocrinol Metab. 2013;17(5):883–9.

Wijnen H, Salemink D, de Boer H. Vitamin D supplementation in nursing home patients: Randomized controlled trial of standard daily dose versus individualized loading dose regimen. Drugs Aging. 2015;32(5):371–8.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, Treatment, and prevention of vitamin d deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.

Nimitphong H and Holick MF. Vitamin D status and sun exposure in Southeast Asia. Dermatoendocrinol. 2013;5(1):34–7.

Wang Y, Li H, Zheng M, Wu Y, Zeng T, Fu J, et al. Maternal vitamin D deficiency increases the risk of adverse neonatal outcomes in the Chinese population: a prospective cohort study. PLoS One. 2018;13(4):e0195700.

Judistiani RTD, Nirmala SA, Rahmawati M, Ghrahani R, Natalia YA, Sugianli AK, et al. Optimizing ultraviolet B radiation exposure to prevent vitamin D deficiency among pregnant women in the tropical zone: report from cohort study on vitamin D status and its impact during pregnancy in Indonesia. BMC Pregnancy Childbirth. 2019;19(1):209.

Aji AS, Yerizel E, Desmawati, Lipoeto NI. The association between lifestyle and maternal vitamin D during pregnancy in West Sumatra, Indonesia. Asia Pac J Clin Nutr. 2018;27:1286–93.

Bardosono S. Maternal Micronutrient Deficiency during the First Trimester among Indonesian Pregnant Women Living in Jakarta. eJournal Kedokteran Indonesia. 2016;4:76-71.

Finkelstein JL, Duggan C, Mehta S. Maternal Vitamin D status and adverse pregnancy and neonatal outcomes in India. FASEB J. 2016;30:44.46.

Chen Y-H, Fu L, Hao J-H, Yu Z, Zhu P, Wang H, et al. Maternal vitamin D deficiency during pregnancy elevates the risks of small for gestational age and low birth weight infants in Chinese population. J Clin Endocrinol Metab. 2015;100(5):1912–9.

Morley R, Carlin JB, Pasco JA, Wark JD. Maternal 25-hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size. J Clin Endocrinol Metab. 2006;91(3):906–12.

Zhou J, Su L, Liu M, Liu Y, Cao X, Wang Z, et al. Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China. Eur J Clin Nutr. 2014;68(8):925–30.

Boyle VT, Thorstensen EB, Mourath D, Jones MB, McCowan LME, Kenny LC, Baker PN. The relationship between 25-hydroxyvitamin D concentration in early pregnancy and pregnancy outcomes in a large, prospective cohort. Br J Nutr. 2016;116(8):1409–15.

Hollis BW, Wagner CL, Kratz A, Sluss P, Lewandrowski K. Normal serum vitamin D levels. N Engl J Med. 2005;352(5):515–6.

ACOG Committee Opinion No. 495: Vitamin D: Screening and supplementation during pregnancy. Obstet Gynecol. 2011;118(1):197–8.

Bodnar LM, Catov JM, Zmuda JM, Cooper ME, Parrott MS, Roberts JM, et al. Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women. J Nutr. 2010; 140(5):999–1006.

Sorensen MG, Andersen LB, Sperling L and Christeen L. Maternal 25-hydroxyvitamin D level and fetal bone growth assessed by ultrasound: a systematic review..Ultrasound Obstet Gynecol. 2014;44(6):633–40.

Article Metrics

Abstract view : 602 times
PDF - 312 times

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Creative Commons License
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


View My Stats