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Ota K, Mitsui J, Katsumata S, Takayanagi Y, Nako Y, Tajima M, Komiya A, Takahashi T, Kawai K. Seasonal Serum 25(OH) Vitamin D Level and Reproductive or Immune Markers in Reproductive-Aged Women with Infertility: A Cross-Sectional Observational Study in East Japan. Nutrients 2023; 15:5059. [PMID: 38140317 PMCID: PMC10745323 DOI: 10.3390/nu15245059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/16/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Several studies have reported that vitamin D may modify human reproductive functions; however, the results are conflicting. We aimed to comprehensively evaluate serum vitamin D levels and examine the relationship between serum vitamin D levels and ovarian reserve markers, and immune markers of implantation, in reproductive-aged Japanese women with infertility.in reproductive-aged women with infertility. This cross-sectional, single-center study included reproductive-aged women who underwent preconception screening for fertility. Serum vitamin D levels and reproductive and immune markers were measured. Standard and advanced statistical techniques were used. We observed a statistically significant difference in the seasonal and monthly 25(OH) vitamin D levels; the 25(OH) vitamin D level during winter was the lowest among all seasons. However, there was no linear correlation between 25(OH) vitamin D levels and ovarian reserve markers, such as follicle-stimulating hormone and anti-Müllerian hormone, or the Th1/Th2 cell ratio, which is used as an implantation-related immunological marker. In this large-scale study, we evaluated the serum 25(OH) vitamin D concentration in reproductive-aged women with infertility in Japan; however, there was no association between reproductive function and vitamin D levels.
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Affiliation(s)
- Kuniaki Ota
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan;
- Department of Obstetrics and Gynecology, Tokyo Rosai Hospital, Japan Labor Health and Safety Organization, 4-13-21 Ohmori-minami, Ohta-ku, Tokyo 143-0013, Japan
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
| | - Junichiro Mitsui
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Shoko Katsumata
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Yuko Takayanagi
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
| | - Yurie Nako
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
| | - Makiko Tajima
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
| | - Akira Komiya
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan;
| | - Kiyotaka Kawai
- Reproductive Medicine, Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase, Mihama-ku, Chiba-City 261-8501, Japan; (J.M.); (S.K.); (Y.T.); (Y.N.); (M.T.); (A.K.); (K.K.)
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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Moon RJ, D’Angelo S, Crozier SR, Curtis EM, Fernandes M, Kermack AJ, Davies JH, Godfrey KM, Bishop NJ, Kennedy SH, Prentice A, Schoenmakers I, Fraser R, Gandhi SV, Inskip HM, Javaid MK, Papageorghiou AT, Cooper C, Harvey NC. Does antenatal cholecalciferol supplementation affect the mode or timing of delivery? Post hoc analyses of the MAVIDOS randomized controlled trial. J Public Health (Oxf) 2023; 45:738-747. [PMID: 36585903 PMCID: PMC10470377 DOI: 10.1093/pubmed/fdac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/07/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Observational studies relating maternal 25-hydroxyvitamin D status to timing and mode of delivery have reported inconsistent results. We assessed the effect of antenatal cholecalciferol supplementation on the incidence of preterm birth, delivery mode and post-partum haemorrhage (PPH). METHODS MAVIDOS was a randomized, double-blind, placebo-controlled trial of 1000 IU/day cholecalciferol from 14 weeks' gestation until delivery. Gestational age, mode of delivery [categorized as spontaneous vaginal delivery (SVD), instrumental (including forceps and vacuum extraction) or Caesarean section] and PPH (>500 ml estimated blood loss) were determined from medical records. RESULTS A total of 965 women participated in the study until delivery. Gestation at birth and incidence of preterm birth (cholecalciferol 5.7%, placebo 4.5%, P = 0.43) were similar between the two treatment groups. SVD (versus instrumental or Caesarean delivery) was more likely in women randomized to cholecalciferol [Relative Risk (RR) 1.13, 95% confidence interval (CI) 1.02,1.25] due to lower instrumental (RR 0.68, 95%CI 0.51,0.91) but similar risk of Caesarean delivery (RR 0.94, 95%CI 0.74,1.19). PPH was less common in women randomized to cholecalciferol [32.1% compared with placebo (38.1%, P = 0.054) overall], but similar when stratified by delivery mode. CONCLUSIONS Antenatal cholecalciferol supplementation did not alter timing of birth or prevalence of preterm birth but demonstrated a possible effect on the likelihood of SVD.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- Paediatric Endocrinology, University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Michelle Fernandes
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Alexandra J Kermack
- Department of Women’s Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas J Bishop
- Academic Unit of Child Health, Sheffield Children’s Hospital, University of Sheffield, Sheffield, UK
| | - Stephen H Kennedy
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Ann Prentice
- MRC Epidemiology Unit, University of Cambridge, previously at MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
| | - Inez Schoenmakers
- Faculty of Medicine and Health Sciences, Department of Medicine, University of East Anglia, Norwich, UK
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield, UK
| | - Saurabh V Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Muhammad Kassim Javaid
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Aris T Papageorghiou
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Takahashi Y, Kaji T, Yasui T, Yoshida A, Yonetani N, Suzue N, Katoh S, Maeda K, Sairyo K, Irahara M, Iwasa T. Ultrasonographic changes in quadriceps femoris thickness in women with normal pregnancy and women on bed rest for threatened preterm labor. Sci Rep 2022; 12:17506. [PMID: 36261471 PMCID: PMC9582004 DOI: 10.1038/s41598-022-22467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 10/14/2022] [Indexed: 01/12/2023] Open
Abstract
This study aimed to evaluate the changes in quadriceps femoris muscle thickness during the pregnancy and postpartum periods and to elucidate the effect of bed rest for threatened preterm labor on muscle thickness. In 26 women with normal pregnancy, quadriceps femoris thickness was measured at 11-13, 26, 30, and 35 weeks' gestation, and at 3-5 days and 1 month postpartum using ultrasonography. In 15 pregnant women treated with bed rest for threatened premature labor, quadriceps femoris thickness was measured at 30 and 35 weeks' gestation and postpartum. In women with normal pregnancy, quadriceps femoris thickness increased, peaking at 35 weeks' gestation, followed by a postpartum decrease. In women on bed rest, quadriceps femoris thickness showed no significant change during the pregnancy and postpartum periods, and the muscle was significantly thinner at 35 weeks' gestation than that in women with normal pregnancy. In conclusion, a significant increase in quadriceps femoris muscle thickness during normal pregnancy was found using ultrasonography. Meanwhile, in pregnant women on bed rest treatment, the quadriceps femoris was significantly thinner in the late third trimester than that in normal pregnant women. Prolonged bed rest can affect normal changes in the quadriceps femoris muscle thickness during the pregnancy and postpartum periods.
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Affiliation(s)
- Yohei Takahashi
- grid.267335.60000 0001 1092 3579Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503 Japan
| | - Takashi Kaji
- grid.267335.60000 0001 1092 3579Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503 Japan
| | - Toshiyuki Yasui
- grid.267335.60000 0001 1092 3579Department of Reproductive and Menopausal Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Atsuko Yoshida
- grid.267335.60000 0001 1092 3579Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503 Japan
| | - Naoto Yonetani
- grid.267335.60000 0001 1092 3579Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503 Japan
| | - Naoto Suzue
- grid.415448.80000 0004 0421 3249Department of Orthopedic Surgery, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Shinsuke Katoh
- Department of Rehabilitation Medicine, Red Cross Tokushima Hinomine Rehabilitation Center for People with Disabilities, Komatsushima, Japan
| | - Kazuhisa Maeda
- grid.472231.10000 0004 1772 315XDepartment of Obstetrics and Gynecology, Shikoku Medical Center for Children and Adults, Zentsuji, Japan
| | - Koichi Sairyo
- grid.267335.60000 0001 1092 3579Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Minoru Irahara
- grid.267335.60000 0001 1092 3579Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503 Japan
| | - Takeshi Iwasa
- grid.267335.60000 0001 1092 3579Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503 Japan
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Yamade I, Inoue T, Hamada H, Sudou S, Otsubo M, Sawada M, Nakayama T, Hatayama H. Ineffectiveness of antenatal guidance intervention for vitamin D insufficiency and deficiency in pregnant women in Kyoto, Japan. J Obstet Gynaecol Res 2021; 47:3540-3550. [PMID: 34376022 DOI: 10.1111/jog.14972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/01/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate the vitamin D status among healthy pregnant women in Japan, and to evaluate the effectiveness of the antenatal health guidance intervention for the pregnant women who were informed about their low vitamin D levels. METHODS We measured the level of 25-hydroxyvitamin D (25[OH]D) using chemiluminescent immunoassay among the singleton pregnant women who received at antenatal routine check-up (8-24 weeks of gestation) with written consent during September 2017-September 2018. The measurement values were informed by the concerned physician and health guidance intervention was given to the pregnant women with inadequate Vitamin D status (25[OH]D < 30 ng/mL). At around 36 weeks of gestation, the measurement of 25(OH)D and a questionnaire regarding behavioral changes after the guidance was conducted. RESULTS The average value of 25(OH)D of 1192 pregnant women before the guidance was 14.89 ± 4.85 ng/mL, and the prevalence of sufficient vitamin D status (25(OH)D ≥ 30 ng/mL) was 0.67% (8/1192). Nine hundred eighty-two pregnant women who had inadequate vitamin D status were followed, thereafter-guidance prevalence of sufficiency was 1.02% (10/982); insufficiency, 14.66% (144/982); and deficiency, 84.32% (828/982), respectively. Although the prevalence of deficiency was decreased after guidance intervention significantly, the prevalence was still high and the effect on behavioral changes was a little. CONCLUSION The prevalence of vitamin D sufficient status among pregnant women in Japan was extremely low, which is a serious condition. It was also revealed the effectiveness of the antenatal health guidance intervention for pregnant women was not enough.
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Affiliation(s)
- Ichiro Yamade
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Takuya Inoue
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Hironori Hamada
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Shinsuke Sudou
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Masahiro Otsubo
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Morio Sawada
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Takahiro Nakayama
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Hiroshi Hatayama
- Department of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
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Ichihara Y, Suga K, Fukui M, Yonetani N, Shono M, Nakagawa R, Kagami S. Serum biotin level during pregnancy is associated with fetal growth and preterm delivery. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 67:170-173. [PMID: 32378602 DOI: 10.2152/jmi.67.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background : Biotin is a water-soluble vitamin that plays various biological roles through histone modification, such as immune functions and fetal growth. Mammalian maternal biotin deficiency during gestation induces fetal growth restriction. Preterm infants are known to be marginal biotin deficiency. However, studies on the biotin status of pregnant women under various conditions are lacking. Method : This was a retrospective case control study to analyze serum biotin concentration during pregnancy and cord blood in normal pregnancy, preterm delivery and small-for-gestational-age (SGA). Results : Twenty pregnant women with normal term delivery, 35 with preterm delivery, 24 with SGA, and 10 non-pregnant adult women were enrolled. Serum biotin concentrations of pregnant women remained low from first to third trimester. The levels of serum biotin in cord blood showed a significant positive correlation with gestational age, and that of pregnant women showed a weak positive correlation with gestational age. The maternal serum biotin levels during second and third trimester of SGA group were significantly lower than those of normal term delivery. Conclusion : This study suggests that maternal biotin deficiency during pregnancy might be the risk of preterm labor or fetal growth restriction. Further studies are required to clarify the roles of biotin in perinatal medicine. J. Med. Invest. 67 : 170-173, February, 2020.
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Affiliation(s)
- Yuko Ichihara
- Department of Pediatrics, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan.,Department of Pediatrics, Tokushima Municipal Hospital, Kitajyosanjimacho, Tokushima, Tokushima, Japan
| | - Kenichi Suga
- Department of Pediatrics, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan
| | - Maika Fukui
- Department of Pediatrics, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan
| | - Naoto Yonetani
- Department of Obstetrics and Gynecology, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan
| | - Miki Shono
- Department of Pediatrics, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan
| | - Ryuji Nakagawa
- Department of Pediatrics, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan
| | - Shoji Kagami
- Department of Pediatrics, Tokushima University Hospital, Kuramotocho, Tokushima, Tokushima, Japan
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Changes in vitamin D status considering hemodilution factors in Japanese pregnant women according to trimester: A longitudinal survey. PLoS One 2020; 15:e0239954. [PMID: 33007019 PMCID: PMC7531781 DOI: 10.1371/journal.pone.0239954] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/15/2020] [Indexed: 01/22/2023] Open
Abstract
Objectives There have been no longitudinal surveys on the changes in 25-hydroxyvitamin D [25(OH)D] while considering hemodilution factors among pregnant Japanese women. Therefore, we examined 25(OH)D levels as well as red blood cell count (RBC), hemoglobin (Hb), and Hematocrit (Hct) at the three trimesters among pregnant Japanese women to determine the distribution of serum 25(OH)D levels and the influence of hemodilution. Design This was a longitudinal study. Setting The study was conducted at Ibaraki Seinan Medical Center Hospital in Japan. Participants The participants comprised 50 women in the first trimester with singleton pregnancies and without any complications. Outcome measures Participants were recruited from June to August 2018, and followed up till their postpartum period. Blood samples were collected at the first, second, and third trimesters, i.e., at 4–15, 16–27, and 28–39 weeks, respectively. 25(OH)D levels, RBC, Hb, and Hct were analyzed across the three trimesters. Results Comparing the first, second, and third trimesters, 25(OH)D, RBC, and Hb were significantly declined in the second and third trimesters (p < 0.001). According to Spearman’s correlation coefficient with 25(OH)D and RCB, Hb, Hct, significant correlations were found between 25(OH)D and Hb (p < 0.001), as well as Hct (p < 0.001) in the third trimester. Conclusions The present study had two major findings. First, it showed that the vitamin D status of most pregnant Japanese women were considered as vitamin D deficient. Second, the maternal serum 25(OH)D levels, RBC, Hb, and Hct of the pregnant women declined in the second and third trimesters. Thus we propose to have routine screening of vitamin D status of pregnant women, especially in the second trimester.
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Shibata M, Kaji T, Yonetani N, Yoshida A, Sogawa E, Maeda K, Irahara M. Effect of prolonged hospitalization on fetal growth in threatened preterm labor. THE JOURNAL OF MEDICAL INVESTIGATION 2019; 66:153-156. [DOI: 10.2152/jmi.66.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Maki Shibata
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
| | - Takashi Kaji
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
| | - Naoto Yonetani
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
| | - Atsuko Yoshida
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
| | - Eishi Sogawa
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
| | - Kazuhisa Maeda
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
| | - Minoru Irahara
- Department of Obstetricsand Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan
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