Associations of Gestational Exposure to Air Pollution With Maternal Vitamin D Levels

Anne-Claire Binter, Akhgar Ghassabian, Runyu Zou, Hanan El Marroun, Aitana Lertxundi, Karen M Switkowski, Marisa Estarlich, Ana Cristina Rodríguez-Dehli, Ana Esplugues, Tanja Vrijkotte, Jordi Sunyer, Loreto Santa-Marina, Ana Fernández-Somoano, Kinga Polanska, Rosemary R C McEachan, Emily Oken, Henning Tiemeier, Mònica Guxens
The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 5, May 2025, Pages 1410–1418
https://doi.org/10.1210/clinem/dgae395

Abstract

Context

Maternal vitamin D level is an important determinant of pregnancy and child health outcomes. Exposure to air pollution is suspected to increase the risk of vitamin D deficiency, but the evidence is scarce.

Objective

We investigated the association between air pollution during pregnancy and maternal vitamin D levels.

Methods

A total of 15 935 pregnant women from 5 birth cohorts in Europe and the United States were included. Averaged concentrations of nitrogen oxides, fine and coarse particles, and composition of fine particles from conception until vitamin D measurement were estimated at participants’ residential addresses using land-use regression or other spatiotemporal models. Cohorts measured vitamin D as 25(OH)D or 25(OH)D₃ levels in serum or plasma at early or mid-pregnancy. We defined suboptimal vitamin D levels as levels below 20 ng/mL. We performed logistic regression models for each cohort to estimate the association between air pollution exposure and suboptimal vitamin D levels and pooled cohort-specific estimates in a random-effect meta-analysis. Models were adjusted for sociodemographic and lifestyle characteristics and month of conception.

Results

We found an association between particulate matter (PM)_2.5 and higher odds of suboptimal vitamin D levels (ie, below 20 ng/mL) (odds ratio per 5 μg/m³ increase in PM_2.5, 1.43; 95% CI: 1.02, 1.99). There was no association between other air pollutant exposure and vitamin D levels.

Conclusion

PM_2.5 exposure might contribute to suboptimal levels of vitamin D in pregnancy. Reducing air pollution exposure should be a priority because vitamin D deficiency may adversely influence offspring development.

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