ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Beyond Deficiency Prevention: Meteorological Determinants and Nonlinear Associations of Maternal Vitamins D, A, and E with Perinatal Outcomes in 10,824 Chinese Pregnancies
Provisionally accepted
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To examine meteorological factors associated with maternal vitamins D, A, and E and their associations with delivery and neonatal outcomes in central China. Methods: In this retrospective cross-sectional analysis of 10,824 third-trimester women who delivered at 37 weeks or later in Wuhan (2020–2023), serum vitamin levels were measured by high-performance liquid chromatography. Daily temperature, humidity, precipitation, and wind speed were matched to individual blood collection dates. Multivariable logistic regression and restricted cubic spline models were used to evaluate associations with fetal distress, meconium-stained amniotic fluid, premature rupture of membranes (PROM), low birth weight, and macrosomia. Results: Vitamin D deficiency (30.2%), vitamin A deficiency (5.5%), and vitamin E excess (41.8%) were common. Each 1°C increase in ambient temperature was associated with lower odds of vitamin D deficiency (aOR 0.970, p < 0.001) and vitamin A deficiency (aOR 0.976, p = 0.008), with significant temperature–humidity and temperature–wind interactions (p < 0.001). Vitamin A deficiency was associated with higher odds of PROM (aOR 1.76, 95% CI 1.44–2.14), whereas low or moderate vitamin D and A levels were associated with lower odds of fetal distress and meconium staining (aOR approximately 0.85, p < 0.05). Vitamin A deficiency was associated with markedly higher odds of macrosomia (aOR 3.14), and vitamin E excess was associated with a 60% increase in odds (aOR 1.60). Restricted cubic spline models revealed U-shaped associations between vitamin A and low birth weight, and between vitamin D and macrosomia. Conclusion: Ambient temperature emerged as the primary meteorological factor associated with maternal vitamin status. Both deficiency and excess were associated with adverse delivery and neonatal outcomes, supporting the need for population-specific optimization beyond deficiency prevention.
Keywords: Environmental determinants, Fat-soluble vitamins, maternal nutrition, Nonlinear associations, outcomes, perinatal, Subtropical populations
Received: 01 Nov 2025; Accepted: 12 Feb 2026.
Copyright: © 2026 Li, deng, Zhou, Rao, Xiang, Xi and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Changzhen Li
shiyong deng
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.