Umbilical cord blood vitamin D levels and neonatal head circumference: findings from a cross-sectional study

Abstract

Background. Vitamin D is essential for fetal skeletal development, neurogenesis, and immune function. Maternal deficiency is widespread and may affect neonatal outcomes, including head circumference, a proxy for early brain growth. Objective. To assess the association between umbilical cord blood vitamin D concentration and neonatal head circumference. Methods. A cross-sectional study was conducted at three hospitals in Makassar, Indonesia, between September 2024 and September 2025. Neonates with a birth weight ≥2,500 g and without congenital anomalies were included through total sampling. Cord blood was collected immediately after delivery to measure 25-hydroxyvitamin D [25(OH)D]. Vitamin D deficiency was defined as <20 ng/mL. Neonatal characteristics and anthropometric measures were recorded. Data were analyzed using the Mann-Whitney U test and Spearman correlation. Results. A total of 89 neonates were enrolled, of whom 51.7% were male. Vitamin D deficiency (<20 ng/mL) was highly prevalent (80.9%). Male infants had significantly larger head circumferences than females (median 34.0 vs 33.0 cm; p = 0.007). Birth weight was positively correlated with head circumference (r = 0.340; p = 0.001). However, cord blood vitamin D concentration was not significantly associated with cranial size, either as a categorical variable (p = 0.086) or continuous variable (r = –0.081; p = 0.450). Conclusion. Cord blood vitamin D concentration was not significantly associated with neonatal head circumference. Sex and birth weight were the main determinants of cranial size at birth. Despite its lack of association with head circumference, the high prevalence of vitamin D deficiency highlights the importance of maternal vitamin D optimization during pregnancy.

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