The effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss in the first trimester

Authors

  • Sharmin Ferdous Department of Feto Maternal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Farhat Hussain Department of Obstetrics and Gynaecology, SSMC and Mitford Hospital, Dhaka, Bangladesh
  • Samira Hayee Department of Neurology, National Institute of Neuroscience and Hospital (NINS), Dhaka, Bangladesh
  • Nahreen Akhtar Department of Feto Maternal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Suraiya Khanam Department of Gyanecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Khadiza Begum Junior Consultant (Obstetrics and Gyanecology), OSD, Director General of Health Services, University, Dhaka, Bangladesh
  • Adeba Sultana Junior Consultant (Obstetrics and Gyanecology), OSD, Director General of Health Services, University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20212150

Keywords:

First trimester, Miscarriage, Serum vitamin D, Gestational age

Abstract

Background: Pregnancy loss in the first trimester is one of the most disappointing matters for a mother. But spontaneous pregnancy loss in the first trimester is the most common negative outcome of pregnancy. It's estimated that about 10% of known pregnancies are lost in the first trimester whereas fewer than 4% of pregnancies miscarry in the second trimester. Aim of current study was to assess the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss in the first trimester.

Methods: It was a case-control study conducted in the department of obstetrics and gynecology, Sir Salimullah medical college Mitford hospital, Dhaka, Bangladesh during the period of September 2018 to August 2019. A total of 100 patients were included in this study. Statistical analyses of the results were obtained by using window-based computer software devised with SPSS version 22.0.

Results: In analyzing the association of serum vitamin D status with first-trimester pregnancy state it was observed that more than half (52.0%) patients had severe deficiency (<10 ng/ml) in the case group and 14 (28.0%) patients in the control group. In total 24 (48.0%) patients had deficiency (10-20 ng/ml) in case and 35 (70.0%) in control group. Only 1 (2.0%) patient had insufficiency (21-29 ng/ml) in control group. The difference was statistically significant (p<0.05) between the two groups.

Conclusions: Maternal serum vitamin D deficiency was significantly associated with early spontaneous pregnancy loss in the first trimester.

References

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.

Malhotra N, Wahl DL & Bonjour JP 2009. ‘Vitamin D status in Asian. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20(11):1807-20.

Islam MZ, Lamberg-Allardt C, Kärkkäinen M, Outila T, Salamatullah Q, Shamim AA. Vitamin D deficiency: a concern in premenopausal Bangladeshi women of two socio-economic groups in rural and urban region. Eur J Clin Nutr. 2002;56(1):51-6.

Hyppönen E. Vitamin D for the prevention of preeclampsia? A hypothesis. Nutr Rev. 2005;63(7): 225-32.

Lagishetty V, Liu NQ, Hewison M. Vitamin D metabolism and innate immunity. Mol Cell Endocrinol. 2011;347(1-2):97-105.

Christakos S, Dhawan P, Benn B, Porta A, Hediger M, Oh GT, et al. Vitamin D: molecular mechanism of action. Annals New York Acad Sci. 2007; 1116(1):340-8.

Diaz L, Sánchez I, Avila E, Halhali A, Vilchis F, Larrea F. Identification of a 25-hydroxyvitamin D3 1á-hydroxylase gene transcription product in cultures of human syncytiotrophoblast cells. J Clin Endocrinol Metab. 2000;85(7):2543-9.

Mitchell DM, Henao MP, Finkelstein JS, Burnett-Bowie SA. Prevalence and predictors of vitamin D deficiency in healthy adults. Endocr Pract. 2012; 18(6):914-23.

Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos CT. Vitamin D status: United states, 2001-2006. NCHS data brief. 2011; 59(59):1-8.

Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48-54.

Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc. 2010;85(8):752-8.

Lerchbaum E, Rabe T. Vitamin D and female fertility. Curr Opin Obstet Gynecol. 2014;26(3):145-50.

Woo J, Lam CW, Leung J, Lau WY, Lau E, Ling X, et al, Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong. Br J Nutr. 2008;99(60):1330-4.

Flood-Nichols SK, Tinnemore D, Huang RR, Napolitano PG, Ippolito DL. Vitamin D deficiency in early pregnancy. PLoS One. 2015;10(4): e0123763.

Ghaedi N, Forouhari S, Zolghadri J, Sayadi M, Nematollahi A, Khademi K. Vitamin D deficiency and recurrent pregnancy loss in Iranian women. Curr Opin Obstet Gynecol. 2016;29(4):157-9.

Andersen LB, Jørgensen JS, Jensen TK, Dalgård C, Barington T, Nielsen J, Beck-Nielsen SS, Husby S, Abrahamsen B, Lamont RF, Christesen HT. Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort. Am J Clin Nutr. 2015;102(3):633-8.

Shareif PDM, Mahmood DSK, Al-Abassy DNH. The association of serum vitamin d and calcium levels with early recurrent spontaneous pregnancy loss. J Med Sci Clin Res. 2008;6(11):272-7.

Kuhr DL, Sjaarda LA, Alkhalaf Z, Omosigho UR, Connell MT, Silver RM, et al. Vitamin D is associated with bioavailability of androgens in eumenorrheic women with prior pregnancy loss. Am J Obstet Gynecol. 2018;218(6):608.e1-6.

Kota AK, Kwon G, Choi W, Mabry JM, Tuteja A. Hygro-responsive membranes for effective oil–water separation. Nature Comm. 2012;3:1025.

Li N, Wu HM, Hang F, Zhang YS, Li MJ. Women with recurrent spontaneous abortion have decreased 25(OH) vitamin D and VDR at the fetal-maternal interface. Braz J Med Biol Res. 2017;50(11):e6527.

Møller UK, Streym S, Heickendorff L, Mosekilde L, Rejnmark L. Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women. Eur J Clin Nutr. 2012;66(7):862-8.

Downloads

Published

2021-05-27

Issue

Section

Original Research Articles