A study on prevalence of vitamin D Deficiency among pregnant women attending a tertiary health centre in Rajasthan, India
Keywords:Antenatal women, BMI, Parity, Rajasthan, Serum level, Vitamin D
Background: Objective of the study was to study the prevalence of vitamin D deficiency among antenatal women and in relation to parity, BMI, diet and working status.
Methods: Prospective study conducted at NIMS Medical College, Jaipur from Dec 2019-July 2021, in the Department of Gynaecology and Obstetrics. It was a hospital based observational study 160 pregnant women were included in the study after obtaining written informed consent. Blood was collected at their first visit itself and 25 (OH) D3 level was tested by Chemiluminescent Immunoassay (CLIA) in hospital lab. And results were analysed.
Results: Out of 160 antenatal women, only 12 (07.50%) had sufficient vitamin D levels of 30-100 ng/ml. Mean (SD) vitamin D level in this group was 41.1±10.8. 41 (25.625%) participants had vitamin D insufficiency (20-29 ng/ml) with a mean (SD) of 22.6±2.3 and 107 (68.875%) participants had vitamin D deficiency with serum level <20 ng/ml with a mean (SD) value of 13.8±3.9. Vitamin D deficiency and insufficiency together (vitamin D <30 ng/ml) constituted 92.50% and the mean (SD) was 16.2±5.6. Among vitamin D deficient group, 26 (16.25%) were having vitamin D level <10 ng/ml with a mean of 8.1±1.3.
Conclusions: There is high prevalence of vitamin D insufficiency and deficiency among antenatal women attending the OPD in NIMS Medical College and Hospitals in Rajasthan region. Since vitamin D has crucial role in maternal and foetal health outcomes, it is of utmost importance to correct this deficiency in pregnancy.
Royal College of Obstetricians and Gynaecologists. Vitamin D in Pregnancy. Scientific Impact Paper No 43. London: RCOG; 2014.
Hall AC, Juckett MB. The role of vitamin D in hematologic disease and stem cell transplantation. Nutrients. 2013;5(6):2206-21.
Laughlin GA, Kritz-Silverstein D, Bergstrom J, Reas ET, Jassal SK, Barrett-Connor E et al. Vitamin D insufficiency and cognitive function trajectories in older adults: the rancho bernardo study. J Alzheimer's Dis. 2017;58(3):871-3.
Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. Am J Obstet Gynecol. 2010;203(4):366-e1.
Shand AW, Nassar N, Von Dadelszen P, Innis SM, Green TJ. Maternal vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre-eclampsia. BJOG. 2010;117(13):1593-8.
Fiscaletti M, Stewart P, Munns CF. The importance of vitamin D in maternal and child health: a global perspective. Public Health Rev. 2017;38(1):1-7.
Lau SL, Gunton JE, Athayde NP, Byth K, Cheung NW. Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Med J Aust. 2011;194(7):334-7.
Bodnar LM, Krohn MA, Simhan HN. Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy. J Nutr. 2009;139(6):1157-61.
Persad MD, Staszewski C, Khan F, Perseleni T, Herrera K, Garre o D. Does Antepartum Vitamin D3 Supplementation Prevent Chorioamnionitis?[24P]. Obstet Gynecol. 2019;133:176S-7S.
Kaushal M, Magon N. Vitamin D in pregnancy: A metabolic outlook. Indian J Endocrinol Metab. 2013;17(1):76.
Lapillonne A. Vitamin D deficiency during pregnancy may impair maternal and fetal outcomes. Med Hypothe. 2010;74(1):71-5.
Kerley CP, Elnazir B, Faul J, Cormican L. Vitamin D as an adjunctive therapy in asthma. Part 1: A review of potential mechanisms. Pulm Pharmacol Ther. 2015;32:60-74.
Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nut. 2008;87(4):1080S-6S.
Lips P. Vitamin D physiology. Prog Biophys Mol Biol. 2006;92(1):4-8.
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53-8.
Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005;10(2):94-111.
Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int. 2005;16(7):713-6.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30.
Aparna P, Muthathal S, Nongkynrih B, Gupta SK. Vitamin D deficiency in India. J Family Med Prim Care. 2018;7(2):324.
Durairaj K, Muthulakshmi M, Venkataraman P, Murali R, Rukumani J. Vitamin D Deficiency among Pregnant Women Attending Tertiary Care Centre in Tamilnadu. J Chem Pharm Res. 2018;10(5):126-31.
Hoseinzadeh E, Taha P, Wei C, Godini H, Ashraf GM, Taghavi M, et al. The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency. Food Chem Toxicol. 2018;113:241-54.
Chandel AB, Mittal R, Sharma A, Mittal S, Samyal P. Prevalence of vitamin D deficiency in antenatal women. Int J Reprod Contracept Obstet Gynecol. 2019;8(6):2302-6.
Binkley N, Novotny R, Krueger D, Kawahara T, Daida YG, Lensmeyer G, et al. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab. 2007;92(6):2130-5.
Tuan VM, Xuan LT, Nhat PQ. Vitamin D deficiency rate in first-trimester pregnant women at Ho Chi Minh City. Gynecol Reprod Health. 2019;3(1):1-5.
Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007;137(2):447-52.
Sharma S, Kumar A, Prasad S, Sharma S. Current scenario of vitamin D status during pregnancy in north Indian population. J Obstet Gynecol India. 2016;66(2):93-100.