Correlation between maternal and neonatal blood vitamin D levels and its effect on the newborn anthropometry

Paulraj Sathish; Sajeethakumari Raveendran; Ramasamy Padma; Doraisami Balakrishnan; Muthulakshmi Muthusami

doi:10.18203/2320-1770.ijrcog20162821

Authors

Paulraj Sathish Department of Medical Research, SRM Medical College Hospital and Research Centre, Kanchipuram, India
Sajeethakumari Raveendran Department of Obstetrics and Gynecology, SRM Medical College Hospital and Research Centre, Kanchipuram, India
Ramasamy Padma Department of Medical Research, SRM Medical College Hospital and Research Centre, Kanchipuram, India
Doraisami Balakrishnan Department of ENT and Audiology, SRM Medical College Hospital and Research Centre, Kanchipuram, India
Muthulakshmi Muthusami Department of Obstetrics and Gynecology, SRM Medical College Hospital and Research Centre, Kanchipuram, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20162821

Keywords:

Pregnancy, New born, Vitamin D, Birth weight, Socioeconomic status

Abstract

Background: Vitamin D deficiency during pregnancy has important implications for the new born and infant. In India, there were few data about the prevalence of hypovitaminosis D in pregnancy and in new-born and its correlation. Hence, this study aim was to determine vitamin D deficiency in pregnant women and their new-borns and to assess the correlation between maternal and new born serum levels of the vitamin D3 and also to study its effect on the newborn anthropometry.

Methods: This cross-sectional, hospital based study was conducted with 54 consecutive women in labour presenting with a singleton term pregnancy at a large tertiary centre in Tamilnadu, India. Data were recorded on a special form and 25-hydroxy vitamin D3 was assessed before delivery in mothers and after delivery in their infant’s umbilical cord blood.

Results: The mean vitamin D levels were 20.21 ng/mL for the participants and 20.07 ng/mL for the newborns. Vitamin D severe deficiency was noted in 3 (6%), deficiency 31 (57%), insufficiency 12 (22%) and sufficiency in 8 (15%) of 54 participants whereas severe deficiency, insufficiency and sufficiency respectively, were noted in 4 (7%), 30 (56%), 11 (20%) and 9 (17%) of the newborns. Maternal vitamin D level significantly associated with socioeconomic status, term of delivery and type of delivery respectively were p=0.000, p=0.000 and p=0.038 whereas age (p=0.081), BMI (p=0.085) and parity (p=0.038) was not significant at p <0.05 level by chi-square analysis. Similarly, the new born characteristics of birth weight (p=0.000), birth length (p=0.016), head and chest circumference (p=0.001, p=0.000) exists significant association at p<0.05 level by analysis of variance (ANOVA) method and also there was a strong positive correlation between the vitamin D levels in maternal and cord blood (r=0.898; P <0.05).

Conclusions: There was a high prevalence of vitamin D deficiency in the south Indian pregnant women and their newborns. Vitamin D deficiency increased the risk of low birth weight neonate and it also had an effect on the length of the baby, head circumference and chest circumference. This public health problem needs urgent attention.

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References

Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clinic Proceedings. 2006;81(3):353-73.

Kelishadi R, Poursafa P. Air pollution and non-respiratory health hazards for children. Arch Med Sci. 2010;6(4):483-95.

Kovacs CS. The role of vitamin D in pregnancy and lactation: insights from animal models and clinical studies. Annu Rev Nutr. 2012;32:97-123

Camadoo L, Tibbott R, Isaza F. Maternal vitamin D deficiency associated with neonatal hypocalcaemic convulsions. Nutr J. 2007;6(23):1-5.

Lucas RM, Ponsonby AL, Pasco JA, Morley R. Future health implications of prenatal and early-life vitamin D status. Nutr Rev. 2008;66(12):710-20.

Mahon P, Harvey N, Crozier S, Inskip H, Robinson S, Arden N, et al. Low maternal vitamin D status and fetal bone development: cohort study. J Bone Miner Res. 2010;25(1):9-14.

Zhang C, Qiu C, Hu FB, David RM, Dam RM, Bralley A, et al. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One. 2008;3(11):3753-8.

Pehlivan I, Hatun S, Aydogan M, Babaoglu K, Gokalp AS. Maternal vitamin D deficiency and vitamin D supplementation in healthy infants. Turk J Pediatr. 2003;45(4):315-20.

Nicolaidou P, Hatzistamatiou Z, Papadopoulou A, Kaleyias J, Floropoulou E, Lagona E, et al. Low vitamin D status in mother-newborn pairs in Greece. Calcif Tissue Int. 2006;78(6):337-44.

Maghbooli Z, Hossein NA, Shafaei AR, Karimi F, Larijani B, Madani FS. Vitamin D status in mothers and their newborns in Iran. BMC Pregnancy Childbirth. 2007;7(1):1-15.

Thomson K, Morley R, Grover SR, Zacharin MR. Postnatal evaluation of vitamin D and bone health in women who were vitamin D-deficient in pregnancy and in their infants. Med J Aust. 2004;181(9):486-8.

Karim SA, Nusrat U, Aziz S. Vitamin D deficiency in pregnant women and their newborns as seen at a tertiary-care center in Karachi, Pakistan. Int J Gynecol and Obstet. 2011;112(1):59-62.

Hossain N, Khanani R, Hussain KF, Shah T, Arif S, Pal L. High prevalence of vitamin D deficiency in Pakistani mothers and their newborns. Int J Gynaecol Obstet. 2011;112(3):229-33.

Goswami R, Kochupillai N, Gupta N, Goswami D, Singh N, Dudha A. Presence of 25(OH) D deficiency in a rural North Indian village despite abundant sunshine. J Assoc Physicians India. 2008;56:755-7.

Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr. 2005;81:1060-4.

Farrant HJW, Krishnaveni GV, Hill JC, Boucher BJ, Fisher DJ, Noonan K et al. Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes of variation in newborn size. Eur J Clin Nutr. 2009;63:646-52.

Ravikumar BP. Kuppusamy’s socioeconomic modified scale - a revision of economic parameters for 2012. Int J Res Devel Health. 2013;1:2-4.

Turpeinen U, Hohenthal U, Stenman U. Determination of 25-hydroxyvitamin D in serum by HPLC and immunoassay. Clin Chem. 2003;49:1521-4.

Ross AC, Taylor CL, Yaktine AL, Del VHB. Dietary reference intakes for calcium and vitamin D. Washington, DC: committee to review dietary reference intakes for vitamin D and Calcium. Institute of Medicine; National Academies Press; 2011.

Bassir M, Laborie S, Lapillonne A, Claris O, Chappuis MC, Salle BL. Vitamin D deficiency in Iranian mothers and their neonates: a pilot study. Acta Paediatr. 2009;90(5):577-9.

Kazemi A, Sharifi F, Jafari N, Mousavinasab N. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. J Womens Health. 2009:18(6):835-9.

Arya V, Bhambri R, Godbole MM, Mithal A. Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporos Int. 2004;15(1):56-61.

Shin JS, Choi MY, Longtine MS, Nelson DM. Vitamin D effects on pregnancy and the placenta. Placenta. 2010;31:1027-34.

Wagner CL, Taylor SN, Dawodu A, Johnson DD, Hollis BW. Vitamin D and its role during pregnancy in attaining optimal health of mother and fetus. Nutr. 2012;4(3):208-30.

Zhuang XL, Zhu ZW, Zhu DB, Chen LQ, Zhao ZY, Shao J. Maternal-neonatal vitamin D status and related factors. Zhonghua Er Ke Za Zhi. 2012;50(7):498-503.

Song SJ, Si S, Liu J, Chen X, Zhou L, Jia G et al. Vitamin D status in Chinese pregnant women and their newborns in Beijing and their relationships to birth size. Pub Health Nutr. 2012;16:1-6.

Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O'Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. British Med J. 2013;346:1169.

Gernand AD, Simhan HN, Klebanoff MA. Maternal serum 25-hydroxyvitamin D and measures of newborn and placental weight in a U.S. multicenter cohort study. e Journal of Clinical Endocrinology and Metabolism, 2013;98(1):398-404.