Correlation of Vitamin D levels with feto-maternal outcome


  • Nidhi Chauhan Department of Obstetrics and Gynecology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India
  • Nikita Pahuja Department of Obstetrics and Gynecology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India
  • Vinita Kalra Department of Biochemistry, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India



Correlation, Feto-maternal outcome


Background: Vitamin D deficiency in adult females may increase risk of pre-eclampsia, gestational diabetes, bacterial vaginosis. Various malpresentation, cephalo-pelvic disproportion and difficult deliveries increases the risk of caesarean section. It may also increase the risk of fetal hypovitaminosis D, neonatal rickets and tetany, lower respiratory tract infections, low birth weight, the largest cause of infant mortality in India. This study was under taken to study the impact of vitamin D deficiency on feto-maternal outcome.

Methods: The study was conducted in the Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Sample size was 100 pregnant females attending antenatal clinic.

Results: Out of 100 subjects, pre-eclampsia was seen in 15, among which 5 (23.80%) had deficient, 9 (13.04%) had insufficient and 1 (10%) had sufficient vitamin D levels. Eclampsia was seen in 3 subjects, out of which 1 (4.76%) had deficient, 2 (2.89%) had insufficient vitamin D status. IUGR was seen in 8 subjects, out of which 4 (19.04%) had deficient vitamin D levels, 4 (5.79%) had insufficient vitamin D status. Neither of the two had sufficient vitamin D status. Deficient vitamin D status with birth weight ≤2.5 kg was seen in 9 (42.85%) subjects and 12 (57.14%) subjects with >2.5 kg Insufficient Vitamin D status was seen in 22 (31.88%) subjects with birth weight ≤2.5 kg and 48 (69.56%) with birth weight >2.5 kg.

Conclusions: Prevalence of vitamin D deficiency and insufficiency was noted in this region and its association with pre-eclampsia (23.80%, 13.04% and 10% in deficient, insufficient and sufficient group respectively) was seen. Higher incidence of LSCS was also present among the deficient and the insufficient group.


Delvin EE, Salle BL, Glorieux FH, Adeleine P, David LS. Vitamin D supplementation during pregnancy: effect on neonatal calcium homeostasis. J Pediatr. 1986;109:328-34.

Purvis RJ, Barrie WJ, MacKay GS. Enamel hypoplasia of the teeth associated with neonatal tetany: a manifestation of maternal vitamin D deficiency. Lancet. 1973;2:811.

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;137:447-52.

Wei SQ, Audibert F, Hidiroglou N, Sarafin K, Julien P, Wu Y, et al. Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia. BJOG. 2012;119:832-9.

Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92:3,517-22.

Powe CE, Seely EW, Rana S, Bhan I, Ecker J, Karumanchi SA, et al. First trimester vitamin D, vitamin D binding protein, and subsequent pre-eclampsia. Hypertension. 2010;56:758-63.

Brooke OG, Brown IRF, Bone CDM. Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth. Br Med J. 1980;1:751-4.

Barclay L. Vitamin D deficiency linked to bacterial vaginosis. J Nutr. 2009;139:1157-61.

Makgoba M, Nelson SM, Savvidou M, Messow CM, Nicolaides K, Sattar N. First-trimester circulating 25-hydroxyvitamin D levels and development of gestational diabetes mellitus. Diabetes Care. 2011;34:1091-3.

Baker AM, Haeri S, Camargo CA Jr, Stuebe AM, Boggess KA. First trimester maternal vitamin D status and risk for gestational diabetes mellitus: a nested case-control study. 2012;28(2):164-8.

Zhang C, Qiu C, Hu FB. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. Plos One. 2008;3:e3753.

Shibata M, Suzuki A, Sekiya T, Sekiguchi S, Asano S, Udagawa Y, et al. High prevalence of hypovitaminosis D in pregnant Japanese women with threatened premature delivery. J Bone Miner Metab. 2011;29(5):615-20.

Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: Double blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res. 2011;26(10):2341-57.

Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009;94(3):940-5.

Pehlivan I, Hatun S, Aydoğan M, Babaoğlu K, Türker G, Gökalp AS. Maternal serum Vitamin D levels in the third trimester of pregnancy. Turk J Med Sci. 2002;32:237-41.

Fernández-Alonso AM, Dionis-Sánchez EC, Chedraui P, González-Salmerón MD. The Spanish Vitamin D and Women's Health Research Group first-trimester maternal serum 25-hydroxyvitamin D3 status and pregnancy outcome. Int J Gynecol Obstet. 2012;116(1):6-9.

Bodnar LM, Catov JM, Zmuda JM, Cooper ME, Parrott MS, Roberts JM, et al. Maternal serum 25-hydroxyvitamin D concentrations are associated with small-forgestational age births in white women. J Nutr. 2010;140(5):999-1006.






Original Research Articles