DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196014

Evaluation of vitamin D levels in term pregnancy and its obstetric outcome in Indian women

Shilpa S. Ciryam, Munikrishna M., Dayanand C. D.

Abstract


Background: Vitamin D deficiency is currently a global pandemic affecting all age groups. Vitamin D is considered a fundamental hormone in calcium homeostasis and bone health. Risk of vitamin D deficiency increases during pregnancy due to increased maternal and fetal demands and altered vitamin D metabolism. Recently, maternal vitamin D deficiency has been linked to adverse pregnancy outcomes, including preeclampsia, gestational diabetes, fetal growth restriction and preterm birth. Adequate vitamin D status appears to be relevant to health at all ages, and even in prenatal life.

Methods: This is a cross sectional, observational study conducted in the department of obstetrics and gynaecology at R. L. Jalappa Hospital. A total number of 160 subjects were included. 5 ml of venous blood was collected and was centrifuged at 3000 rpm and stored at - 80°C till analysis. Analysis of 25-hydroxy Vitamin D was done using ELISA.

Results: Majority of the subjects were vitamin D deficient (81.87%) and 12.5% were vitamin D insufficient and only 5.63% were vitamin D sufficient. The prevalence of vitamin D deficiency was more among primigravidas (85.6%) and was associated with higher rates of caesarean section (92.4%). High prevalence of vitamin D deficiency was seen in lower middle socioeconomic class (62.5%). Maternal vitamin D deficiency was associated low birth weight of neonates (100%).

Conclusions: In this study it was concluded that majority of subjects were vitamin D deficient and belonged to lower middle socioeconomic class. Majority of this subjects who underwent caesarean section were vitamin D deficient. Vitamin D deficiency was associated only with low birth weight of neonates and no other adverse obstetric outcome.


Keywords


Obstetric outcome, Term gestation, Vitamin D

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References


Evans KN, Nguyen L, Chan J, Innes BA, Bulmer JN, Kilby MD, et al. Effects of 25-hydroxyvitamin D3 and 1, 25-dihydroxyvitamin D3 on cytokine production by human decidual cells. Biol Repro. 2006;75(6):816-22.

Al-Shaikh G, Ibrahim G, Fayed A, Al-Mandeel H. Impact of vitamin D deficiency on maternal and birth outcomes in the Saudi population: a cross-sectional study. BMC Preg Childbirth. 2016;16(1);119.

De-Regil L, Palacios C, Lombardo L, Peña-Rosas J. Vitamin D supplementation for women during pregnancy. Sao Paulo Med J. 2016;134(3):274-5.

Amegah AK, Klevor MK, Wagner CL. Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: a systematic review and meta-analysis of longitudinal studies. PLoS One. 2017;12(3):e0173605.

Sachan A, Gupta R, Das V, Agarwal A, Awasthi P, 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.

Flood-Nichols S, Tinnemore D, Huang R, Napolitano P, Ippolito D. Vitamin D deficiency in early pregnancy. PLoS One. 2015;10(4):e0123763.

Domaracki P, Sadlecki P, Odrowaz-Sypniewska G, Dzikowska E, Walentowicz P, Siodmiak J, et al. Serum 25(OH) Vitamin D levels in polish women during pregnancies complicated by hypertensive disorders and gestational diabetes. Int J Mol Sci. 2016;17(10):1574.

Dawodu A, Salameh K, Al-Janahi N, Reedy A. Prevalence and risk factors for low vitamin D status among breastfeeding mother and infant dyads in an environment with abundant sunshine. Int J Women's Health. 2016;8:529-35.

Pratumvinit B, Wongkrajang P, Wataganara T, Hanyongyuth S, Nimmannit A, Chatsiricharoenkul S, et al. Maternal vitamin D status and its related factors in pregnant women in Bangkok, Thailand. PLoS One. 2015;10(7):e0131126.

Liu Y, Jin Q, Bao Y, Li S, Wang J, Qiu L. Investigation of the vitamin D nutritional status in women with gestational diabetes mellitus in Beijing. Lipids Health Dis. 2017;16(1):22.

Lindqvist P, Silva A, Gustafsson S, Gidlöf S. Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case–control study. BMJ Open. 2016;6(9):e009733.

Rodriquez A, Marina S, Jimenez AM, Espluques A, Ballester F, Espada M, et al. Vitamin D Status in Pregnancy and Determinants in a Southern European Cohort Study. Paediatr Perinat Epidemiol. 2016;30(3):217-28.

Veena S, Gale C, Krishnaveni G, Kehoe S, Srinivasan K, Fall C. Association between maternal nutritional status in pregnancy and offspring cognitive function during childhood and adolescence; a systematic review. BMC Preg Childbirth. 2016;16(1):220.

Bowyer L, Catling-Paull C, Diamond T, Homer C, Davis G, Craig ME. Vitamin D, PTH and calcium levels in pregnant women and their neonates. Clin Endocrinol (Oxf). 2009;70:372-7.

Leffelaar ER, Vrijkotte TG, van EM. Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort. Br J Nutr 2010;104:108-17.

Nagulesapillai T, Ronksley P, Aghajafari F, Tough S, O’Beirne M, Rabi D. Association between maternal serum 25-hydroxyvitamin d level and pregnancy and neonatal outcomes. Obstet Anesth Digest. 2014;34(2):115-6.

Ataseven F, Aygün C, Okuyucu A, Bedir A, Kücük Y, Kücüködük Ş. Is vitamin D deficiency a risk factor for respiratory distress syndrome?. Int J Vit Nutr Res. 2013;83(4):232-7.

Mirzakhani H, Litonjua A, McElrath T, O’Connor G, Lee-Parritz A, Iverson R. Early pregnancy vitamin D status and risk of preeclampsia. J Clin Invest. 2016;126(12):4702-15.