scholarly journals High Prevalence of Vitamin D deficiency among normotensive and hypertensive pregnant women in Ghana

Author(s):  
Linda Ahenkorah Fondjo ◽  
Worlanyo Tashie ◽  
William K. B. A. Owiredu ◽  
Enoch Appiah Adu-Gyamfi ◽  
Laila Seidu

Abstract Background: Hypovitaminosis D in pregnancy is associated with adverse health outcomes in mothers, newborns and infants. This study assessed the levels of 25-hydroxyvitamin D [25(OH)D] in normotensive pregnancies and pregnancies complicated by preeclampsia, and evaluated the association between vitamin D deficiency and foeto-maternal outcome. Methods: This case-control study was conducted among pregnant women who visited the Comboni Hospital, in Ghana from January 2017 to May 2018 for antenatal care. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Socio-demographic, clinical and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of 25(OH)D using enzyme-linked immunosorbent assay technique. Lipids (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) and were also estimated. Results: A total of 81.7% of the study participants had vitamin D deficiency. Of these, 88.6% of the women with PE had vitamin D deficiency compared to 75.0% in the NP. Vitamin D levels was significantly reduced in the PE women compared to the normotensive pregnant women (p=0.001). A higher proportion of the preeclamptic women who were vitamin D deficient had preterm delivery (p < 0:0001) and delivered low birth weight infants (p < 0:0001), and infants with IUGR (p < 0:0001) compared to the control group (p < 0:0001). Pregnant women with PE presented with significant dyslipidaemia, evidenced by significantly elevated TC (p=0.008), LDL (p<0.0001), triglycerides (p=0.017) and a significantly reduced HDL (p=0.001) as compared to NP. In the preeclamptic women, serum 25(OH)D showed an inverse, but not significant association with TC (β= -0.087, p=0.464), TG (β= -0.143, p=0.233) and LDL (β= -0.101, p=0.388) and a positive, but not significant association with HDL (β= 0.166, p=0.154). Conclusion: The prevalence of vitamin D deficiency is high in both normotensive pregnancies and pregnancies complicated by preeclampsia but amplified in preeclampsia. Higher proportion of pregnant women with hypovitaminosis D had preterm babies and delivered low birth weight neonates. Additional studies are needed to explore the potential benefits and optimal dosing of vitamin D use in pregnancy especially in sub-Saharan Africa.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linda Ahenkorah Fondjo ◽  
Worlanyo Tashie ◽  
William K. B. A. Owiredu ◽  
Enoch Appiah Adu-Gyamfi ◽  
Laila Seidu

Abstract Background Hypovitaminosis D in pregnancy is associated with adverse health outcomes in mothers, newborns and infants. This study assessed the levels of 25-hydroxyvitamin D [25(OH)D] in normotensive pregnancies and in preeclampsia, evaluated the association between vitamin D deficiency and preeclampsia risk; and determined the foeto-maternal outcome in preeclamptic women with vitamin D deficiency. Methods This case-control study was conducted among pregnant women who visited the Comboni Hospital, in Ghana from January 2017 to May 2018 for antenatal care. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Socio-demographic, clinical and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of 25- hydroxyvitamin D [25(OH)D] using enzyme-linked immunosorbent assay technique. Lipids (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) were also estimated. Results A total of 81.7% of the study participants had vitamin D deficiency. Of these, 88.6% of the women with PE had vitamin D deficiency compared to 75.0% in the NP. Vitamin D levels were significantly reduced in the PE women compared to the normotensive pregnant women (p = 0.001). A higher proportion of the preeclamptic women who were vitamin D deficient had preterm delivery (p < 0:0001) and delivered low birth weight infants (p < 0:0001), and infants with IUGR (p < 0:0001) compared to the control group (p < 0:0001). Pregnant women with PE presented with significant dyslipidemia, evidenced by significantly elevated TC (p = 0.008), LDL (p < 0.0001), triglycerides (p = 0.017) and a significantly reduced HDL (p = 0.001) as compared to NP. In the preeclamptic women, serum 25(OH) D showed an inverse, but not significant association with TC (β = − 0.043, p = 0.722, TG (β = − 0.144, p = 0.210) and LDL (β = − 0.076, p = 0.524) and a positive, but not significant association with HDL (β = 0.171, p = 0.156). Conclusion The prevalence of vitamin D deficiency is high in both normotensive pregnancies and pregnancies complicated by preeclampsia but amplified in preeclampsia. Higher proportion of pregnant women with hypovitaminosis D had preterm babies and delivered low birth weight neonates. Additional studies are needed to explore the potential benefits and optimal dosing of vitamin D use in pregnancy, especially in sub-Saharan Africa.


Author(s):  
Anupama Dave ◽  
Monica Verma ◽  
Neelam Jain ◽  
Atisha Dave

Background: From conception the embryo is dependent on the mother for all nutritional requirements until birth. Vitamin D deficiencies have adverse effect on pregnancy outcome result in poor growth, prematurity, NTD, even congenital anomalies. The aim and objectives of the study was to assess the prevalence of deficiencies among pregnant woman attending M.Y. Hospital and assess the correlation with the pregnancy complications.Methods: Total 110 patients were studied for vitamin d levels and associated obstetrical complications and risk factors over a period of six months. 53 pregnant women were found to be deficient with vitamin D.Results: 53 pregnant women out of total of 110 were deficient in vitamin D levels. Maximum patients belonged to group (21-30yr) of age. Vitamin D deficiency was more in housewives (65.3%) and in urban(86.8%). Low birth weight<2.5kg were born 50(45.5%) and 2 IUD. 2 were diagnosed NTD in USG reports. 80% low birth weight babies were born in vitamin D deficient women.Conclusions: Our study fails to show a causal relation between low vitamin D level and adverse maternal and fetal outcome in terms of preeclampsia, cesarean delivery, oligo and diabetes. There was a relation between vitamin D deficiency and low birth weight babies.


2021 ◽  
Author(s):  
Anna Liori ◽  
Damaskini Polychroni ◽  
Georgios K Markantes ◽  
Maria Stamou ◽  
Sarantis Livadas ◽  
...  

Adequate vitamin D levels are particularly important in pregnant women for both the maternal and neonatal health. Prior studies have shown a significantly high prevalence of vitamin D deficiency (VDD) among refugees. However, no study has addressed the prevalence of VDD in pregnant refugees and its effects on neonatal health. In this study, we examined the prevalence of VDD in refugee pregnant women living in Greece and compared our results with Greek pregnant inhabitants. Vitamin D deficiency was frequent in both groups but was significantly more common in refugees (92.2% vs 67.3% of Greek women, p=0.003) with 70.6% of refugees having severe hypovitaminosis D (<10 ng/ml). As a result, most newborns had Vitamin D deficiency, which affected refugee newborns to a greater extent. Our results suggest a need to screen newcomer children and pregnant women for vitamin D deficiency in all host countries around the world. Such a screen will appropriately guide early and effective interventions with the goal to prevent adverse neonatal and maternal outcomes.


2021 ◽  
Vol 20 (5) ◽  
pp. 114-123
Author(s):  
E.V. Shikh ◽  
◽  
A.A. Makhova ◽  
Zh.M. Sizova ◽  
N.V. Shikh ◽  
...  

Vitamin D status during pregnancy has an impact on fetal growth and development and plays an important role in the prevention of pregnancy complications. Fetal vitamin D supplementation is completely dependent on maternal status, which explains the high correlation between 25(OH)D concentrations in maternal and umbilical cord blood. Adequate vitamin D supplementation in pregnant women is associated with a decreased risk of preterm birth and low birth weight. Most newborns, regardless of gestational age, have insufficient vitamin D levels. Thus, the problem of Vitamin D supplementation is relevant not only for pregnant women, but also for newborns. Research studies of recent years have aimed at comparing the efficacy of Vitamin D dosing to prevent pregnancy complications. Doses higher than 4000 IU have virtually no effect on the risk of preeclampsia compared with doses of 4000 IU or less. Administration of Vitamin D in doses less than 2000 IU per day reduces the risk of low birth weight, intrauterine or neonatal mortality. Doses higher than 2000 IU have no additional benefit. Recommendations for vitamin D supplementation based on objective pharmacokinetic characteristics should be developed. Key words: pregnancy, vitamin D, doses, preterm birth, gestational diabetes, preeclampsia


Author(s):  
Sujatha M. S. ◽  
Shruthi K. R. ◽  
Neelaharika .

Background: Vitamin  D  deficiency  is  thought  to  be   common among  pregnant  women  and  is  associated  with  adverse  maternal  and  perinatal  outcome. Maternal  and foetal  outcome  in  pregnant  women  with  standard  obstetric  care  was compared with   women with  additional  vitamin D  supplementation.Methods: A randomized comparative  study  was  conducted  on  100  patients attending  the  antenatal  clinic at JSS Medical College and Hospital, Mysuru, Karnataka, India   who were randomly  grouped   into  group A (50 patients) who  received  standard  obstetric care  (500 mg calcium+200 IU vitamin D)  and  group  B (50 patients)  who  received  in  addition  to  standard  obstetric  care   supplementation  of   Vitamin  D  1000 IU/day starting  from  14  weeks  of  gestation  till  delivery.  Vitamin  D  levels  were assessed  in  both  the  groups  with  onset  of  labour  by  chemiluminescence immunoassay  and  obstetric  and  neonatal  outcomes  in  both  groups  were compared.Results: High  incidence  of vitamin  D  deficiency  (96%)  in  standard  care  group  compared  to  vitamin  D supplemented  group  ( p= <0.0001)  was  noted. The  study  showed  significant  reduction  in  risk  of  Preeclampsia (P=0.004),  GDM  (P= 0.02)  and  primary  caesarean  delivery  (0.008)  in  Vitamin  D  supplemented  group. Significantly  high  birth  weight  in  vitamin  D supplemented   group,  an  increase  in  320 grams  in  birth  weight  was  noted  (P <0.0001).Conclusions: There is a high incidence of subnormal vitamin D levels in antenatal women and is associated with maternal and neonatal adverse effects. Measuring Vitamin D levels and appropriate supplementation of higher dose of vitamin D is an effective strategy in prevention of adverse maternal and neonatal outcomes.


2017 ◽  
Vol 21 (1) ◽  
pp. 42-48
Author(s):  
Sanjay Jain ◽  
Arijit Debnath ◽  
Somosri Ray

ABSTRACT Introduction Hypovitaminosis D in pregnancy has been reported to cause various maternal effects, i.e., hypocalcemia, subclinical myopathy, increased risk of preeclampsia (PE), gestational diabetes mellitus (GDM), cesarean sections, and fetal effects, i.e., neonatal tetany, hyperbilirubinemia congenital rickets, infantile rickets, etc. Only few Indian studies are available in this regard. Objective To estimate serum vitamin D levels in pregnant women, cord blood, and study fetomaternal outcomes. Materials and methods A prospective observational study was conducted on 54 consecutive pregnant women and their newborn babies. Serum 25-hydroxy vitamin D [25(OH)D] level was estimated in all women at the time of admission in labor ward. They were followed up to delivery and 48 hours postpartum. Vitamin D was also estimated in cord blood collected during delivery. All results were recorded and analyzed statistically. Results The mean 25(OH)D level in pregnancy was 6.81 ± 7.38 ng/mL. The mean 25(OH)D level in their babies (cord blood) was 6.34 ± 7.05 ng/mL. There was very strong positive correlation between maternal and fetal serum 25(OH)D levels (p-value 0.001, r-value 0.9). Vitamin D deficiency was strongly associated with obesity, PE, and GDM (p-value 0.001). Neonatal jaundice and tetany were also significantly associated with severe vitamin D deficiency. Conclusion Low levels of vitamin D have been observed in pregnant women and their newborn babies. Hypovitaminosis D has been associated with adverse fetomaternal outcomes. As there is a strong correlation of maternal and neonatal levels, supplementing vitamin D in a pregnant women might improve these adverse pregnancy outcomes. How to cite this article Gupta M, Debnath A, Jain S, Saini V, Ray S. Vitamin D Status in Pregnancy: Fetomaternal Outcome and Correlation with Cord Blood Vitamin D. Indian J Med Biochem 2017;21(1):42-48.


Author(s):  
Nidhi Chauhan ◽  
Nikita Pahuja ◽  
Vinita Kalra

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.


2017 ◽  
Vol 36 (3) ◽  
pp. 243-249 ◽  
Author(s):  
K. Jagadish Kumar ◽  
Abhishek Chavan ◽  
K. Shushma ◽  
Srinivasa Murthy

Introduction: Though pregnant mothers are at risk of developing Vitamin D deficiency, their level differs among the urban and rural population and has various implications on newborns. This study was undertaken to compare the vitamin D status in urban and rural population of South India among pregnant women and their newborns.Material and Methods: Ninety one pregnant women and their newborns (46 urban and 45 rural) were recruited. Maternal Vitamin D levels and serum concentrations of calcium, phosphorus, alkaline phosphatase and Vitamin D were measured in the cord blood.Results: Eighty two (90%) of the pregnant women, 38 from rural and 44 from urban, had vitamin D deficiency. However, the mean vitamin D levels were low in urban (9.42 ± 12.2) compared to rural women (35.86 ± 16.3,p=0.037).Hypovitaminosis D was noted in 88% of the newborns, deficiency being more in neonates born to urban women. Though the dietary calcium intake was uniformly low, it was lower in rural (960.1 ± 139.9 mg/d) Vs urban mothers (1060.1 ± 150.6 mg/d, p< 0.001). Urban mothers were found to be exposed to sun for lower duration of 0.3 hours compared to rural mothers 0.5 hours. Similarly the surface area of body exposed to sun was lower in urban mothers (7.5%) compared to rural mothers (15%, p=0.0001). A moderate positive correlation between mother-neonate pair was noted.Conclusions: The magnitude of Hypovitaminosis D observed among pregnant women and their newborn warrants public health intervention in terms of vitamin D supplementations during pregnancy.J Nepal Paediatr Soc 2016;36(3):243-249


Author(s):  
Shilpa S. Ciryam ◽  
Munikrishna M. ◽  
Dayanand C. D.

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.


2021 ◽  
Vol 15 (10) ◽  
pp. 2829-2830
Author(s):  
Maria Ahmad Khan ◽  
Uzma Shaheen ◽  
Farah Naz ◽  
Saba .

Objective: to record the rate of low birth weight in pregnant women with vitamin D deficiency Methodology: We enrolled 120 pregnant women having <30ng/mL serum level of 25(OH)D during first trimester of pregnancy. These cases were enrolled from Deptt. of Obstet & Gynaecol, Nishter Hospital, Multan. The age range was reproductive age group with any parity and 37-40weeks of gestation. The levels of 25(OH)D were evaluated through hospital laboratory whereas these cases were followed till delivery with routine treatment of Vitamin D deficiency. Birth weight of the neonate i.e. weight<2.5kg was considered as low birth weight neonates Results: Frequency of vitamin D deficiency in low birth weight neonates was 40.83%(n=49) Conclusion: We concluded that the frequency of low birth weight is higher among pregnant women with vitamin D deficiency. Keywords: Pregnant women, vitamin D deficiency, low birth weight


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