The effect of multi mineral-vitamin D supplementation on pregnancy outcomes in pregnant women at risk for Pre-eclampsia

BACKGROUND: Calcium and vitamin D deficiency is common among Iranian women of childbearing age and poses adverse effects on pregnancy outcomes. The aim of the current study was to determine the prevalence of vitamin D and calcium in a sample of Iranian pregnant women and to assess its correlation with the feto-maternal outcomes. METHODS: In this prospective cross-sectional study, a sample of pregnant women between 15 to 45 years who were in the third trimester were recruited from a number of hospitals in Tehran. Data were collected by the means of a self-developed questionnaire, interviews, physical examination, and paraclinical tests including measuring the serum level of calcium, vitamin D, parathormone (PTH) and phosphorous (Pi). The questionnaire obtained information on age, level of education, socio-economic status, parity, gravidity, calcium intake during pregnancy, as well as feto-maternal outcomes. RESULTS: We included a total number of 233 singleton pregnancies. Most of the subjects (58.4%) had vitamin D deficiency and 12.0% suffered from severe vitamin D deficiency. Vitamin D deficiency was adversely associated with the years of education (p= 0.007), serum level of parathormone (p< 0.001). The Metabolic Equivalent of Task (MET) (p< 0.001), the exercise sequence per week (p< 0.001), sun exposure (p< 0.001), higher rate of sunscreen usage (p= 0.011) and higher BMI (p= 0.005). Vitamin D deficiency was associated with higher rate of cesarean delivery (p= 0.024), higher rate of diastolic hypertension (p= 0.019), higher rate of neonatal jaundice (p= 0.009) and higher rate of neonatal respiratory infections (p< 0.001). Serum level of PTH was a significant risk factor for severe vitamin D deficiency while calcium D supplementation, MET and sunscreen were significant protective factors. CONCLUSION: The prevalence of vitamin D deficiency during pregnancy among Iranian women is extremely high and is associated with adverse pregnancy outcomes including cesarean delivery, neonatal jaundice and neonatal respiratory infections. Low vitamin D supplementation and sun exposure, lack of physical activity and high BMI are the etiologies. Increasing the knowledge along with vitamin D supplementation during the pregnancy is recommended in Iranian population.

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The effects of vitamin D plus calcium supplementation on metabolic profiles, biomarkers of inflammation, oxidative stress and pregnancy outcomes in pregnant women at risk for pre-eclampsia

Journal of Human Nutrition and Dietetics ◽

10.1111/jhn.12339 ◽

2015 ◽

Vol 29 (4) ◽

pp. 505-515 ◽

Cited By ~ 24

Author(s):

M. Samimi ◽

M. Kashi ◽

F. Foroozanfard ◽

M. Karamali ◽

F. Bahmani ◽

...

Keyword(s):

Oxidative Stress ◽

At Risk ◽

Vitamin D ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Calcium Supplementation ◽

Metabolic Profiles

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Cost-effectiveness of a Vitamin D supplementation programme in pregnant women and children to prevent rickets in the UK

Bone Abstracts ◽

10.1530/boneabs.7.p110 ◽

2019 ◽

Author(s):

Vilius Floreskul ◽

Fatima Juma ◽

Anjali Daniel ◽

Imran Zamir ◽

Zulf Mughal ◽

...

Keyword(s):

Vitamin D ◽

Cost Effectiveness ◽

Pregnant Women ◽

Vitamin D Supplementation ◽

Women And Children ◽

The Uk

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Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women

10.21203/rs.3.rs-27917/v3 ◽

2020 ◽

Author(s):

Siew-Siew Lee ◽

King-Hwa Ling ◽

Maiza Tusimin ◽

Raman Subramaniam ◽

Kartini Farah Rahim ◽

...

Keyword(s):

Vitamin D ◽

Gene Polymorphism ◽

Pregnant Women ◽

Binding Protein ◽

Lifestyle Factors ◽

Vitamin D Supplementation ◽

Dietary Vitamin ◽

Vitamin D Binding Protein ◽

Significant Positive Association ◽

Cross Sectional

Abstract Background: Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women. Method: Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using a Ultra-High-Performance Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique. Results: Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD <30 nmol/L). VDD (25OHD <30 nmol/L) was significantly associated with age, veiled clothing, maternal vitamin D intakes, from both food and supplements, and GC rs7041(and GC diplotypes). In contrast to previous studies that reported for non-pregnant population, significant positive association was found between CC genotype for SNP GC rs7041, GC 1s-1s and GC If-2 with risk of VDD (25OHD <30 nmol/L). Conclusions: The high prevalence of maternal VDD found in this study suggests the need for urgent development and implementation of vitamin D supplementation or fortification strategies to reduce VDD among pregnant women. The discrepancy in the association between GC rs7041 gene polymorphism and VDD reflects the variation in the factors associated with VDD in pregnancy compared to non-pregnant state

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Vitamin D monitoring and management within men's secure services

BJPsych Open ◽

10.1192/bjo.2021.885 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S337-S338

Author(s):

Jason Niblett ◽

Shay-Anne Pantall ◽

Anis Ahmed

Keyword(s):

At Risk ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Treatment Effectiveness ◽

Average Length ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

High Rate ◽

List Type ◽

Electronic Patient Records

AimsTo audit the investigation, identification and treatment of Vitamin D deficiency within Men's Secure Services.BackgroundVitamin D and/or vitamin D deficiency has been suggested to play a role in the pathogenesis of mental illness. There is evidence that Vitamin D inadequacy is pandemic among rehabilitation patients in inpatient settings. Patients within secure hospitals are similarly considered to be at high risk, due to their limited solar exposure during often lengthy admissions. It has been suggested that these patients should be considered an ‘at-risk’ cohort, for whom Vitamin D supplementation should be routine. Men's secure services in Birmingham comprise of two medium secure units and a low secure rehabilitation unit. Here we present an audit of Vitamin D monitoring and treatment completed in 2019.MethodA three year retrospective review of electronic patient records, for all inpatients admitted within men's secure services as of 1 September 2019 (n = 188). Standards were based on the Trust accepted guidelines for management of Vitamin D deficiency.ResultKey findings included:- The majority of inpatients were Caucasian (43%) and African-Caribbean (24%). Ages ranged from 18 to 70, with a mean age of 39.Approximately two-thirds (65%) had been in hospital for over a year, of which 44% had been admitted for more than 3 years. The average length of admission was 885 days.Only 47% of patients had their Vitamin D level checked within the study period.Of those checked, 24% were tested within 1 month of admission. The mean duration between admission and Vitamin D testing was 464 days.Results ranged from 10.3 to 118.5nmol/L. A high rate of Vitamin D deficiency was identified (54%), whilst a further 16% had ‘inadequate’ levels.23% of those identified as requiring treatment did not receive any supplementation, whilst 59% of those with sufficient Vitamin D were prescribed treatment.Only 48% had their levels rechecked following treatment; of these, only 59% now had an adequate Vitamin D status.ConclusionThis audit demonstrates limited Vitamin D monitoring within male forensic inpatients. There was a high prevalence of Vitamin D insufficiency in this population, yet a substantial proportion of patients with identified deficiency were not prescribed any treatment. Ongoing monitoring and review of treatment effectiveness was poor. We argue that more consideration should be given to this population, with robust guidelines introduced for the treatment of this specific ‘at-risk group’.

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Vitamin D status and its determinants in Pre Diabetic pregnant mothers attending tertiary care centre in Tamilnadu, India

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i1.1865 ◽

2020 ◽

Vol 11 (1) ◽

pp. 617-622

Author(s):

Kavitha Durairaj ◽

Muthulakshmi M ◽

Venkataraman P ◽

Murali R ◽

Rukumani J ◽

...

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Infection Type ◽

Tertiary Care ◽

Challenge Test ◽

Vitamin D Supplementation ◽

Ultraviolet B ◽

Oral Glucose ◽

College Hospital ◽

The Impact

Vitamin D is a vital nutrient factor in the healthiness of the mother and infant. Vitamin D is mainly amalgamated in the skin following exposure to ultraviolet B radiation. Insufficiency of vitamin D in Pregnancy had been related to various sicknesses, such as respiratory infection, type 1 diabetes mellitus, high risk of childhood wheezing. The aim of this study was to investigate the impact of Vitamin D supplementation on the incidence of pregestational diabetes in pregnant women referred to antenatal clinics in SRM Medical College hospital, Tamilnadu, India. 200 pregnant women were recruited, and oral glucose challenge test (OGCT), serum calcium and 25(OH) D were determined. Participants were in the age group of 18 to 35 years, with a mean age of 26.29. Among the participants, 59% were multiparous. The present study showed that a high prevalence of vitamin D deficiency (61.5%) and insufficiency (34%) in pregnant women before supplementation with a mean of 16.84. Vitamin D supplementation during the early weeks of pregnancy might help in the improvement of maternal and child health.

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PREVALENCE, ASSOCIATED FACTORS AND ROLE OF VITAMIN D AND GLUTATHIONE REDUCTASE OF PRE-ECLAMPSIA IN PREGNANT WOMEN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1435 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Simerpreet Kukreja

Keyword(s):

Fatty Acids ◽

Vitamin D ◽

Pregnant Women ◽

Glutathione Reductase ◽

Gestational Hypertension ◽

Multiple Pregnancy ◽

Vitamin D Supplementation ◽

Research Centre ◽

Biochemical Basis

Introduction: In maternal and neonatal cases, preeclampsia is a multi-organ, heterogeneous pregnancy condition associated with significant morbidity and mortality. Since preeclampsia is a progressive disease, in some cases, delivery is necessary to stop the progression to the benefit of the mother and foetus. However, the need for early delivery has adverse effects on significant neonatal outcomes that are not limited to the most premature babies. The results include oxidative stress in the disease and invoke the biochemical basis for antioxidant clinical trials to prevent and treat hypertension caused by pregnancy. In the management of preeclampsia, supplementation of antioxidants along with polyunsaturated fatty acids, particularly omega-3 fatty acids, may be useful. This describes vitamin Ds potential role in the pathogenesis of preeclampsia. However, the role of vitamin D supplementation and dosing is controversial in preventing preeclampsia. Method: The study was carried out from March 2019 to April 2020 at Shalinitai Meghe Hospital and Research Centre using institutional-based cross-sectional study design among women whose age was greater than or equal to eighteen. Data were collected using a standardised and pretested questionnaire from 150 participants by face-to - face interview technique. Using Chemiluminiscent Immunoassay (CLIA), vitamin D estimation was performed. The behaviour of Glutathione Reductase was calculated according to the Goldberg et al 1983 procedure. To classify the factors associated with the development of preeclampsia, logistic regression analysis was used. Result: With a mean age of 30.28, a total of 150 participants were enrolled in the study. Evaluation of vitamin D and glutathione levels The prevalence of preeclampsia among current pregnant women attending ANC at Shalinitai Meghe Hospital was 16 with a 95 % CI. The current preeclampsia was significantly correlated with predictive variables such as the age of the respondents, current multiple pregnancy, and history of diabetes mellitus. Conclusion: The findings of this study showed that preeclampsia was present in a large proportion of women. For both urban and rural residents, health seeking actions towards pregnant women should be promoted, offering an opportunity to detect preeclampsia as early as possible and preventing the coming complication of preeclampsia. The role of antioxidants is controversial in the prevention of preeclampsia. Vitamin D deficiency is associated with preeclampsia in a major way. To document the role of vitamin D supplementation in the prevention of preeclampsia, further studies are required. Keywords: Gestational hypertension, Pre-eclampsia, Vitamin D, GSH

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Can Iron and Folic Acid-IFA and Ca & Vitamin D Supplementation in Pregnancy be Fitted into Habitual Pattern of Three Meals A Day?

The Indian Journal of Nutrition and Dietetics ◽

10.21048/ijnd.2019.56.4.23960 ◽

2019 ◽

Vol 56 (4) ◽

pp. 341

Author(s):

Prema Ramachandran ◽

Amrita Pramanik ◽

K. Kalaivani

Keyword(s):

Vitamin D ◽

Folic Acid ◽

Side Effects ◽

Pregnant Women ◽

Ferrous Sulphate ◽

Vitamin D Supplementation ◽

Meal Pattern ◽

Iron And Folic Acid ◽

Habitual Pattern ◽

In Pregnancy

In India prevalence of anaemia and vitamin D deficiency in pregnancy are widespread. National programmes recommend that two tablets of iron and folic acid (IFA) and two tablets of calcium and vitamin D (Ca & Vit D) to be given every day from second trimester till delivery. To minimize the side effects and increase compliance, it is advised that each tablet should be taken after a meal. Most households follow a three meal pattern. A study was taken up to find out how IFA and Ca & Vit D supplementations can be fitted into the habitual three meal pattern. A short term crossover supplementation study was carried out on 38 pregnant women to assess side effects following consumption after lunch of one or two tablets containing 500mg elemental calcium (as calcium carbonate) and 250 IU vitamin D or 60 mg of elemental iron as ferrous sulphate. Prevalence of side effects was higher in women who received iron supplements as compared to Ca & Vit D supplements. Taking two tablets of Ca & Vit D together after meal was associated with significantly higher prevalence of side effects as compared to taking one tablet after meal. Taking two tablets of iron together after meal was not associated with any significant increase in prevalence of side effects as compared to one tablet. Giving two tablets of iron together after one meal and giving one tablet of calcium and vitamin after two meals is feasible option for providing two tablets each of iron and Ca & Vit D to pregnant women who habitually follow a three meal pattern.

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