Abstract
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
Highlights
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
Vitamin D deficiency during pregnancy may result in immediate newborn illness such as hypocalcaemic seizures and poor Vitamin D stores[6,12].Further, this leads to Vitamin D deficiency in breastfed infants[10]
We found a higher percentage of cord blood Vitamin D level deficiencies in neonates born to urban mothers compared to the neonates of rural mothers, i.e. 91% of urban vs 84% of rural cord blood samples (p=0.35) Table 3
Summary
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. Cultural practices of remaining indoor, higher skin pigmentation and poverty leading to poor intake may all be contributory As such the daily dietary intake of calcium of both the urban and rural population is low compared to that of recommended daily/dietary allowances (RDA) issued by Indian Council of Medical Research[8,9].Current supplementation recommendations are inadequate to ensure vitamin D sufficiency in pregnant and lactating women[10]. This study was undertaken to compare to the Vitamin D levels between urban and rural mothers and their respective newborns
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