Pregnancy Outcomes among Obese Pregnant Women with Varying Levels of Vitamin D in King Abdulaziz University Hospital: A Single-center Retrospective Study.

Anas M Fallatah,Hassan S Abduljabbar,Yousef Aledreesi,Hussam M Babatin,Areej J Bahrawi,Khalid M Nassibi

doi:10.7759/cureus.6220

Abstract

BackgroundVitamin D deficiency among pregnant women is a global issue. Despite its high prevalence, the optimal level of vitamin D among pregnant women is not well established. On the other hand, multiple adverse pregnancy outcomes have been strongly associated with vitamin D deficiency.ObjectivesTo identify the potential effect varying levels of vitamin D have on maternal and neonatal outcomes.MethodsThis is a non-intervention retrospective record review conducted on pregnant women who delivered in King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 1, 2013, and December 31, 2018. Data were collected from their hospital electronic files and analyzed by Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY) version 24. A p-value of <0.05 is used to calculate statistical significance.ResultsA total of 9095 pregnant women had delivered in the last five years, 137 of these pregnant women had vitamin D measurement during their pregnancy. Out of 137, 99 were deficient, 20 optimal, 11 therapeutic, and two excess. A total of 97 (70.8%) were Saudis and 40 (29.2%) were non-Saudis. The majority of pregnant women in obese class 1 and 2 were deficient with 99 cases, while obese class 3 was mostly those with optimal levels. Regarding pregnancy outcomes, those with vitamin D deficiency had the majority of undesired antepartum, neonatal, and postpartum outcomes. Placenta previa, endometritis, poor APGAR scores, birth defects, intrauterine fetal demise, low birthweight, and macrosomia were significantly associated with abnormal vitamin D levels (P < 0.05).ConclusionAlthough vitamin D optimum level during pregnancy is not known, pregnant women with deficient levels appeared to have more serious risks to develop adverse pregnancy outcomes. Therefore, early screening during prenatal visit or antenatal for vitamin D level with vitamin D supplementations is important to reduce these negative pregnancy outcomes for pregnant women with deficient levels.

Highlights

Vitamin D is the most micronutrient that has gained and sustained massive interest in the fields of health and biomedical research community [1]
Those with vitamin D deficiency had the majority of undesired antepartum, neonatal, and postpartum outcomes
Endometritis, poor APGAR scores, birth defects, intrauterine fetal demise, low birthweight, and macrosomia were significantly associated with abnormal vitamin D levels (P < 0.05)

Summary

Introduction

Vitamin D is the most micronutrient that has gained and sustained massive interest in the fields of health and biomedical research community [1]. Vitamin D deficiency is defined as 25(OH) D level to be lower than 50 nmol/l (20 ng/ml). It is an epidemic and it became to be a global issue [3]. In Saudi Arabia, according to meta-analysis study made in 2016, it showed that almost 81% of Saudis are considered to be deficient [1]. This pattern is seen in other Arabian Gulf countries [5,6,7,8]. Multiple adverse pregnancy outcomes have been strongly associated with vitamin D deficiency

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