Prevalence and risk factors of hypovitaminosis D in pregnant Spanish women

Andrés Díaz-López,Nuria Serrat,Marcela Villalobos,Josep Basora,Victoria Arija,Cristina Jardí

doi:10.1038/s41598-020-71980-1

Abstract

The hypovitaminosis D epidemic is a global health problem. Our aim was to assess the prevalence and potential risk factors of hypovitaminosis D among pregnant women on the eastern Mediterranean coast. Cross-sectional analysis involved 793 healthy pregnant women (35.3 ± 5.0 years) participating in ECLIPSES, a multicenter randomized trial. Socio-demographic, obstetric, anthropometric, lifestyle, dietary variables and blood draw was collected in the first trimester. Vitamin D deficiency was identified in 50.2% and insufficiency in 30.3% of pregnant women. The mean vitamin D level in the overall sample was 33.9 nmol/L (SD, 17.0). Multivariable logistic regression analysis applying AIC-based backward selection identified excess weight during the 1st trimester (BMI ≥ 25 kg/m2) (OR = 1.950, 95% CI = 1.409, 2.699), Arab ethnic group/dark skin colour (OR = 4.005, 95% CI = 2.488, 6.447), winter/spring (OR = 4.319, 95% CI = 3.112, 5.994), and consumption of milk (OR = 0.754, 95% CI = 0.572, 0.993) and yogurt (OR = 0.635, 95% CI = 0.436, 0.922) as independent risk factors for vitamin D deficiency. All of these factors (except yogurt consumption) and physical activity were independently associated with vitamin D deficiency/insufficiency risk in the final multivariable model (all p < 0.05). All these factors and social class were the most important determinants of circulating 25(OH)D concentrations. Our results confirm a high prevalence of vitamin D deficiency and insufficiency among pregnant women from the eastern Mediterranean coast.

Highlights

It is well established that vitamin D deficiency is a worldwide public health problem of epidemic proportions in all age groups[1]
Despite Spain being one of Europe’s sunniest countries, the few studies available show a relatively high prevalence of vitamin D deficiency among pregnant women[12,13,15]. This may be attributed, at least in part, by less time spent outdoors, low skin exposure due to clothing choices, the use of sunscreens, or avoiding exposure to UVB-radiation[14]. Other factors such as blood sampling in winter[12,20], excess weight[14], non-European ethnicity, physical inactivity, low socio-economic and education levels, or low dietary intake of foods containing vitamin D could contribute to vitamin D deficiency in pregnant w omen[14,21]
This means increasing our knowledge on the vitamin D status of pregnant women in the Spain population and may contribute significantly to the public health and clinical area, because those pregnant women who are at high risk of vitamin D deficiency could be screened or intervened in advance to prevent the deficiency during pregnancy

Summary

Introduction

It is well established that vitamin D deficiency is a worldwide public health problem of epidemic proportions in all age groups[1]. The objective of this study was to assess the prevalence of vitamin D deficiency and deficiency/insufficiency in the first trimester of gestation and to identify potential risk factors of hypovitaminosis D in pregnant Spanish women on the eastern coast of the Mediterranean This means increasing our knowledge on the vitamin D status of pregnant women in the Spain population and may contribute significantly to the public health and clinical area, because those pregnant women who are at high risk of vitamin D deficiency could be screened or intervened in advance to prevent the deficiency during pregnancy

Objectives

Methods

Results

Discussion

Conclusion