Rural versus Urban Umbilical Cord Blood Vitamin D Levels at Parturition in Appalachia

Abstract

The aim of this study was to compare fetal cord blood levels of vitamin D in rural versus urban areas in the Appalachian region. There is a positive correlation between maternal and cord blood vitamin D levels, and prior studies have shown that maternal vitamin D insufficiency is associated with multiple adverse maternal and fetal outcomes during pregnancy including: increased risk of gestational diabetes, pre-eclampsia, anemia, and small for gestational age infants. A comparative cross-sectional study was conducted on 134 patients, 67 rural and 67 urban. Cord blood was collected at the time of delivery and analyzed for serum concentrations of vitamin D. Vitamin D levels (mean + SD) were 22.81 + 8.06 ng/mL in rural samples versus 24.73 + 10.17 ng/mL in urban. An independent sample t-test showed no significant difference (p = 0.23) between urban and rural samples. Irrespective of geographic location at the time of delivery 75% of neonates (n=100) were vitamin D insufficient (<30 ng/ml) and 34% of neonates (n=46) were vitamin D deficient (<20 ng/mL). Our findings indicate that in the Appalachian region vitamin D insufficiency and deficiency were prevalent regardless of rural or urban status.