To Study the Prevalence of Vitamin D Deficiency in Third Trimester and Feto-Maternal Outcome.

Sheetal Dagar,Santosh Minhas,Srishti Aggarwal,Monika Jindal,Monika Gupta

doi:10.32553/ijmsdr.v6i2.913

Abstract

Aim: To estimate the prevalence of vitamin D deficiency in third trimester and itscorrelation with feto-maternal outcome Material and Methods: Present study was conducted 200 pregnant women who were admitted to the labor room in the third trimester in the department of Obstetrics &amp; Gynecology of Maharishi Markandeshwar Medical College and Hospital, Solan (H.P.) for delivery after fulfilling the inclusion &amp; exclusion criteria. Detailed history including complete demographic information, past medical history, dietary history, previous menstrual &amp; obstetric history, any antenatal complications. Delivery details including mode of delivery, birth weight and APGAR scores were recorded on the proforma. Serum vitamin D was estimated fromthe maternal blood sample. Vitamin D deﬁciency was deﬁned as 25(OH) D levels in blood less than 20 ng/ml, and insufficiency of vitamin D was deﬁned as 25(OH) D levels between 20-30 ng/ml.Results: In this study, there was a high prevalence of vitamin D deficiency (93.5%) in the pregnant women though there was no significant difference in socio-demographic factors in the deficient and non-deficient group. Present study showed that the proportion of vitamin D deficient pregnant women having maternal complications and NICU admission was statistically significant as compared to the non-deficient group (p=0.0109) and (p=0.0384) respectively. Conclusion: Maternal complications, increased cesarean section rate and NICU admission weremore associated with hypovitaminosis D but any causal relationship between vitaminD deficiency and pregnancy complications was not found in this study design. Wepropose that vitamin D supplementation is simple and economical, and hence weshould incorporate vitamin D testing, increase its awareness and treat its deficiency inadolescence, pre-conceptional period or 1st trimester to avoid maternal complicationsand poor fetal outcome. Keywords: Vitamin D Deficiency, Third trimester, Fetal outcome, Maternal outcomex

Highlights

Pregnancy increases the demand for vitamins and microelements, including vitamin D
Maternal complications, increased cesarean section rate and NICU admission were more associated with hypovitaminosis D but any causal relationship between vitamin D deficiency and pregnancy complications was not found in this study design
We propose that vitamin D supplementation is simple and economical, and we should incorporate vitamin D testing, increase its awareness and treat its deficiency in adolescence, pre-conceptional period or 1st trimester to avoid maternal complications and poor fetal outcome

Summary

Introduction

Pregnancy increases the demand for vitamins and microelements, including vitamin D. Adaptation of calcium metabolism to pregnancy involve doubling of calcitriol synthesis that necessitates an adequate supply of vitamin D. Despite being a tropical country and adequate sunshine throughout the year, studies have shown widespread prevalence of hypovitaminosis D in India and reason for this can be less outdoor activity, vegetarian diet, wearing of more covered clothing, and no policy of fortification of food items with vitamin D. There paradox may be partly explained by the many prevalent social and cultural practices in India that preclude adequate exposure of adolescent girls and young women to sunshine. Increasing urbanization & exposure to computer and games has resulted in poor outdoor activity and greater pollution, coupled with skin pigment, may further compound this problem.[2]

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