Vitamin D Supplementation for Pregnant Women in Bulgaria

Anna-Maria Borissovа ,Lilia Dakovska,Mircho Vukov,Eugenia Mihailova,Boyana Trifonova

doi:10.11648/j.ejpm.20200804.14

Abstract

The aim: of our study was to evaluate the levels of 25-hydroxy vitamin D [25 (OH) D] in pregnant Bulgarian women with and without vitamin D supplementation. Material and methods: We investigated 547 pregnant Bulgarian women, mean age 30±5 years, median 30 (18-47). All pregnant women filled in a specially designed standard questionnaire. The cohort consisted of 547 unselected pregnant women, 278/547 (50.82%) taking vitamins at the time of the investigation, as a monotherapy or in combination with other medications. We introduced four category level of vitamin D: Severe deficiency: < 10 ng / ml; Moderate deficiency: 10 - 20 ng / ml; Insufficiency: 20 - 30 ng / ml; Sufficiency: > 30 ng / ml. The peripheral levels of 25(OH)D were investigated using a standard Electro Chemyluminescence Immuno Assay (Competition principle) in a central laboratory on the day of the sampling. Results: For the whole group (547 pregnant women), the mean 25(OH)D level was 25.86±9.46 ng / ml; median 24.51 (7.96 - 70.00), corresponding to mild insufficiency. Sufficient vitamin D (≥ 30 ng / ml) had a significantly higher percentage of pregnant women supplemented with vitamin D compared to the non-supplementеd group - 87 (31.29%) versus 61 (22.68%), P < 0.05. At the same time, vitamin D deficiency (< 20 ng/ml) was significantly higher in pregnant women without supplementation with vitamin D - 86 (31.98%) versus those with supplementation - 61 (21.94%), P < 0.01. In conclusion: the levels of vitamin D among pregnant Bulgarian women are within the span of mild insufficiency, probably due to the intake of combined vitamin supplements by approximately half of the studied women during the pregnancy.

Highlights

Vitamin D deficiency (VDD) is a global health care issue, with billions carrying deficiency or insufficiency around the world. This hormone plays an important role throughout pregnancy, so that maintenance of an adequate vitamin D status is essential in this setting
The low vitamin D status in pregnancy may contribute to the risk of adverse perinatal outcomes including hypertensive disorders, fetal growth restriction and preterm birth [3]
Vitamin D is important for musculoskeletal health, but there are data that vitamin D may be important for fertility, pregnancy outcomes and lactation

Summary

Introduction

Vitamin D deficiency (VDD) is a global health care issue, with billions carrying deficiency or insufficiency around the world. Reasons for vitamin D deficiency, which have been widely reported among pregnant women, are connected with low sun exposure, high BMI, low vitamin D intakes and some socioeconomic disadvantages such as poor quality diets. These women are at greatest risk of vitamin D deficiency, leading to very low serum concentrations of 25-hydroxyvitamin D [25(OH)D] in their offspring and an increased risk of nutritional rickets. 25(OH)D3 and VDR are present in a variety of female reproductive organs such as pituitary glands, hypothalamus, uterus, ovaries, mammary glands, and the placenta [4] In this line, a-hydroxylase expressed in the decidua and placenta highlights the role of vitamin D synthesis in the

Objectives

Methods

Results

Conclusion