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Birth asphyxia 2.4 more likely if low maternal vitamin D – Sept 2016

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case-control study.

BMJ Open. 2016 Sep 22;6(9):e009733. doi: 10.1136/bmjopen-2015-009733.
Lindqvist PG1, Silva AT2, Gustafsson SA3, Gidlöf S4.
1Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Department of Obstetrics & Gynecology, Karolinska University Hospital, Stockholm, Sweden.
2Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
4Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Department of Obstetrics & Gynecology, Karolinska University Hospital, Stockholm, Sweden Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

See also VitaminDWiki

Healthy pregnancies need lots of vitamin D has the following summary

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
RCT
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial

 Download the PDF from VitaminDWiki

OBJECTIVE:
Vitamin D deficiency causes not only skeletal problems but also muscle weakness, including heart muscle. If the fetal heart is also affected, it might be more susceptible to fetal distress and birth asphyxia. In this pilot study, we hypothesised that low maternal vitamin D levels are over-represented in pregnancies with fetal distress/birth asphyxia.
DESIGN AND SETTING:
A population-based nested case-control study.
PATIENTS:
Banked sera of 2496 women from the 12th week of pregnancy.
OUTCOME MEASURES:
Vitamin D levels were analysed using a direct competitive chemiluminescence immunoassay. Vitamin D levels in early gestation in women delivered by emergency caesarean section due to suspected fetal distress were compared to those in controls. Birth asphyxia was defined as Apgar <7 at 5 min and/or umbilical cord pH=7.15.
RESULTS:
Vitamin D levels were significantly lower in mothers delivered by emergency caesarean section due to suspected fetal distress (n=53, 43.6±18 nmol/L) compared to controls (n=120, 48.6±19 nmol/L, p=0.04). Birth asphyxia was more common in women with vitamin D deficiency (n=95) in early pregnancy (OR 2.4, 95% CI 1.1 to 5.7).
CONCLUSIONS:
Low vitamin D levels in early pregnancy may be associated with emergency caesarean section due to suspected fetal distress and birth asphyxia. If our findings are supported by further studies, preferably on severe birth asphyxia, vitamin D supplementation/sun exposure in pregnancy may lower the risk of subsequent birth asphyxia.

PMID: 27660312


See also web

  • Perinatal asphyxia Wikipedia
    "Perinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely."
    "WHO estimates that 4 million neonatal deaths occur yearly due to birth asphyxia, representing 38% of deaths of children under 5 years of age"

Attached files

ID Name Comment Uploaded Size Downloads
7107 birth asphyxia.pdf PDF 2016 admin 26 Sep, 2016 14:52 617.30 Kb 251
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